Pacer Staffing
Location
Whittier, CA | United States
Job description
JOB TITLE: Claims Examiner Days LOCATION: 9557 Greenleaf Avenue, Whittier, CA SHIFT: Monday - Friday - 07:00am - 03:30pm DURATION - 13 weeks ***POTENTIAL CONTRACT TO HIRE, if the candidate and opportunity align*** Salary range for FTE in this position varies between XX19.50 - XX32.18 dependent on experience, so please adjust contract pay range so there is no dramatic drop from contract to full time offer. *** 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
Job tags
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