What are the responsibilities and job description for the Medical Claims Examiner position at business integra?
Must have listed claims reimbursement experience
Must have DOFR
Must have processed lab claims
* Will Need References to Submit.
* Will Need References to Submit.
* Will Need References to Submit.
**ONSITE INTERVIEW REQUIRED**
JOB TITLE: Claims Examiner – Days
LOCATION: 9557 Greenleaf Avenue, Whittier, CA
SHIFT: Monday - Friday - 07:00am - 03:30pm
PLEASE NOTE ORIENTATION TIME MAY DIFFER THAN SHIFT TIMES LISTED
DURATION - 13 weeks
*** 2 YEARS EXPERIENCE REQUIRED - MUST BE ABLE TO VERIFY HS DIPLOMA or GED or HIGHER EDUCATION***
POSITION SUMMARY:
The claims examiner reports directly to the claims manager. They are primarily responsible for the processing functions (operation, adjudication, and payment) of UB-92 and HCFA-1500 claims that are received from PHP affiliated medical groups and hospitals for HMO patients.
EDUCATION/EXPERIENCE/TRAINING:
- High school graduate or equivalent required. Must have physical proof on hand if background check is unable to verify your education background.
- Minimum of 2 years claims ADJUDICATION related experience in ambulatory, acute care hospital, HMO, or IPA environment
- Knowledge of payment methodologies for: Professional (MD), Hospital, Skilled Nursing Facilities, and Ancillary Services
* Knowledge and understanding of timeliness and payment accuracy guidelines for commercial, senior and Medi-Cal claims
* Knowledge of compliance issues as they relate to claims processing
- Experience in interpreting provider contract reimbursement terms desirable
- Ability to identify non-contracted providers for Letter of Agreement consideration
- Data entry experience
- Training on basic office automation and managed care computer systems
Job Types: Full-time, Contract, Temporary
Pay: $20.54 - $27.00 per hour
Expected hours: 40 per week
Benefits:
- Tuition reimbursement
Schedule:
- 8 hour shift
- Day shift
- Monday to Friday
Experience:
- Claims Reimbursement: 2 years (Required)
- DOFR: 2 years (Required)
- Lab Claims: 2 years (Required)
- Claims ADJUDICATION: 2 years (Required)
- Ambulatory: 2 years (Required)
- Acute Care hospital: 2 years (Required)
- HMO: 2 years (Required)
- UB-92: 2 years (Required)
- HCFA-1500: 2 years (Required)
Work Location: In person
Salary : $21 - $27
