- 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.
- 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
1 week ago
alphapro technology, a.p.r., inc. Whittier, United StatesOverview: · **Responsibilities**: · - Review and analyze insurance claims to determine their validity · - Investigate potentially fraudulent claims · - Utilize auto estimating software to assess damage and costs · - Negotiate settlements with claimants or their representatives · ...
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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 ...
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The Principle Group Whittier, United States**Description**: · **JOB TITLE**: Claims Examiner - Days · **LOCATION**: 9557 Greenleaf Avenue, Whittier, CA · **SHIFT**: Monday - Friday - 07:00am - 03:30pm · **DURATION - 13 weeks(extend)** · ** 2 YEARS EXPERIENCE REQUIRED - MUST BE ABLE TO VERIFY HS DIPLOMA or GED or HIGHER ED ...
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Claims Examiner
2 weeks ago
MemorialCare Medical Foundation Fountain Valley, United States**Claims Examiner** · - (MEM008006) · **Description** · **Title**: Claims Examiner · **Location**: Fountain Valley · **Department**: Claims · **Status**: Full-Time · **Shift**: Days (8hrs) · **Pay Range**:$21.37/hr - $30.97/hr · At MemorialCare Health System, we believe in provid ...
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Claims Examiner
4 hours 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
3 weeks 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
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
4 hours 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
3 weeks ago
Health Advocates Network, Inc. Whittier, United StatesHealth Advocates Network ishiring a Claims Examiner (2 Years Exp Req) This is a full-time contract position at a nationally recognized hospitallocated in Whittier, CA. · Pay Rate: $29.00/hour · Shift: Days (8hrs) · Start Date: ASAP · Contract Length: 13 weeks · Claims Exami ...
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Claims Examiner
3 weeks ago
TEKsystems Whittier, CA, United StatesJoin a large hospital here in the Whittier Area · Job Description: · 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 ...
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Claims Examiner
1 day 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
2 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
E-Solutions IT Services Private Limited Whittier, United States*MUST HAVE:* · *1. 2+ years of Claims ADJUDICATION experience | * · *2. 1+ years experience working as a claims examiner | * · *3. Experience in ambulatory, acute care hospital, HMO, or IPA environment | * · *4. 3+ years experience in a CoC-accredited site and are versed in Ca ...
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Claims Examiner
3 weeks 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 adjudicatio ...
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Claims Examiner
1 week 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
6 hours 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
1 week 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 days 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
3 weeks 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
1 week 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 ...
Claims Examiner - Whittier, United States - TEKsystems
Description
Job Description
Job DescriptionJoin a large hospital here in the Whittier Area
Job Description:
Main Details:
Start Date: Two weeks post offer date, once you have cleared the onboarding process
Pay: $24.00/Hr
Schedule: Monday - Friday 7:00am - 3:30pm
Location: Whittier, CA
Duration: 3 Month Contract. Possibility of extension based on business need
Qualifications:
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
