Claims Examiner III
Company: DOCTORS HEALTHCARE PLANS, INC.
Location: Miami
Posted on: February 18, 2026
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Job Description:
Job Description Job Description Position Purpose: The Claims
Examiner III ensures that claims are processed according to
department standards and assists the Claims manager in maintaining
the workflow and processes, in order to achieve set goals. Key
Responsibilities: Review and release professional and institutional
claims Process Member Reimbursement claims Coordinates with the
Assistant Director the weekly/monthly workflow issues and set goals
for the department Assists the Assistant Director on generating
reports to track productivity and pending items Collaborate in the
application of policies and procedures of the department
Collaborate with the Assistant Director to ensure the team is
meeting production and quality metrics Communicate effectible to
the department staff the strategy to improve performance and meet
stablished goals Maintain a positive environment that support staff
well-being and foster an atmosphere that builds teamwork Ensure
that the team utilizes the system capabilities to its maximum
potential Performs other duties as necessary Qualifications: High
School Diploma or GED 3 years as Medical Claims Examiner Experience
in contract interpretation Knowledge of CMS guidelines and
regulations Ability to work Windows and other computer applications
Ability to work well with others Note: This description indicates,
in general terms, the type and level of work performed and
responsibilities held by the team member(s). Duties described are
not to be interpreted as being all-inclusive or specific to any
individual team member. No Third Party Agencies or Submissions Will
Be Accepted. Our company is committed to creating a diverse
environment. All qualified applicants will receive consideration
for employment without regard to race, color, religion, gender,
gender identity or expression, sexual orientation, national origin,
genetics, disability, age, or veteran status. DFWP Opportunities
posted here do not create any implied or express employment
contract between you and our company / our clients and can be
changed at our discretion and / or the discretion of our clients.
Any and all information may change without notice. We reserve the
right to solely determine applicant suitability. By your submission
you agree to all terms herein. Powered by JazzHR f4pdPp1WXY
Keywords: DOCTORS HEALTHCARE PLANS, INC., Coconut Creek , Claims Examiner III, Accounting, Auditing , Miami, Florida
