A Health Plan in Los Angeles is in search of a Senior Medical Claims Examiner. The Senior Medical Claims Examiner is tasked with handling the claims to for the IPA. The Senior Medical Claims Examiner must have solid experience and longevity in his or her career. The Senior Medical Claims Examiner must have 5 years of claims experience. Essential Functions Audit high dollar claims, $3,500 and over, on a prospective and/or retrospective basis. Identify root causes and associated error trends to determine appropriate training needs and suggest modifications to policies and procedures. Use detail oriented concepts & company policies & procedures to solve a wide range of difficult problems in imaginative & practical ways. Perform follow-up on the status of outstanding internal audit issues. Provide training to staff as assigned. Participate in meetings with participants and other departments. Write letters to participants and providers requesting additional information when necessary.