Long Beach, California
Claims Examiner/Claims Specialist Job Opening in Long Beach, California - CLAIMS ADJUSTER
POSITION SUMMARY
In this role you will be responsible for researching and adjudicating claims which are underpaid and/or denied for the purposes of ensuring that all claim components are valid and correct for processing. In this role, you will be experienced and knowledgeable in all working components of the claim, including but not limited to; member, provider, authorization, claim and system. Your intercommunication abilities will require excellent verbal and written communication skills as you interface with other departments to resolve outstanding challenges affecting claims re-work.
QUALIFICATIONS / REQUIREMENTS
Must know computerized claims processing systems (MHC exp. preferred)
Data entry and 10-key skills by touch and sight.
Knowledge of CPT/HCPC and ICD9 coding, procedures and guidelines
Comprehensive knowledge of medical terminology
Experience in processing all types of medical claims
3+ years experience in claims adjudication
Good verbal & written communication skills
Must demonstrate high-accuracy of claim payments during processing and/or audit stages
Must demonstrate excellent written and verbal communication skills
HOURS & COMPENSATION
Monday - Friday (days) Commensurate with Experience
Job Type: Full-time
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