Claims Processor

Claims Processor

Whittier, CA.

We are currently hiring for a Claims Processor in the Whittier, CA area. We have several opportunities available due to our growing needs We are specifically looking for entry to mid-level candidates who are interested in a long-term career with opportunities for growth, development, and advancement. If you’re interested in such an opportunity, this position could be the right fit for you.

Claims Processor Pay Rate:

• starting pay is $20.00-$24.00

Claims Processor Shift :

• 1st shift
• 7:00am-3:30pm

Claims Processor Job Description:

• 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.
• Investigate the claims filed and decide to deny, pay, or negotiate a settlement with the policyholder themselves or their representatives.
• Submit claims to patients’ insurance carriers using codes that are assigned to each of the medical or diagnostic procedures performed by the provider and communicate with insurance companies as they track and monitor the status of payments

Claims Processor Requirements:

• High School Diploma or GED.
• Minimum of 2 years Claims Adjudication related experience in ambulatory, acute care hospital, HMO, or IPA environment.
• Ability to pass a drug and background check.
• 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

Apply today to be considered for this opportunity.

Job Type: Full-time

Salary: From $20.00 -$24.00 per hour

Experience level:

• 2 years of experience

Schedule: 7:00am-3:30pm

• 8 hour shift
• Day shift
• Monday to Friday

Work Location: In person