Healthcare Claims Examiner — Day-Shift Adjudicator

Prime Healthcare; Victorville (CA); On-site; USD 32,000 - 38,000; Full time

Benefits offered by this job

Comprehensive benefits for eligible

Paid time off and holidays

Professional development opportunities

Supportive and collaborative work环境

Career growth opportunities

Job summary

Desert Valley Medical Group in Victorville, CA is seeking a Claims Examiner to review and adjudicate healthcare claims, applying policies and processing standards. This full-time weekday role offers stable work and the opportunity to contribute to accurate claim processing.

The ideal candidate has 2+ years of healthcare claims experience, strong attention to detail, and solid analytical abilities. Benefits and professional development are provided within the Prime Healthcare network.

Qualifications

• 2+ years healthcare claims experience.
• Strong attention to detail and analytical skills.
• Ability to interpret and apply policies and procedures.
• Strong organizational and problem-solving skills.

Responsibilities

• Review and adjudicate routine and non-routine healthcare claims.
• Evaluate claims for accuracy, completeness, and appropriate processing.
• Apply established claims policies, procedures, and standards.
• Research and resolve claim discrepancies.
• Meet established processing timelines and quality expectations.
• Maintain accurate claims documentation.

Skills

Attention to detail

Analytical skills

Policy interpretation

Organizational skills

Education

High School Diploma or GED

Job description

Desert Valley Medical Group in Victorville, CA is seeking a Claims Examiner to review and adjudicate healthcare claims, applying policies and processing standards. This full-time weekday role offers stable work and the opportunity to contribute to accurate claim processing.

The ideal candidate has 2+ years of healthcare claims experience, strong attention to detail, and solid analytical abilities. Benefits and professional development are provided within the Prime Healthcare network.