What are the responsibilities and job description for the Claims Examiner position at Intilify INC?
JOB TITLE: Claims Examiner
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
Pay: $28.00 - $30.00 per hour
Expected hours: 40 per week
Benefits:
- Referral program
Schedule:
- 8 hour shift
- Day shift
- Monday to Friday
Education:
- High school or equivalent (Required)
Experience:
- claims ADJUDICATION: 2 years (Required)
- acute care or ambulatory, HMO or IPA environment: 2 years (Required)
Ability to Commute:
- Whittier, CA 90601 (Required)
Work Location: In person
Salary : $28 - $30
