Healthcare Claims Examiner I/II — Growth & Impact

Key Staffing, Inc; Bakersfield (CA); On-site; USD 30,000 - 32,000; Full time

Job summary

Key Staffing, Inc. is actively recruiting a Claims Examiner I/II in Bakersfield, CA. The role reviews, audits, and processes medical and facility claims submitted by providers, subscribers, and members, ensuring accuracy and timeliness.

The position may be filled at I or II level based on experience. The ideal candidate will have medical claims processing experience, knowledge of billing, coding, and healthcare operations, with strong analytical skills and attention to detail.

Qualifications

• High School Diploma or equivalent required.
• Up to 1–2 years in medical claims processing or related healthcare experience preferred.
• Experience investigating Coordination of Benefits (COB).
• Ability to calculate benefits and reimbursements accurately.
• Strong attention to detail and problem-solving skills.
• Ability to work independently in a fast-paced environment.

Responsibilities

• Review and process medical and facility claims accurately and efficiently.
• Apply contract benefits, policies, and procedures to determine payment.
• Deny inappropriate claims per guidelines.
• Identify billing errors and potential fraudulent submissions.
• Collaborate with departments to resolve complex claims issues.
• Maintain productivity and quality standards; support COB investigations.

Skills

Medical terminology

COB investigations

HCPCS CPT ICD-10 coding

UB-04 CMS-1500 forms

Communication skills

Time management

Attention to detail

Education

High School Diploma or equivalent

Job description

Key Staffing, Inc. is actively recruiting a Claims Examiner I/II in Bakersfield, CA. The role reviews, audits, and processes medical and facility claims submitted by providers, subscribers, and members, ensuring accuracy and timeliness.

The position may be filled at I or II level based on experience. The ideal candidate will have medical claims processing experience, knowledge of billing, coding, and healthcare operations, with strong analytical skills and attention to detail.