Claims Examiner at US Tech Solutions
Job Description
Job Title: Claims Examiner
Job Location: 9557 Greenleaf Avenue, Job Title: Claims Examiner
Job Location: 9557 Greenleaf Avenue, Whittier, CA 90601
Duration: 13 weeks
SHIFT
- Monday - Friday - 07:00am - 03:30pm
Job Description
Must have listed claims reimbursement experience
Must have DOFR
Must have processed lab claims
- Will Need References to Submit.
- Will Need References to Submit.
- Will Need References to Submit.
ONSITE INTERVIEW REQUIRED
PLEASE NOTE ORIENTATION TIME MAY DIFFER THAN SHIFT TIMES LISTED
*** 2 YEARS EXPERIENCE REQUIRED - MUST BE ABLE TO VERIFY HS DIPLOMA or GED or HIGHER EDUCATION***
Position Summary
The claims examiner reports directly to the claims manager. They are primarily responsible for the processing functions (operation, adjudication, and payment) of UB-92 and HCFA-1500 claims that are received from PHP affiliated medical groups and hospitals for HMO patients.
Education/Experience/Training
• High school graduate or equivalent required. Must have physical proof on hand if background check is unable to verify your education background.
• Minimum of 2 years claims ADJUDICATION related experience in ambulatory, acute care hospital, HMO, or IPA environment
• Knowledge of payment methodologies for: Professional (MD), Hospital, Skilled Nursing Facilities, and Ancillary Services
- Knowledge and understanding of timeliness and payment accuracy guidelines for commercial, senior and Medi-Cal claims
- Knowledge of compliance issues as they relate to claims processing
• Experience in interpreting provider contract reimbursement terms desirable
• Ability to identify non-contracted providers for Letter of Agreement consideration
• Data entry experience
• Training on basic office automation and managed care computer systems
Duration: 13 weeks
SHIFT
- Monday - Friday - 07:00am - 03:30pm
Job Description
Must have listed claims reimbursement experience
Must have DOFR
Must have processed lab claims
- Will Need References to Submit.
- Will Need References to Submit.
- Will Need References to Submit.
ONSITE INTERVIEW REQUIRED
PLEASE NOTE ORIENTATION TIME MAY DIFFER THAN SHIFT TIMES LISTED
*** 2 YEARS EXPERIENCE REQUIRED - MUST BE ABLE TO VERIFY HS DIPLOMA or GED or HIGHER EDUCATION***
Position Summary
The claims examiner reports directly to the claims manager. They are primarily responsible for the processing functions (operation, adjudication, and payment) of UB-92 and HCFA-1500 claims that are received from PHP affiliated medical groups and hospitals for HMO patients.
Education/Experience/Training
• High school graduate or equivalent required. Must have physical proof on hand if background check is unable to verify your education background.
• Minimum of 2 years claims ADJUDICATION related experience in ambulatory, acute care hospital, HMO, or IPA environment
• Knowledge of payment methodologies for: Professional (MD), Hospital, Skilled Nursing Facilities, and Ancillary Services
- Knowledge and understanding of timeliness and payment accuracy guidelines for commercial, senior and Medi-Cal claims
- Knowledge of compliance issues as they relate to claims processing
• Experience in interpreting provider contract reimbursement terms desirable
• Ability to identify non-contracted providers for Letter of Agreement consideration
• Data entry experience
• Training on basic office automation and managed care computer systems
About US Tech Solutions:
US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com.
US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity,
national origin, disability, or status as a protected veteran.
Recruiter Details:
Name: Adil Saifi
Email: [email protected]
Internal Id: 24-22803
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