Claims Technician II

The Alliance; Bakersfield (CA); Hybrid; USD 10,000 - 60,000; Full time

Job summary

Join a dedicated team as a Claims Technician II at a leading healthcare organization in California. This role involves verifying and processing claims, supporting team training, and ensuring accurate data entry. Ideal candidates will have administrative experience and knowledge of medical terminology and coding. Enjoy a hybrid work environment and competitive compensation tailored to your region.

Benefits

Medical, Dental, Vision

Paid Time Off and Holidays

Retirement and Deferred Compensation Plans

Health and Wellness Programs

Onsite EV Charging Stations

Qualifications

• At least two years of administrative experience, including one year in medical claims processing.
• Knowledge of medical insurance Explanation of Benefits.

Responsibilities

• Verify, process, and adjudicate claims.
• Assist with training new hires and cross-training other Claims Technicians.
• Perform claims data entry, verifying accuracy.

Skills

Medical terminology

Procedure and diagnostic coding

Office equipment and systems

Education

High school diploma or equivalent

Tools

Windows

Word

Excel

Outlook

Job description

We have an opportunity to join the Alliance as a Claims Technician II in the Claims Department.

The Claims Technician II is the full working level in the Claims Technician series, responsible for verifying, processing, and adjudicating both Level I and II claim types. It is distinguished from Claims Technician I by these responsibilities, and from Claims Technician III by not processing Level III claims or acting as a trainer and resource for lower levels.

Applications will close Friday 5/16 at 5pm PT.

This position is open to current Claims Technician Temps II meeting their production metrics or internal employees.

WHAT YOU'LL BE RESPONSIBLE FOR

Reporting to the Claims Supervisor, you will:

1. Verify, process, and adjudicate claims, ensuring proper application of program policies.
2. Assist with training new hires and cross-training other Claims Technicians.
3. Perform claims data entry, verifying the accuracy of data entry by staff and providers.

ABOUT THE TEAM

We support Alliance members' access to care by ensuring timely and accurate payment to network providers.

WHAT YOU'LL NEED TO BE SUCCESSFUL

For the full position description and requirements, click here.

Knowledge of:

• Medical terminology, procedure and diagnostic coding (CPT, ICD, HCPCS), and resource tools.
• Medical insurance Explanation of Benefits.
• Office equipment and systems such as Windows, Word, Excel, Outlook.

Ability to:

• Utilize various computer systems and databases.
• Stay current on claims processing practices.
• Read and understand Explanation of Benefits documents.

Education and Experience:

• High school diploma or equivalent plus at least two years of administrative experience, including one year in medical claims processing or billing, or an equivalent combination.

OTHER INFORMATION

• Work is in a hybrid environment; interviews will be remote via Microsoft Teams.
• Attendance at quarterly events or meetings may be required.
• Some positions may require in-office presence based on business needs.

Compensation ranges vary by location:

• Zone 1 (Bay Area, Sacramento, LA, San Diego): $21.30 — $34.09 USD
• Zone 2 (Fresno, Bakersfield, Central Valley, Eastern California, Eureka): $19.38 — $31.02 USD

OUR BENEFITS

• Medical, Dental, Vision
• Paid Time Off and Holidays
• Retirement and Deferred Compensation Plans
• Health and Wellness Programs
• Onsite EV Charging Stations

ABOUT US

We are a dedicated team of over 500 employees committed to accessible, quality healthcare guided by local innovation. Our work makes a community impact.

Join us at Central California Alliance for Health, a regional non-profit serving multiple counties. Learn more through our Fact Sheet.

We are an equal opportunity employer and participate in E-Verify. Currently, we do not sponsor visas; applicants must be authorized to work in the U.S. full-time without sponsorship.

Contact Information

Deaf and Hard of Hearing Assistance: TTY 877-548-0857

The Alliance Nurse Advice Line: 844-971-8907 (TTY) or dial 711, available 24/7