Medical Claims Processor

AppleOne Employment Services; Folsom (CA); On-site; USD 65,000 - 90,000; Full time

Job summary

AppleOne Employment Services is seeking a Full Cycle Medical Claims Examiner Processor in California. The ideal candidate has 3–5 years in the employee benefits field and strong ICD-10, CPT, HCPCS coding skills.

Excellent typing (22 wpm) and solid computer literacy are required, with tests administered before in-person interviews. The role involves adjudicating medical claims and coordinating benefits per plan guidelines.

Qualifications

• 3–5 years in employee benefits industry as full cycle medical claims examiner.
• Proficient in ICD-10, CPT and HCPCS coding.
• Must pass tests: 22 wpm typing, basic computer/internet navigation, Outlook, and desktop proficiency.

Skills

Medical claims processing

Coordinate benefits

Typing 22 wpm

Tools

Outlook

Desktop (Windows)

Job description

• Must have 3-5 years’ experience in employee benefits industry (Full Cycle Medical Claims Examiner Processor- Adjudicates medical claims, applies coordination of benefits as outlined in plan guidelines and works with providers to gather the necessary documents to make final payment determination on claims etc.)
• Must be highly proficient in ICD-10, CPT, and HCPCS codes.
• Field Shared Notes ***They will have to take the following tests before they meet with me and I will need the results:
• Data/Typing (22 wpm or better)
• Basic computer/Internet navigation
• Outlook
• Desktop (Moderate experience or better)
• ***They will need to take a Claims Examiner test the day of their in-person interview with the hiring manager (If they get to that step)