Claims Adjuster

LHH; Pleasanton (CA); On-site; USD 34,000 - 55,000; Full time

Job summary

LHH in Pleasanton, CA is seeking two bilingual Claims Adjusters to handle high-volume medical claims and member inquiries. The role requires solid knowledge of medical terminology, claims processing, and coding, with the ability to assess information and provide clear guidance.

You will work in a fast-paced environment with up to 40 calls per day, verify coding accuracy, review benefits information, and assist members with next steps. Proficiency in Microsoft Teams and Excel is preferred.

Qualifications

• Experience with medical terminology, medical coding, and/or claims processing.
• Ability to assess and make judgment calls on claim accuracy.
• Strong attention to detail and problem-solving skills.
• Comfortable handling high call volumes in a fast-paced environment.
• Confident communicator who is not hesitant to ask questions.

Responsibilities

• Handle high-volume inbound calls (up to 40 calls/day) regarding medical claims
• Review and interpret medical claims, coding, and benefits information
• Verify accuracy of coding and supporting documentation
• Assist members in understanding claims and next steps
• Route or escalate claims to appropriate parties when needed
• Input and maintain accurate data in internal systems
• Collaborate with team members and proactively ask questions when needed

Skills

Medical terminology

Claims processing

Bilingual

Attention to detail

Communication

Tools

Microsoft Teams

Microsoft Excel

Basis

Phone systems

Job description

Employment Type: Contract (6 months+, potential for extension or conversion)

Position Overview

A growing and supportive team is seeking two bilingual Claims Adjusters to handle high-volume medical claims and member inquiries. This role is ideal for someone with a strong understanding of medical terminology, claims, and coding who can confidently assess information and provide accurate guidance.

Key Responsibilities

• Handle high-volume inbound calls (up to 40 calls/day) regarding medical claims


• Review and interpret medical claims, coding, and benefits information


• Verify accuracy of coding and supporting documentation


• Assist members in understanding claims and next steps


• Route or escape claims to appropriate parties when needed


• Input and maintain accurate data in internal systems


• Collaborate with team members and proactively ask questions when needed

Qualifications

• Experience with medical terminology, medical coding, and/or claims processing


• Ability to assess and make judgment calls on claim accuracy


• Strong attention to detail and problem-solving skills


• Comfortable handling high call volumes in a fast-paced environment


• Confident communicator who is not hesitant to ask questions

Systems & Tools

• Microsoft Teams


• Microsoft Excel


• Basis (data entry for member/laborer information)


• Phone systems (daily use)

Equal Opportunity Employer/Veterans/Disabled

To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.lhh.com/us/en/candidate-privacy

The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:

• The California Fair Chance Act


• Los Angeles City Fair Chance Ordinance


• Los Angeles County Fair Chance Ordinance for Employers