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    Claims Examiner II - Pasadena, United States - Imperial Health Plan of California, Inc.

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    Description

    ESSENTIAL JOB FUNCTIONS:

    • Adjudicates complex professional and institutional claims.
    • Responsible for meeting performance measurement standards for productivity and accuracy.
    • Adjudication of claims adjustment.
    • Follow all appropriate Federal and State regulatory requirements and guidelines applicable to HealthPlan operations or as documented in company policies and procedures.
    • Maintain required levels of production and quality standards as established by management.
    • Adheres to payroll policies and properly uses timekeeping system with minimal manual changes.
    • Maintains regular and consistent attendance.
    • Adheres to Compliance Plan and HIPAA regulations.

    MARGINAL JOB FUNCTIONS:

    • Takes on special projects as needed.
    • Performs other duties as assigned.


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