Payers Side Medical Claims 1+yr Exp AppleOne - 3.8 Bakersfield, CA Job Details Temporary $22 an hour 13 hours ago Benefits Health insurance Dental insurance 401(k) Vision insurance Paid sick time Qualifications Microsoft Excel Managed care Managed care organization experience Practice management software Patient management software Medical claims processing software High school diploma or

GED ICD-10 HCPCS

Health insurance knowledge Decision making SharePoint Productivity software Medical claim denial management Medical terminology Full Job Description We are hiring Payer side Medical Claims Examiner in Bakersfield, CA! We are seeking candidates with at least 1 year of recent payer-side medical claims adjudication experience working for a health plan, insurance carrier, HMO, managed care organization, or third-party administrator (TPA). This temporary opportunity offers up to $22.00/hour, a hybrid/remote work environment, and the opportunity to work with a respected healthcare organization. If you have experience processing, reviewing, auditing, and adjudicating medical claims, we encourage you to apply today. Qualifications High School Diploma or equivalent Minimum 1 year of recent payer-side medical claims examiner or claims adjudication experience Experience working for a: Health Plan Insurance Carrier HMO Managed Care Organization Third-Party Administrator (TPA) Strong understanding of: Medical claims adjudication Benefit interpretation Provider contracts Claims payment methodologies Medical terminology

Knowledge of:

CPT, HCPCS, and ICD-10 coding CMS-1500 and UB-04 claim forms Eligibility verification processes Experience handling: Suspended claims Denied claims Adjusted claims Manually reviewed claims Strong organizational, analytical, and decision-making skills Experience in use of Medical Claims Processing Systems Electronic Health Records (EHR) Electronic Practice Management (EPM)

Systems Practice Management Software Online Eligibility Verification Tools SharePoint Microsoft Office Suite Important:

Provider-side medical billing, collections, accounts receivable, patient financial services, or physician office billing experience alone does not meet the minimum qualifications unless accompanied by direct payer-side claims adjudication experience. Equal Opportunity Employer / Disabled / Protected Veterans The Know Your Rights poster is available here: https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12.pdf The pay transparency policy is available here: https://www.dol.gov/sites/dolgov/files/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf For temporary assignments lasting 13 weeks or longer, the Company is pleased to offer major medical, dental, vision, 401k and any statutory sick pay where required. We are committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation for any part of the employment process, please contact your staffing representative who will reach out to our HR team. AppleOne participates in the E-Verify program in certain locations as required by law. Learn more about the E-Verify program.

https:

//e-verify.uscis.gov/web/media/resourcesContents/E-Verify_Participation_Poster_ES.pdf We also consider for employment qualified applicants regardless of criminal histories, consistent with legal requirements, including, if applicable, the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance. Pursuant to applicable state and municipal Fair Chance Laws and Ordinances, we will consider for employment-qualified applicants with arrest and conviction records, including, if applicable, the San Francisco Fair Chance Ordinance. For Los Angeles, CA applicants: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. #1087