Santa Fe Springs, CA 90670
We have an immediate need for 3 claims examiners to work in our Whittier office!
The Claims Examiner administers health plan contracts by processing medical claims in an efficient, cost-effective, and timely matter meeting all required guidelines and performs adjustments as necessary.
Specific Skills Needed:
• Computer and 10-key by touch
• Knowledge of medical terminology, CPT/RBRVS/ICD-9 codes
• Full understanding of HMO & capitation concepts and Medicare guidelines
Duties and Responsibilities:
• Ensure claims are processed according to contractual guidelines
• Review claims for possible coordination of benefits and coordinate if applicable
• Responsible for the processing and payment of health plan billings within contractual guidelines
• Process capitated specialist claims accurately and timely
• Maintain working knowledge of all health plan divisions of responsibility
• Perform payment adjustments when necessary
• Other duties as assigned
Pay is up to $28.00/hr depending on experience.
If you have the skills and knowledge described above and are available to interview and start immediately, please apply now!