# Medical Claims Examiner

> Trident · United States (Remote) · Full-time · Posted 2026-07-22

**Workplace:** remote

**Department:** Trident US Positions

## Description

We are seeking a highly skilled and independent **Claims Examiner** to join our team on a 100% remote, 1099 contract basis. In this role, you will be responsible for the accurate and timely processing of self-funded medical health insurance claims.

Because this is a fully remote, independent contractor position, we are looking for a self-starter who requires minimal supervision and has deep, hands-on experience navigating the **WLT software system**. Your expertise will directly ensure our claims are adjudicated accurately according to specific plan documents and TPA guidelines.

### Key Responsibilities

-   Review, analyze, and process complex self-funded medical claims from start to finish.
-   Utilize the **WLT system** daily to adjudicate claims, ensuring all coding, billing, and pricing rules are applied correctly.
-   Verify patient eligibility, benefit limits, and plan coverage exclusions based on specific self-funded plan documents.
-   Identify and investigate claims requiring additional information, such as coordination of benefits (COB), subrogation, or medical necessity reviews.
-   Maintain strict compliance with all federal and state regulations, including HIPAA and ERISA guidelines.
-   Meet or exceed established quality accuracy and production turnaround standards.

## Requirements

**Required:**

-   **WLT System Experience:** Proven, hands-on experience adjudicating claims within the WLT software platform. (Candidates without WLT experience will not be considered).
-   **Self-Funded Expertise:** Demonstrated background processing self-funded medical health insurance claims.
-   **Contractor Readiness:** Ability to work independently as a 1099 contractor, managing your own remote office setup and schedule to meet production targets.
-   **Technical Setup:** A secure, HIPAA-compliant home office environment with high-speed internet.

**Ideal / Preferred:**

-   **TPA Experience:** Previous experience working within a Third Party Administrator (TPA) environment is highly preferred and will make you a standout candidate.
-   Deep understanding of medical terminology, CPT, ICD-10, HCPCS codes, and standard billing forms (UB-04, CMS-1500).

### Why Partner With Us?

-   **Total Flexibility:** 100% remote work structure from anywhere in the U.S.
-   **Competitive Rate:** Straightforward compensation at $30.00 per hour.
-   **Autonomy:** As a 1099 contractor, you have the independence to do what you do best without corporate micromanagement.

## Apply

[Apply at Trident](https://apply.workable.com/trident-works/j/0016DAA169/apply)

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