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Pomona Valley Hospital Medical Center

EXAMINER, CLAIMS

Pay: $61,162/yr

Posted: 7 weeks ago

Location: Pomona, CA (Onsite)

Last Updated: 1 week ago

Hours: Full-Time

Expires: 9/26/2026

Career Insights for Claims Examiner (General)

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Based on California data

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What they do

A Claims Examiner evaluates insurance claims in accordance with applicable contracts and government regulations within their insurance type. Determines member eligibility and financial responsibility of the insurance company.

$88,344 / year median in California

-7% projected decline

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Job Description

Position summary: Manually input and adjudicate non-pvhmc claims. Interpret and utilize capitation contracts, payor matrixes, subscriber benefit plan, and provider contracts. Resolves customer service inquiries, status calls and claim tracers. May perform other duties as assigned.

Required Qualifications:

High school diploma or equivalent.

Preferred Qualifications:

One year claims processing experience; one year experience with the UB92, UB04 and

HCFA 1500

forms; one year experience with EZ-CAP claims processing software Salary range: $24.43 - $34.38 hourly. Salary will be commensurate with experience. As part of our ongoing effort to remain an employer of choice, eligible employees who work qualifying weekend shifts receive a competitive weekend rate.