Senior Medi-Cal Claims Examiner II

Partnership HealthPlan of California; California (MO); On-site; USD 52,000 - 70,000; Full time

Job summary

Partnership HealthPlan of California is seeking a Claims Examiner II to review, research, and resolve Medi-Cal claims within established production and quality standards. This role handles manual processing, completes claims and worksheets, and generates provider communications as needed.

In addition, the examiner routes claims for review, tracks statuses, and ensures timely updates. A high school diploma and at least one year in Medi-Cal billing or claims examining are required, with strong

Qualifications

• Education: High school diploma or equivalent.
• Experience: 1 year in Medi-Cal billing and/or claims examining in automated environments.
• Skills: effective written and oral communication, good organizational abilities.

Responsibilities

• Review, research, and resolve pended Medi-Cal claims within production standards.
• Route claims to appropriate departments and follow up until resolution.
• Comply with applicable policies, manuals, and guidelines; generate required correspondence.

Skills

Medi-Cal billing

Claims processing

Data entry

Education

High school diploma

Job description

Partnership HealthPlan of California is seeking a Claims Examiner II to review, research, and resolve Medi-Cal claims within established production and quality standards. This role handles manual processing, completes claims and worksheets, and generates provider communications as needed.

In addition, the examiner routes claims for review, tracks statuses, and ensures timely updates. A high school diploma and at least one year in Medi-Cal billing or claims examining are required, with strong