Automatically apply for jobs with Zippia

Upload your resume to get started.

Health claims examiner skills for your resume and career

Updated January 8, 2025

3 min read

Below we've compiled a list of the most critical health claims examiner skills. We ranked the top skills for health claims examiners based on the percentage of resumes they appeared on. For example, 12.8% of health claims examiner resumes contained medical terminology as a skill. Continue reading to find out what skills a health claims examiner needs to be successful in the workplace.

15 health claims examiner skills for your resume and career

1. Medical Terminology

Here's how health claims examiners use medical terminology:

Processed health insurance claims utilizing superior knowledge of medical terminology and CPT codes.
Learned medical terminology, CPT/ IDC 9 Coding, and developed excellent decision making skills.

2. Medicaid

Here's how health claims examiners use medicaid:

Processed Medicaid, insurance patient liable, Medicaid and State Children's Health Insurance program.
Completed training on Texas Medicaid benefit claims.

3. HMO

Here's how health claims examiners use hmo:

Processed multiple HMO and traditional accounts/reviewed claim information to ensure accurate payment.
Completed application for HMO participation.

4. Data Entry

Data entry means entering data into a company's system with the help of a keyboard. A person responsible for entering data may also be asked to verify the authenticity of the data being entered. A person doing data entry must pay great attention to tiny details.

Here's how health claims examiners use data entry:

Position involves extensive telephone contact, data entry input, case research.
Run reports, Data Entry, Medical Transcription.

5. Blood Pressure

Here's how health claims examiners use blood pressure:

Performed assigned clinical procedures such as taking of blood pressures manually, calibrating machines and performing tests.
Obtain physical measurements such as Blood pressure, height, weight, pule and waist circumference.

6. Medical Claims

Here's how health claims examiners use medical claims:

Resolved medical claims by approving or denying documentation; calculating benefit due; initiating payment or composing denial letter.
Process hospital and medical claims in accordance with policies and procedures established by Viva.

Choose from 10+ customizable health claims examiner resume templates

Build a professional health claims examiner resume in minutes. Our AI resume writing assistant will guide you through every step of the process, and you can choose from 10+ resume templates to create your health claims examiner resume.

7. Appeals

Here's how health claims examiners use appeals:

Process insurance claims and appeals.
Worked in Utilization Management completing medical documentation review for claims, appeals, retrospective reviews and provider complaints.

8. Health Plan

Here's how health claims examiners use health plan:

Generated eligibility of benefits to the medical providers and health plan members.
Provide customer relations, assisting callers in Health Plan Payments and Dental Claims

9. Physical Examinations

Here's how health claims examiners use physical examinations:

Perform phlebotomy and instant lab analysis as well as do physical examinations.

10. Diagnosis Codes

Here's how health claims examiners use diagnosis codes:

Examined diagnosis codes for accuracy, completeness, specificity, and appropriateness according to services rendered.
Examined diagnosis codes for accuracy, completeness, specificity and appropriateness according to services rendered.

11. Medical History

Here's how health claims examiners use medical history:

Collect specimens such as blood and urine, obtain vitals and medical history.
Obtain medical history, blood draws, EKG's and urinalysis.

12. Health Screenings

Here's how health claims examiners use health screenings:

Complete health screenings, measure vital signs, and perform EKG tests * Collecting and preparing specimens for laboratory analysis
Assemble and Complete Biometric Health Screenings for the State of Ohio Reception and participant check-in Health engagement counseling

13. EKG

Here's how health claims examiners use ekg:

Assisted with pre-employment exams, which included EKG's and blood work and addressed triage needs.
Have collected hair and done EKG's on patients and own all of my own equipment if it is required.

14. Vital Signs

Vital signs are a set of values indicating different body systems' performance. They are measurements of the body's most basic functions. The four major vital signs used in medicine to assess a patient are body temperature, pulse rate, respiration rate, and blood pressure.

Here's how health claims examiners use vital signs:

Performed health screening examinations including vital signs, collected blood and urine specimen for clients for insurance purposes.
Obtain medication information from applicant Perform vital signs as requested by life insurance company.

15. Process Claims

Process claims refers to the procedure an insurance agent follows once receiving a claim from an insured individual. This often includes reviewing, investigating, and deciding on whether the claim will be accepted or denied depending on the results of the insurer's investigation. This is a common procedure for all kinds of insurance including medical, auto, and liability insurance.

Here's how health claims examiners use process claims:

Process claims/verify authorization requirements/coordinate benefits/follow mandates.
Exceeded established productivity and quality goals; monitor inventory aging to select and process claims within established time frames.

5 Health Claims Examiner resume examples

Build a professional health claims examiner resume in minutes. Browse through our resume examples to identify the best way to word your resume. Then choose from 5+ resume templates to create your health claims examiner resume.

Create my resume

Build a professional resume in minutes using this template.

What skills help Health Claims Examiners find jobs?

Tell us what job you are looking for, we’ll show you what skills employers want.

List of health claims examiner skills to add to your resume

The most important skills for a health claims examiner resume and required skills for a health claims examiner to have include:

Medical Terminology
Medicaid
HMO
Data Entry
Blood Pressure
Medical Claims
Appeals
Health Plan
Physical Examinations
Diagnosis Codes
Medical History
Health Screenings
EKG

Vital Signs
Process Claims
Biometrics
CPT-4
COB
Health Insurance Claims
HIPAA
ICD-9
Computer System
Quality Standards
Wellness Events
Blood Draws
PPO

Plan Provisions
EOB
Insurance Coverage
UB
Dental Claims
Production Standards
Policy Provisions
Blood Samples
Health Exams
Consent Forms
Pending Claims
Telephone Inquiries

Updated January 8, 2025

Zippia Team

Editorial Staff

The Zippia Research Team has spent countless hours reviewing resumes, job postings, and government data to determine what goes into getting a job in each phase of life. Professional writers and data scientists comprise the Zippia Research Team.

Updated January 8, 2025

Browse business and financial jobs