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AppleOne
Payers Side Medical Claims 1+yr Exp
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Based on California data
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What they do
A Medical Claims Examiner evaluates medical insurance claims in accordance with applicable contracts and government regulations. Verifies that medical treatment costs are accurate given a patient's diagnosis. May specialize in specific types of treatments or types of drug claims.
$54,632 / year median in California
-1% projected decline
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