Claims Specialist
Whittier, CA 90601
13 Weeks Contract
Shift -Monday - Friday - 07:00am - 03:30pm
Must Have skills
POSITION SUMMARY:
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 HMO patients.
EDUCATION/EXPERIENCE/TRAINING:
• High school graduate or equivalent required. Must have physical proof on hand if background check is unable to verify your education background.
• Minimum of 2 years claims ADJUDICATION related experience in 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 payment accuracy guidelines for commercial, senior and Medi-Cal claims
* Knowledge of compliance issues as they relate to claims processing
• Experience in interpreting provider contract reimbursement terms desirable
• Ability to identify non-contracted providers for Letter of Agreement consideration
• Data entry experience
• Training on basic office automation and managed care computer systems
Recruiter Details:
Vishakha Singh
Sr IT Recruiter
E-mail: vishakha.singh@ustechsolutionsinc.com
Internal ID-25-43050
About US Tech Solutions:
US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit .
US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
...not be construed as an employment contract. Any statements made in this job description are subject to change at the discretion of Italian Terrazzo & Tile Co. of Brevard, LLC. Italian Terrazzo & Tile Co. of Brevard, LLC is an Equal Opportunity Employer and makes employment...
...the site manager or site supervisor Fill out JSA and make sure all technicians sign JSA daily Send a copy of JSA GoFormz to composite manager Completely required paperwork (e.g., service reports, timecards, expense reports, etc.) Send daily reports to site management...
About Us: Founded in 2008 by Ross Sapir, Roadway Moving is built on the core principles of accountability, kindness, generosity, and dedication. These values drive a culture of excellence, where our peoplenot just our trucksset us apart in a crowded industry. We believe...
...Join Our Team as a Behavior Technician at Behavioral Health Works! About Us: Behavioral Health Works is an expanding company dedicated to responsible and sustainable growth. We are committed to delivering personalized ABA therapy for children and adolescents diagnosed...
...About iVitaFi: iVitaFi is a dynamic and rapidly growing fintech start-up committed to revolutionizing the healthcare patient payment and financing landscape. With a focus on innovation, technology, and patient-centric solutions, iVitaFi aims to empower healthcare providers...