Claims Examiner II

Overview

We are seeking a skilled Claims Examiner to join our team. The ideal candidate will be responsible for reviewing insurance claims to ensure accuracy and compliance with policies.

EXPERIENCE:

• 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 Type: Contract

Pay: $26.20 - $27.20 per hour

Schedule:

• 8 hour shift
• Monday to Friday

Experience:

• Claims adjudication: 2 years (Required)

Ability to Commute:

• Whittier, CA 90601 (Required)

Work Location: In person

Salary : $26 - $27