Medical Claims Specialist

2 weeks ago


Torrance, California, United States Optum Full time
Job Summary

Optum is seeking a highly skilled Medical Billing and Claims Specialist to join our team. As a key member of our Business Office, you will play a critical role in ensuring the accuracy and efficiency of our medical claims processing.

Key Responsibilities
  • Review and prepare incoming encounter data and explanation of benefits information for accuracy and completeness.
  • Print and maintain claim forms, ensuring all necessary information is included.
  • Perform electronic claims submission and review insurance claim forms for accuracy and completeness.
  • Make necessary claims corrections and sort and review payments received by the Business Office.
  • Apply knowledge of Medicare and Medi-Cal guidelines to ensure appropriate use of modifiers and CPT/ICD-9 codes.
  • Maintain a working knowledge of general claims requirements and updates to ICD-9/CPT codes.
Requirements
  • 1+ year of medical billing experience.
  • 1+ year of general office experience.
  • Ability to work any 8-hour shift schedule between 6:00am and 6:00pm, Monday-Friday.
  • Must be 18 years old or older.
  • Working knowledge of business billing office duties.
  • Knowledge of HMO and PPO claims requirements.
What We Offer

At Optum, we offer a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contribution. We are an Equal Employment Opportunity/Affirmative Action employer and welcome applications from diverse candidates.



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