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Fortuna BMC
Folsom, CA | Full Time
$57k-72k (estimate)
1 Week Ago
Claims Examiner
Fortuna BMC Folsom, CA
$57k-72k (estimate)
Full Time 1 Week Ago
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Fortuna BMC is Hiring a Claims Examiner Near Folsom, CA

Pay: $20 - $26 per hour
Location: Folsom, CA
Employment Type: Full-time

WHAT WE OFFER:

  • Competitive pay rates based on experience and expertise
  • Comprehensive benefits package including medical, dental, and vision coverage
  • 401k with generous company match
  • Ample paid time off and holidays
  • Dynamic work environment with opportunities for growth and advancement

WHAT YOU'LL DO:

  • Adjudicate medical claims in accordance with established guidelines, ensuring accuracy and compliance with plan regulations.
  • Utilize your expertise in ICD-10, CPT, and HCPCS codes to accurately process claims and minimize errors.
  • Collaborate effectively with healthcare providers to obtain necessary documentation for timely claim resolution, demonstrating strong communication skills.
  • Maintain high standards of accuracy and efficiency in claim processing workflows, contributing to overall operational excellence.

WHAT YOU'LL BRING:

  • 3-5 years of experience in the employee benefits industry, demonstrating a solid understanding of medical claims adjudication processes.
  • Proficiency in ICD-10, CPT, and HCPCS codes, enabling accurate and efficient claim processing.
  • Strong attention to detail and ability to thrive in a fast-paced environment, ensuring consistent quality in claim processing.
  • Excellent communication and interpersonal skills, facilitating effective collaboration with internal and external stakeholders.

A drug and background screening is required for this position. 

Job Summary

JOB TYPE

Full Time

SALARY

$57k-72k (estimate)

POST DATE

05/09/2024

EXPIRATION DATE

06/06/2024

WEBSITE

fortunabmc.com

HEADQUARTERS

Folsom, CA

SIZE

25 - 50

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The following is the career advancement route for Claims Examiner positions, which can be used as a reference in future career path planning. As a Claims Examiner, it can be promoted into senior positions as a Claims Examiner III that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Claims Examiner. You can explore the career advancement for a Claims Examiner below and select your interested title to get hiring information.

If you are interested in becoming a Claims Examiner, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become a Claims Examiner for your reference.

Step 1: Understand the job description and responsibilities of an Accountant.

Quotes from people on Claims Examiner job description and responsibilities

Most medical claims examiners deal with paperwork on a daily basis and they are expected to work on multiple claims per day.

04/03/2022: Springfield, MA

Each claim often comes with supporting documents such as medical records and hospital bills and examiners need to look over each file carefully.

03/08/2022: Manchester, NH

Claims examiners are responsible for approving or rejecting claims or arranging settlements.

01/25/2022: Santa Fe, NM

Examiners may review medical bills or accident reports and they may consult specialists.

01/30/2022: Santa Barbara, CA

The Claims Examiner maintains a full case load of professional liability claims.

01/24/2022: Monroe, LA

Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.

Career tips from people on Claims Examiner jobs

Keep reading to learn more about a claims examiner role.

03/28/2022: Oklahoma City, OK

Candidates should know that having a critical thinking and outstanding decision-making give examiners the logic and reasoning to evaluate and resolve claims.

04/05/2022: Tulsa, OK

Most employers require or strongly prefer medical claims examiners that have some medical background such as a postsecondary diploma.

03/11/2022: San Antonio, TX

To determine whether a claim should be rewarded, an examiner must be aware of the red flags associated with fraudulent claims and possess detailed analysis skills.

01/30/2022: Bellingham, WA

To begin a career as a medical claims examiner, one must first learn certain knowledge and skills that will help them execute the duties of the job.

02/17/2022: Lawton, OK

Step 3: View the best colleges and universities for Claims Examiner.

Butler University
Carroll College
Cooper Union
High Point University
Princeton University
Providence College