Medical Claims Processor - Whittier, United States - Alpha Pro
3 weeks ago
Description
Description:
JOB TITLE:
Claims Examiner - Days
LOCATION:
9557 Greenleaf Avenue, Whittier, CA
SHIFT:
Monday - Friday - 07:
00am - 03:
30pm
DURATION:
- 13 weeks
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
Job Types:
Contract, Temporary
Pay:
$ $26.00 per hour
Expected hours:
40 per week
Schedule:
- 8 hour shift
- Day shift
- Ambulatory surgery center
- Children's hospital
- Hospital
- Military hospital
- Nursing home
- Office
- Whittier, CA 90601
Relocate before starting work (required)
Work Location:
In person
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