Non-Clinical - Finance/Accounting
3 weeks ago
• 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 RTO MUST BE SUBMITTED AT TIME OF SUBMITTAL, NO EXCEPTIONS
Shifts: Day (5x8 Hours) 7:00 15:30
Job Priority: MSP
Facility: Non-Clinical - PIH Health Physicians
Location: Whittier , CA , 90601
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