Claims Processor

**Job Title**: Claims processor

**Job Locations**: Whittier, CA

**Shift time**: Monday to Friday (7am to 3:30pm)

**Contract duration**: 13 weeks + possible extension

**Guarantee hours**: 40 hours

**Payrate: $30/hr on W2 without benefits**

**Start Date**:ASAP

**Responsibilities**:

- 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

**Minimum requirement**:

- Minimum of 2 years claims ADJUDICATION related experience in ambulatory, acute care hospital, HMO, or IPA environment
- High school graduate or equivalent required. Must have physical proof on hand if background check is unable to verify your education background
- 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
- Covid card
- 2 professional references
- Updated resume
- Immunization and flu shots (if the position offered)

**Job Types**: Full-time, Contract

Pay: $30.00 per hour

Expected hours: 40 per week

Schedule:

- 8 hour shift
- Monday to Friday

Work setting:

- Office

**Experience**:

- claims processor: 2 years (preferred)

Ability to Commute:

- Whittier, CA 90601 (preferred)

Ability to Relocate:

- Whittier, CA 90601: Relocate before starting work (preferred)

Work Location: In person