- Minimum 2 years' relevant experience
- UB-92, HCFA-1500 claims experience
- Commercial, Medi-Cal Claims
- Adjudication experience in Ambulatory, Acute Care, HMO, or IPA
- Payment methodologies; MD, Hospital, Nursing, Ancillary Services
- 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.
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Claims Examiner
13 minutes ago
E-Solutions Whittier, United StatesPOSITION 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 ...
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Claims Examiner
1 week ago
Innovative Management Systems Incorporated Whittier, United States:The Position. · We are looking for a detail-oriented individual that can accurately review, research, and analyze professional claims to determine and calculate the type and level of benefits based on established criteria and provider contracts. Experience in adjudication of Com ...
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Claims Examiner
2 weeks ago
TEKsystems Whittier, United States contract*Top Hospital Network is Hiring a Medical Claims Examiner * · *Title*: Claims Examiner · *Pay*: 22-25/hr · *Location*: Whittier, CA · *Duration:* 3 month Contract – Potential to be extend · * * · *Employee Value:,* · * Weekly Pay · * Benefits through TEKsystems · * Great oppor ...
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Claims Examiner
3 weeks ago
Innovative Management Systems Incorporated City of Industry, United States:The Position. · We are looking for a detail-oriented individual that can accurately review, research, and analyze professional claims to determine and calculate the type and level of benefits based on established criteria and provider contracts. Experience in adjudication of Com ...
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Claims Examiner
1 week ago
Innovative Management Systems Incorporated City of Industry, United States:The Position. · We are looking for a detail-oriented individual that can accurately review, research, and analyze professional claims to determine and calculate the type and level of benefits based on established criteria and provider contracts. Experience in adjudication of Com ...
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Claims Examiner
1 week ago
Innovative Management Systems Incorporated San Francisco, United States Permanent:The Position. · We are looking for a detail-oriented individual that can accurately review, research, and analyze professional claims to determine and calculate the type and level of benefits based on established criteria and provider contracts. Experience in adjudication of Com ...
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Claims Examiner
1 week ago
Innovative Management Systems Incorporated City of Industry, United States:The Position. · We are looking for a detail-oriented individual that can accurately review, research, and analyze professional claims to determine and calculate the type and level of benefits based on established criteria and provider contracts. Experience in adjudication of Com ...
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Claims Examiner
6 days ago
Innovative Management Systems Incorporated Whittier, United StatesJob Description · Job DescriptionDescription:The Position. · We are looking for a detail-oriented individual that can accurately review, research, and analyze professional claims to determine and calculate the type and level of benefits based on established criteria and provider ...
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Claims Examiner
3 weeks ago
Managed Staffing Santa Fe Springs, United StatesJob Description · Job DescriptionJob Title: Claims Examiner · Location: 9557 Greenleaf Avenue, Whittier, CA · Shift: Monday - Friday, 07:00 am - 03:30 pm · Experience Requirement: Minimum of 2 years of adjudication-related experience in an ambulatory, acute care hospital, HMO, or ...
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Senior Claims Examiner
1 week ago
PIH Health Whittier, United StatesThe Senior Claims Examiner administers health plan contracts by processing medical claims in an efficient, cost-effective, and timely manner meeting all required guidelines and performs adjustments as necessary. Some of the duties include handling of Third-Party Liability request ...
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Claims Examiner
3 weeks ago
North American Staffing Group Montebello, United StatesJob Description · Job DescriptionPosition Type: Direct HireLocation: Montebello, CA (Hybrid after initial training onsite is completed)Hourly Rate: $24 - 30/HR depending on years of experienceSchedules Available: 6AM - 3PM, 7AM - 4PM, 8AM - 5PM · Requirements:Minimum 2 - 3 years ...
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Claims Examiner
6 days ago
APR Consulting Whittier, United StatesClaims Examiner Location: Whittier, California · Type: Contract · Job #76499 · APR Consulting, Inc. has been engaged to identify a Claims Examiner · Location: Whittier, CA 90601 · Position: Claims Examiner · Pay Rate: $29.10/hr. · Duration: 13 weeks · Expected Schedule: M ...
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Claims Examiner
6 days ago
TEKsystems Whittier, United StatesTop Hospital Network is Hiring a Medical Claims Examiner Title : Claims Examiner Pay : 22-25/hr Location : Whittier, CA Duration: 3 month Contract – Potential to be extend · Employee Value:, Weekly Pay Benefits through TEKsystems Great opportunity to grow professionally Fantasti ...
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Claims Examiner
2 weeks ago
APR Consulting Whittier, United StatesAPR Consulting, Inc. has been engaged to identify a Claims Examiner · Location: Whittier, CA 90601 · Position: Claims Examiner · Pay Rate: $29.10/hr. · Duration: 13 weeks · Expected Schedule: Monday - Friday 7:00 AM - 3:30 PM · Job Summary: · The claims examiner reports dire ...
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Claims Examiner
1 week ago
Innovative Management Systems Incorporated Whittier, United States: · The Position. · We are looking for a detail-oriented individual that can accurately review, research, and analyze professional claims to determine and calculate the type and level of benefits based on established criteria and provider contracts. · Experience in adjudication o ...
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Claims Examiner
3 weeks ago
Innovative Management Systems Incorporated Whittier, United StatesJob Description · Job DescriptionDescription:The Position. · We are looking for a detail-oriented individual that can accurately review, research, and analyze professional claims to determine and calculate the type and level of benefits based on established criteria and provider ...
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Claims Examiner
3 weeks ago
Innovative Management Systems Incorporated City of Industry, CA, United States: · The Position. We are looking for a detail-oriented individual that can accurately review, research, and analyze professional claims to determine and calculate the type and level of benefits based on established criteria and provider contracts. Experience in adjudication of C ...
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Claims Examiner
2 weeks ago
TEKsystems Whittier, United StatesJob Description · Job DescriptionTop Hospital Network is Hiring a Medical Claims Examiner · Title: Claims Examiner · Pay: 22-25/hr · Location: Whittier, CA · Duration: 3 month Contract – Potential to be extend · Employee Value:, · Weekly Pay · Benefits through TEKsystems · Gr ...
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Claims Examiner
2 weeks ago
E-Solutions Whittier, United StatesPOSITION SUMMARY: · Please read the following job description thoroughly to ensure you are the right fit for this role before applying. · The claims examiner reports directly to the claims manager. They are primarily responsible for the processing functions (operation, adjudica ...
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Claims Examiner
2 weeks ago
Diversified Technologies Inc. (DTI) Whittier, United StatesJob Location:9557 Greenleaf Avenue · - Whittier, CA 90601 · - Description: · - JOB TITLE: Claims Examiner - Days · - No interviews for this role. Offers based upon resume experience. · - LOCATION: 9557 Greenleaf Avenue, Whittier, CASHIFT: Monday - Friday - 07:00am - 03:30pm** 2 Y ...
Medical Insurance Claims Examiner - Whittier, United States - A.P.R., Inc. (AlphaProTemps)
Description
Job Description
Job DescriptionCovid-19 Vaccinated
Flu Vaccinated
(Medical and Religious exemptions and declinations allowed)
Initial 3 month contract, may extend
Required:
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:
.
Company DescriptionAlphaProTemps is specialized in providing "best-in-class" professional staff augmentation services. These recruiting directives include temporary labor, contract sourcing, professional & technical niches, vendor-on-site, and managed service programs.
