Qualifications Education & Experience:

Associate degree or equivalent combination of experience in health insurance or related fields, which would provide the necessary knowledge, skills, and abilities to successfully perform the work. Three or more (3 +) years of experience in examining and processing institutional claims for inpatient, dialysis, SNF, and home health using Medicare prices. Two (2) years of experience in examining and processing medical claims, professional or institutional. Experience with Medicare/Medi-Cal is preferred. Experience with claim adjustments, provider appeals, and/or disputes is preferred.

Skills:

Advanced knowledge and skills in medical terminology, HCPCS/CPT, and

ICD-9/ICD-10.

Knowledge of Centers for Medicare and Medicaid Services claims payment guidelines. Strong analytical skills, including the ability to analyze and organize data. Strong attention to detail. Excellent organizational, oral presentation, and written and verbal communication skills. Proficiency in MS Office products, including PowerPoint, Excel, and Word. Ability to provide effective leadership and direction within an organization. Meet and consistently maintain production standards for Claims Adjudication.

Job Type:

Full-time Pay:

From $29.00 per hour

Benefits:

401(k) Dental insurance Health insurance Life insurance Paid time off Vision insurance

Work Location:

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