5 Jobs in Whittier, CA
BizTek People, Inc. | APA International Placement Consultants is Hiring a Claims Examiner Near Whittier, CA
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 fromPHP affiliated medical groups and hospitals for HMO patients.
EDUCATION/EXPERIENCE/TRAINING:
• High school graduate or equivalent required
• Minimum of 2 years claims ADJUDICATION related experiencein ambulatory, acute care hospital, HMO, or IPA environment
• Knowledge of payment methodologies for: Professional (MD),Hospital, Skilled Nursing Facilities, and Ancillary Services
* Knowledge and understanding of timeliness and paymentaccuracy guidelines for commercial, senior and Medi-Cal claims
* Knowledge of compliance issues as they relate to claimsprocessing
• Experience in interpreting provider contract reimbursementterms desirable
• Ability to identify non-contracted providers for Letter ofAgreement consideration
• Data entry experience
• Training on basic office automation and managed carecomputer systems
Job Summary
Full Time
$70k-90k (estimate)
11/21/2023
06/07/2024
The job skills required for Claims Examiner include Data Entry, etc. Having related job skills and expertise will give you an advantage when applying to be a Claims Examiner. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Claims Examiner. Select any job title you are interested in and start to search job requirements.
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.
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