Medical Claims Examiner II – Precision Adjudication

Universal Healthcare MSO, LLC; Bakersfield (CA); On-site; USD 29,000 - 37,000; Full time

Benefits offered by this job

Medical

Dental

Vision

Paid Time Off (PTO)

Floating Holiday

Simple IRA Plan with a 3% Employer Con

Employer Paid Life Insurance

Employee Assistance Program

Job summary

Universal Healthcare MSO, LLC in Bakersfield, CA seeks a Claims Examiner II to adjudicate medical claims using CMS 1500 and CMS 1450/UB04. You will verify data, ensure completeness, and process batches with accuracy in our claims system.

This full-time, non-exempt, hourly role supports eligibility, contracting terms, and coordination with health plans. Benefits include Medical, Dental, Vision, PTO, Floating Holiday, Simple IRA with 3% employer match, and more.

Qualifications

• High school diploma or equivalent.
• Strong knowledge of professional and institutional claim processing procedures.
• Familiar with CPT, HCPCS, ICD-10, ASA, Revenue Codes, etc.
• Performs high volume data entry.
• Proficiency in MS Excel, Word, and Outlook.
• Ability to type 40-50 WPM (WPM) or 6,000-8,000 Keystrokes per Hour.
• One or more years working in a healthcare or related environment; medical billing/managed care preferred.

Responsibilities

• Follow written criteria, policies, and procedures to thoroughly review and process claims.
• Evaluate claims for appropriateness of payment based on eligibility, benefits, authorizations, coding, compliance, and contracts.
• Stay informed about changes in contracts and apply correct terms to claims.
• Ensure accurate denial processing and generate correspondence when needed.
• Meet timeliness standards for processing claims and maintain production/quality.
• Handle confidential information with discretion.
• Refer non-conforming claims to UM and work with Eligibility, Member Services, providers, and health plans as needed.
• Maintain autonomy in task execution and adhere to policies.

Skills

Data entry

Claims processing knowledge

CPT/HCPCS/ICD-10 familiarity

Typing 40-50 WPM

MS Excel

MS Word

Outlook

Education

High School diploma or equivalent

Tools

MS Excel

MS Word

Outlook

Job description

Universal Healthcare MSO, LLC in Bakersfield, CA seeks a Claims Examiner II to adjudicate medical claims using CMS 1500 and CMS 1450/UB04. You will verify data, ensure completeness, and process batches with accuracy in our claims system.

This full-time, non-exempt, hourly role supports eligibility, contracting terms, and coordination with health plans. Benefits include Medical, Dental, Vision, PTO, Floating Holiday, Simple IRA with 3% employer match, and more.