Adjustments Senior Medical Claims Examiner
1 month ago
Adjustments Senior Medical Claims Examiner Monday, July 22, 2024 Motion Picture Industry Pension & Health Plans (MPI) is looking for an experienced, highly organized Senior Medical Claims Examiner with strong attention to detail to join our Medical Claims Department on the Adjustments Team. Please note this position works onsite in our office in Studio City, CA. Qualified candidates only, please submit letter of interest with resume and salary requirements for consideration. MPI offers free employee health, dental, vision and life insurance ($50/month for family coverage), retirement and pension, and generous paid time off. The Department: The Medical Claims Department is responsible for timely, accurate processing of Participant medical claims. Responsibilities: Test configuration changes. Participate in development and maintenance of departmental procedures. Research Plan guidelines and documents as needed for the accurate processing of medical claims. Review and process requests for claim adjustments when necessary, including handling responses to providers and members. Process complex high dollar claims. Actively execute appropriate claim activities to ensure consistent quality/configuration of claims processing. Other Duties as assigned including, but not limited to, assisting other departments and units as needed. Qualifications: High school diploma or GED required. Some college preferred. Minimum 2 years verifiable claims processing experience with quality average of 95%. Knowledge of: CPT, HCPCs, ICD-9, COB, and Medical Terminology. Intermediate level of proficiency in PC skills including MS Word, Outlook, and Excel. Previous customer service/call handling experience in a health care environment. Familiarity with QNXT configuration. Clear and effective oral and written communication skills. Excellent attendance & reliability with the ability to work overtime/extended hours as required. Strong organizational skills. Ability to handle fast-paced work. Good interpersonal skills; able to interact with individuals at all levels. Ability to accept direction and developmental guidance from lead and manager. Meet production and quality assurance goals/standards. Flexible team player, with a positive, cooperative, and helpful attitude; willing to assume additional duties as needed. Preferred Qualifications: Knowledge of MPI Plan benefits. Working knowledge of Anthem WGS claims system. In-depth knowledge of V3 Eligibility system. Submissions will be reviewed; only candidates most closely matching the requirements of the position will be contacted. Please note, this is an onsite position at our offices in Studio City, CA. MPI requires employees to be vaccinated against Covid-19 with exceptions as required by law. This is a Class 3a Union-affiliated position with an overscale. About MPI: Located in Studio City, CA, the Motion Picture Industry Pension and Health Plans (MPI) are multi-employer trust funds established by collective bargaining agreements between various employers and over 30 Unions and Guilds representing employees in the motion picture industry. Recognized as an Employer of Choice for its employee-focused work environment, competitive compensation and benefits, MPI is a recipient of the World at Work Seal of Distinction and is Great Place to Work Certified Motion Picture Industry Pension & Health Plans (MPI) is an equal opportunity employer and does not discriminate against any applicant or employee on the basis of race, religion, color, national origin, ancestry, sex, sexual orientation, gender identity, age over 40, marital status, veteran status, mental or physical disability, pregnancy, genetic information, or any other basis prohibited by law. Any applicant who, because of disability, requires accommodation or assistance in completing this application or at any time during the application process should contact the Human Resources Department. MPI also provides reasonable accommodations to disabled employees consistent with its obligations under applicable law. #J-18808-Ljbffr
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Senior Claims Adjustment Specialist
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Los Angeles, California, United States Motion Picture Industry Pension & Health Plans Full timePosition Overview:We are seeking a meticulous and experienced Senior Claims Adjustment Specialist to join our dynamic Medical Claims Department. This role is essential in ensuring the accurate and timely processing of medical claims adjustments.About the Organization:The Motion Picture Industry Pension & Health Plans (MPI) is a distinguished multi-employer...
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Senior Claims Adjustment Specialist
1 week ago
Los Angeles, California, United States Motion Picture Industry Pension & Health Plans Full timeThe Motion Picture Industry Pension & Health Plans (MPI) is seeking a meticulous and organized Senior Claims Adjustment Specialist to enhance our Medical Claims Department within the Adjustments Team. Position Overview:This role is essential for ensuring the precise and timely processing of medical claims adjustments. Key Responsibilities:Evaluate and test...
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