What are the responsibilities and job description for the Claims Adjuster position at Dignity Health Management Services?
Overview
The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health’s Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups hospitals health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first.Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options including medical dental and vision plans for the employee and their dependents Health Spending Account (HSA) Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.
Responsibilities
The Claims Adjuster is responsible for reviewing, analyzing, and processing healthcare claims to ensure timely and accurate payment. This role involves assessing claims for compliance with established policies, procedures, and regulatory requirements, and identifying potential discrepancies or issues. The Claims Adjuster will work closely with providers, patients, and internal departments to resolve claim issues and maintain a high level of service.
Qualifications
Minimum Qualifications:
Pay Range
$29.16 - $42.28 /hour
The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health’s Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups hospitals health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first.Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options including medical dental and vision plans for the employee and their dependents Health Spending Account (HSA) Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.
Responsibilities
The Claims Adjuster is responsible for reviewing, analyzing, and processing healthcare claims to ensure timely and accurate payment. This role involves assessing claims for compliance with established policies, procedures, and regulatory requirements, and identifying potential discrepancies or issues. The Claims Adjuster will work closely with providers, patients, and internal departments to resolve claim issues and maintain a high level of service.
Qualifications
Minimum Qualifications:
- High School Diploma/GED - High school diploma or equivalent
- Minimum of 2 years of experience in healthcare claims processing, billing, or a related field.
- Knowledge of medical terminology, CPT, ICD-10, and HCPCS coding.
- Familiarity with claims management software and electronic health records (EHR) systems.
Preferred Qualifications:
- Experience with Medicare and Medicaid claims. Certification in medical billing or coding (e.g., CPC, CCS).
- Associate’s or Bachelor’s degree in healthcare administration, business, or related field preferred.
Pay Range
$29.16 - $42.28 /hour
Salary : $29 - $42
