Senior Claims Examiner, FT Days
2 weeks ago
The Senior Claims Examiner administers health plan contracts by processing medical claims in an efficient, cost-effective, and timely manner meeting all required guidelines and performs adjustments as necessary. Some of the duties include handling of Third-Party Liability requests, Out-of-pocket Maximum requests, EDI rejects and other special projects.
PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Downey Hospital, PIH Health Good Samaritan Hospital, PIH Health Whittier Hospital, 37 outpatient medical office buildings, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, digestive health, orthopedics, women's health, urgent care and emergency services. The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nation's top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology. For more information, visit PIHHealth.org or follow us on Facebook, Twitter, or Instagram.
Required Skills
- Computer and 10-key skills by touch;
- Knowledge of medical terminology, CPT/RBRVS/ICD-9 codes;
- Full understanding of HMO & capitation concepts and Medicare guidelines;
- Excellent communication skills;
- Ability to work independently and function under time deadlines.
Required:
- High school diploma or General Education Development, relevant experience in lieu of education will be considered
- Minimum two (2) years medical claims processing experience
- N/A
-
Claims Examiner
4 days ago
Whittier, CA, United States Pacer Group Full timeMust have listed claims reimbursement experience Must have DOFR Must have processed lab claims **ONSITE INTERVIEW REQUIRED** JOB TITLE: Claims Examiner - Days LOCATION: 9557 Greenleaf Avenue, Whittier, CA SHIFT: Monday - Friday - 07:00am - 03:30pm PLEASE NOTE ORIENTATION TIME MAY DIFFER THAN SHIFT TIMES LISTED DURATION - 13 weeks *** 2 YEARS...
-
Claims Examiner
12 hours ago
Whittier, CA, United States Pacer Group Full timeMust have listed claims reimbursement experience Must have DOFR Must have processed lab claims **ONSITE INTERVIEW REQUIRED** JOB TITLE: Claims Examiner - Days LOCATION: 9557 Greenleaf Avenue, Whittier, CA SHIFT: Monday - Friday - 07:00am - 03:30pm PLEASE NOTE ORIENTATION TIME MAY DIFFER THAN SHIFT TIMES LISTED DURATION - 13 weeks *** 2 YEARS...
-
Claims Examiner
6 hours ago
Whittier, CA, United States Pacer Group Full timeMust have listed claims reimbursement experience Must have DOFR Must have processed lab claims **ONSITE INTERVIEW REQUIRED** JOB TITLE: Claims Examiner - Days LOCATION: 9557 Greenleaf Avenue, Whittier, CA SHIFT: Monday - Friday - 07:00am - 03:30pm PLEASE NOTE ORIENTATION TIME MAY DIFFER THAN SHIFT TIMES LISTED DURATION - 13 weeks *** 2 YEARS...
-
Claims Examiner
1 week ago
Whittier, CA, United States BizTek People, Inc. | APA International Placement Consultants Full timeJob Description POSITION SUMMARY: Contract role. Contract to hire potential for the right candidate! 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...
-
Claims Examiner
2 weeks ago
Whittier, CA, United States BizTek People, Inc. | APA International Placement Consultants Full timeJob Description POSITION SUMMARY: Contract role. Contract to hire potential for the right candidate! 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...
-
Claims Examiner
5 days ago
Whittier, CA, United States BizTek People, Inc. | APA International Placement Consultants Full timeJob Description POSITION SUMMARY: Contract role. Contract to hire potential for the right candidate! 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...
-
Claims Examiner
1 week ago
Whittier, CA, United States BizTek People, Inc. | APA International Placement Consultants Full timeJob Description POSITION SUMMARY: Contract role. Contract to hire potential for the right candidate! 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...
-
Claims Examiner
3 days ago
Whittier, CA, United States vTech Solution Full timeJob Summary: The Claims Examiner is responsible for processing UB-92 and HCFA-1500 claims from affiliated medical groups and hospitals for HMO patients. This includes operation, adjudication, and payment functions, reporting directly to the claims manager. Location:Whittier, California, United States Responsibilities: - Process UB-92 and HCFA-1500 claims....
-
Claims Examiner
1 week ago
Whittier, CA, United States vTech Solution Full timeJob Summary: The Claims Examiner is responsible for processing UB-92 and HCFA-1500 claims from affiliated medical groups and hospitals for HMO patients. This includes operation, adjudication, and payment functions, reporting directly to the claims manager. Location:Whittier, California, United States Responsibilities: - Process UB-92 and HCFA-1500 claims....
-
Claims Examiner
1 week ago
Whittier, CA, United States vTech Solution Full timeJob Summary: The Claims Examiner is responsible for processing UB-92 and HCFA-1500 claims from affiliated medical groups and hospitals for HMO patients. This includes operation, adjudication, and payment functions, reporting directly to the claims manager. Location:Whittier, California, United States Responsibilities: - Process UB-92 and HCFA-1500 claims....
