Medical Claims Processor

Medasource; Bakersfield (CA); Presencial; USD 28 000 - 40 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Free onsite parking

Dress code: Business casual or scrubs

Health screening and onboarding

Onsite interview

Resumo da oferta

Medasource is seeking a detail-oriented Medical Claims Processor to support a Bakersfield-based healthcare organization. The role focuses on reviewing, processing, and adjudicating medical claims to ensure correct reimbursement and adherence to billing guidelines.

Ideal candidates have 2–3 years in medical claims processing, healthcare billing, or claims administration, with strong analytical, organizational, and Microsoft Office skills to handle complex claims and respond to inquiries

Qualificações

• 2–3 years of relevant experience in medical claims processing, healthcare billing, or claims administration.
• High school diploma or GED required.
• Proficiency in Microsoft Office Suite, including Excel, Word, and Outlook.

Responsabilidades

• Review, process, and adjudicate medical claims and billing submissions to determine payment or denial.
• Analyze claims for accuracy, completeness, and compliance with policies.
• Research claims and obtain supporting documentation for billing information.
• Identify discrepancies and make adjustments for accurate processing and reimbursement.
• Investigate and resolve billing discrepancies, payment issues, and denials.
• Respond to inquiries from providers, vendors, and members about claim status and outcomes.
• Maintain documentation of claims processing and resolutions.
• Collaborate with internal teams to improve claims processing efficiency.
• Utilize Microsoft Office applications and internal systems to manage claims data.

Conhecimentos

Analytical skills

Problem-solving

Organizational skills

Attention to detail

Formação académica

High school diploma or GED

Ferramentas

Microsoft Office Suite

Descrição da oferta de emprego

Contract Duration: Through December 31, 2026, with potential for extension

Schedule: Monday–Friday, Full-Time (Pacific Time)

Start Date: ASAP

About the Opportunity

Medasource is seeking a detail-oriented Medical Claims Processor to support a leading healthcare organization in Bakersfield, CA. This individual will be responsible for reviewing, processing, and adjudicating medical claims to ensure accurate reimbursement and compliance with established billing and benefit guidelines.

The ideal candidate will have 2–3 years of experience in medical claims processing, healthcare billing, or claims administration, with strong attention to detail, analytical skills, and proficiency in Microsoft Office.

Key Responsibilities

• Review, process, and adjudicate medical claims and billing submissions to determine appropriate payment or denial.
• Analyze medical claims for accuracy, completeness, and compliance with established policies and benefit guidelines.
• Research claims and obtain supporting documentation to validate billing information and payment decisions.
• Identify discrepancies, make necessary adjustments, and ensure accurate claims processing and reimbursement.
• Investigate and resolve billing discrepancies, payment issues, and claim denials.
• Respond to inquiries and complaints from healthcare vendors, providers, and members regarding claim status and payment outcomes.
• Maintain accurate documentation of claims processing activities and resolutions.
• Collaborate with internal teams to support billing operations and improve claims processing efficiency.
• Utilize Microsoft Office applications and internal systems to manage and track claims information.

Required Qualifications

• High school diploma or GED required.
• 2–3 years of relevant experience in healthcare billing, medical claims processing, or claims administration.
• Experience reviewing and assessing medical bills and claims for accuracy.
• Knowledge of claims administration, billing procedures, and payment processing.
• Proficiency in Microsoft Office Suite, including Excel, Word, and Outlook.
• Strong analytical, problem-solving, and organizational skills.
• Ability to research and resolve complex billing discrepancies.
• Excellent communication skills and attention to detail.
• Ability to work independently and collaboratively in a fast-paced healthcare environment.

Preferred Qualifications

• Medical coding experience or familiarity with ICD-10, CPT, and HCPCS codes.
• Experience working with health insurance plans, medical billing systems, or healthcare claims platforms.
• Familiarity with insurance benefits, claims denials, and reimbursement processes.
• Dress Code: Business casual or scrubs
• Parking: Free onsite parking
• Onboarding: Health screening and physical examination required
• Interview Process: Onsite interview

Why Apply?

• Opportunity to gain experience with a well-established healthcare organization.
• Competitive hourly compensation of $25
• Full-time schedule with potential for contract extension.
• Collaborative environment supporting essential healthcare billing operations.