Claims Examiner

Healthcare Support Staffing; Monterey Park (CA); On-site; USD 50,000 - 70,000; Full time

Job summary

A prestigious healthcare company is seeking an experienced Claims Examiner to join their team. In this role, you will conduct claims analyses, adjudicate medical claims, and verify patient eligibility. The ideal candidate has 2-5 years of claims examining experience, a minimum typing speed of 45 WPM, and knowledge of medical coding. This position offers an exciting opportunity for career advancement within a rapidly growing company. Interested applicants should contact Tyler at 407-478-0332 EXT 117.

Qualifications

• 2-5 years medical claims examining experience.
• Minimum typing speed of 45 WPM and use of Ten-Key by touch.
• Knowledge of ICD9-CM, HCPCS level II and III, CPT, and revenue Codes.

Responsibilities

• Conducts claims payment analyses to identify claims issues.
• Adjudicates medical claims and verifies patient account details.
• Requests additional information for incomplete claims.

Skills

Claims adjudication

Facility claims experience

Medical coding knowledge

Job description

Job Description

Intro:

Are you an experienced Claims Examiner looking for a new opportunity with a prestigious healthcare company? Do you have claims adjudication or facility claims experience in healthcare? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions – this is the position for you!

Responsibilities

• Conducts claims payment analyses to identify root cause of claims issues/deficiencies.
• Adjudicates medical claims
• Verifies patient account, eligibility, benefits and authorizations.
• Prioritizes assigned claims according to regulatory timelines.
• Requests additional information for incomplete or unclean claims; follows up with provider as necessary.
• Runs claims report to adjudicate adjustments due to retroactive effective date of contract or fee schedule changes.
• Corresponds with IPAs/Medical Groups regarding misdirected claims.

Qualifications

Requirements:

• 2-5 years medical claims examining experience,
• Minimum typing speed of 45 WPM and use of Ten-Key by touch
• Knowledge of ICD9-CM, HCPCS level II and III, CPT, and revenue Codes, DRG and APC coding a plus
• Knowledge of different payment methodologies such as Medi-Cal, RBRVS, DRG and other Medicare reimbursements

Additional Information

If you are interested, PLEASE CONTACT Tyler AT 407-478-0332 EXT 117