Sr Adjuster, Claims - Long Beach, United States - Molina Healthcare

Molina Healthcare Long Beach, United States

1 week ago

Description

**Job Description**

**Job Summary**

Responsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage amount and benefit interpretation. Monitors and controls backlog and workflow of claims. Ensures that claims are settled in a timely fashion and in accordance with cost control standards.

**Knowledge/Skills/Abilities**

Leads overall performance accountability (attendance, communication, flexibility, adaptability, interpersonal skills, teamwork and cooperation).

Researches tracers, adjustments, and re-submissions of more complex claims.

Adjudicates or re-adjudicates high volume of claims in a timely manner to ensure compliance to departmental turn-around time and quality standards.

Manages defect reduction by identifying and communicating error issues and potential solutions to management.

Handles special projects as assigned and required by changes in claims payment policies or contracting methodologies.

Meets department quality and production standards..

**Job Qualifications**

**Required Education**

Associate's Degree or equivalent combination of education and experience

**Required Experience**

3-5 years

**Preferred Education**

Bachelor's Degree or equivalent combination of education and experience

**Preferred Experience**

5-7 years

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

**Job Type:** Full Time **Posting Date:** 01/31/2022 **ABOUT OUR LOCATION**

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