Claims Processor - Whittier, United States - alphapro technology, a.p.r., inc.

alphapro technology, a.p.r., inc.
alphapro technology, a.p.r., inc.
Verified Company
Whittier, United States

4 weeks ago

Mark Lane

Posted by:

Mark Lane

beBee recruiter
Description
:


JOB TITLE:

Claims Examiner - Days


LOCATION:

9557 Greenleaf Avenue, Whittier,

CA


SHIFT:

Monday - Friday - 07:
00am - 03:
30pm


2 YEARS EXPERIENCE REQUIRED - MUST BE ABLE TO VERIFY HS DIPLOMA or GED or HIGHER EDUCATION
:

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 noncontracted providers for Letter of Agreement consideration
  • Data entry experience
  • Training on basic office automation and managed care computer systems
  • COVID19 Vaccine (Facility Guideline)
:

Required + Booster


Job Type:

Contract

Pay:

$ $27.28 per hour

Schedule:


  • Monday to Friday
Application Question(s):


  • Any work experience in ambulatory?

Experience:

- claims


ADJUDICATION:

3 years (preferred)
- acute care hospital:
3 years (preferred)

Work Location:

On the road
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