OPT Medical Claims Examiner Jobs
Medical Claims Examiner roles fall under healthcare administration, a field where many employers hire on OPT. Your 12-month standard OPT window is enough to demonstrate value, and a STEM extension may apply if your degree is in health informatics or a related qualifying field. Attention to compliance and billing accuracy transfers directly into this role.
Find OPT Medical Claims Examiner JobsOverview
Showing 5 of 19+ Medical Claims Examiner jobs
See all Medical Claims Examiner Jobs
Sign up for free to unlock all listings, filter by visa type, and get alerts for new Medical Claims Examiner roles.
Get Access To All JobsINTRODUCTION
We’re a member company of W. R. Berkley Corporation, an A. M. Best A+ rated Fortune 500 holding company. Berkley is comprised of individual operating units that serve a defined insurance market segment. Berkley Risk is focused on providing self-insured entities program administration services and insurance operations which can include taking or sharing risk using Berkley paper. This capability allows us to customize both an insurance company option and a purely administrative option for our customers.
Responsibilities
- Responsible for managing a caseload consisting of incoming and more complex workers’ compensation cases including extended disability cases, litigation, employer’s liability claims, and assigned claims.
- Responsible for all technical aspects of claim management for assigned files including compliance with all established performance guidelines.
- Investigate claims and make appropriate decisions regarding claim compensability and general claims management for assigned files.
- Document claim handling activities; create and document action plans.
- Establish appropriate case reserves.
- Actively manage medical treatment and disability while assisting the injured worker to return to work.
- Comply with all performance guidelines.
- Identify loss trends and communicate to supervisor and/or clients.
- Use automated diary system to issue indemnity payments and for claims management.
- Investigate and manage claim subrogation and negotiate settlements.
- Manage coverage B or conflict of interest cases as assigned.
- Address customer complaints and inquiries in an exemplary and professional manner.
- Participate in client claim reviews when scheduled or requested.
- May perform other functions as assigned.
BASIC QUALIFICATIONS
- Demonstrated working knowledge of workers’ compensation administration rules/laws.
- Excellent communication and presentation skills.
- Must be able to interface with clients, legal counsel, health care professionals, etc.
- Good math and analytical ability.
- Excellent customer service skills.
- Basic PC skills and a working knowledge of Windows environment.
- Experience with a client/server based claims processing system.
Education
BA/BS degree with three years’ experience. Experience must include litigation, subrogation and complex medical/legal issues; or two years post-high school education and five years’ experience in workers compensation claims management.
COMPENSATION
- Pay Range: $60/hr
The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.
Important Outside Agency Notice: Only solicited resumes/candidate profiles that are submitted by a Berkley Preferred Agency Partner that have been requested by Berkley Internal Recruiting to engage in a particular search will be subject to the payment of Agency fees as defined in the formal agency agreement. Any unsolicited resumes/candidate profiles are not subject to payment of the agency fees.
INTRODUCTION
We’re a member company of W. R. Berkley Corporation, an A. M. Best A+ rated Fortune 500 holding company. Berkley is comprised of individual operating units that serve a defined insurance market segment. Berkley Risk is focused on providing self-insured entities program administration services and insurance operations which can include taking or sharing risk using Berkley paper. This capability allows us to customize both an insurance company option and a purely administrative option for our customers.
Responsibilities
- Responsible for managing a caseload consisting of incoming and more complex workers’ compensation cases including extended disability cases, litigation, employer’s liability claims, and assigned claims.
- Responsible for all technical aspects of claim management for assigned files including compliance with all established performance guidelines.
- Investigate claims and make appropriate decisions regarding claim compensability and general claims management for assigned files.
- Document claim handling activities; create and document action plans.
- Establish appropriate case reserves.
- Actively manage medical treatment and disability while assisting the injured worker to return to work.
- Comply with all performance guidelines.
- Identify loss trends and communicate to supervisor and/or clients.
- Use automated diary system to issue indemnity payments and for claims management.
- Investigate and manage claim subrogation and negotiate settlements.
- Manage coverage B or conflict of interest cases as assigned.
- Address customer complaints and inquiries in an exemplary and professional manner.
- Participate in client claim reviews when scheduled or requested.
- May perform other functions as assigned.
BASIC QUALIFICATIONS
- Demonstrated working knowledge of workers’ compensation administration rules/laws.
- Excellent communication and presentation skills.
- Must be able to interface with clients, legal counsel, health care professionals, etc.
- Good math and analytical ability.
- Excellent customer service skills.
- Basic PC skills and a working knowledge of Windows environment.
- Experience with a client/server based claims processing system.
Education
BA/BS degree with three years’ experience. Experience must include litigation, subrogation and complex medical/legal issues; or two years post-high school education and five years’ experience in workers compensation claims management.
COMPENSATION
- Pay Range: $60/hr
The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.
Important Outside Agency Notice: Only solicited resumes/candidate profiles that are submitted by a Berkley Preferred Agency Partner that have been requested by Berkley Internal Recruiting to engage in a particular search will be subject to the payment of Agency fees as defined in the formal agency agreement. Any unsolicited resumes/candidate profiles are not subject to payment of the agency fees.
See all OPT Medical Claims Examiner Jobs
Sign up for free to unlock all listings, filter by visa type, and get alerts for new OPT Medical Claims Examiner Jobs.
Get Access To All JobsTips for Finding OPT Sponsorship in Medical Claims Examiner
Highlight your healthcare billing knowledge upfront
Employers screening OPT candidates want proof you can contribute immediately. Lead your resume with specific systems you know, such as ICD-10 coding, CPT codes, or claims processing software. Concrete technical skills reduce perceived hiring risk for OPT applicants.
Target mid-size insurers and third-party administrators
Large national insurers often have rigid hiring pipelines, but mid-size TPAs and regional health plans hire more flexibly. These employers process high claim volumes and need trained examiners quickly, making them more receptive to sponsoring or extending OPT candidates.
Confirm your OPT end date before applying
Medical claims roles often have onboarding timelines of four to six weeks. If your OPT expires within 90 days of an offer, flag this early. Employers need time to evaluate H-1B visa sponsorship options before your authorization lapses mid-employment.
Frame STEM OPT eligibility if your degree qualifies
Degrees in health informatics, healthcare analytics, or biomedical informatics may qualify for the 24-month STEM extension. Employers who hesitate over a 12-month window often reconsider when they learn you can remain authorized for three years total.
Emphasize accuracy and compliance in interviews
Claims examiners handle adjudication decisions with real financial and legal consequences. Interviewers want to see that you understand HIPAA, fraud detection protocols, and denial logic. Connecting your academic background to regulatory compliance builds credibility quickly.
Get your EAD card details ready before offers move fast
Some healthcare employers finalize OPT hires within days of an interview. Have your EAD card, I-20 with OPT authorization, and DSO contact information organized before you start applying. Delays in producing documents can stall or lose an offer.
Medical Claims Examiner OPT: Frequently Asked Questions
Does a Medical Claims Examiner role qualify for OPT work authorization?
Yes, Medical Claims Examiner positions qualify for OPT as long as the work is directly related to your field of study. Degrees in health information management, healthcare administration, business, or a related field typically satisfy this requirement. You should confirm the connection with your DSO before accepting an offer to ensure your employment is properly reported in SEVIS.
Can I work as a Medical Claims Examiner remotely on OPT?
Remote work is permitted on OPT, but your DSO must report your employer's address in SEVIS, not your home address. If your employer is fully remote and has no fixed location, your DSO will typically use your home address as the work site. Keep your DSO updated if your work arrangement or employer address changes at any point during your OPT period.
Does a Medical Claims Examiner job qualify for the STEM OPT extension?
The job title itself does not determine STEM OPT eligibility. What matters is whether your degree is on the DHS STEM Designated Degree Program list. Degrees in health informatics, biomedical informatics, or healthcare analytics may qualify. If your degree qualifies, your employer must also be enrolled in E-Verify and sign a formal training plan with you before USCIS approves the extension.
How do I find Medical Claims Examiner jobs that are open to OPT students?
Many employers do not advertise OPT-friendliness in job postings, so filtering by sponsorship openness saves significant time. Migrate Mate is built specifically for this, letting you browse Medical Claims Examiner roles from employers who have hired international candidates before. Searching there narrows your list to opportunities where OPT work authorization is far less likely to be an immediate disqualifier.
What happens to my OPT status if my employer terminates my Medical Claims Examiner role?
If your employment ends before your OPT expires, you have a 60-day grace period to find a new qualifying job, transfer to a different visa status, or depart the United States. You must report the separation to your DSO promptly. Accumulating more than 90 days of unemployment during your OPT period violates the terms of your work authorization, so acting quickly matters.