Claims Processor

You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients. Job Summary As a Claims Processor for our client, you will be responsible for accurately adjudicating high volumes of inpatient, outpatient, and professional medical claims. Your responsibilities will include managing electronic and manual claim submissions, reviewing claims for correct coding to prevent overpayment, and utilizing enterprise claims platforms to document and finalize claims actions. Key Responsibilities Accurately adjudicate high volumes of inpatient, outpatient, and professional claims. Manage a weekly queue of electronic submissions and manual paper claims. Review claims for correct coding and adjudication to prevent overpayment. Apply knowledge of insurance plans to determine benefit coverage. Utilize enterprise claims platforms like Athena IDX to document claims actions. Qualifications Minimum 3+ years of medical claims processing experience with an insurance carrier, TPA, or health plan (Payer side). Proficiency with

ICD-10, CPT

codes, and universal claim forms (UB-04/CMS-1500). Prior experience with Athena IDX, Epic, or Workday is preferred. Exceptional attendance and dependability in production-driven environments. Extreme attention to detail to identify minor errors with significant financial impact. Benefits Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances). Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)). 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1). Short Term Disability Insurance. Term Life Insurance Plan. Required Employment / Compliance Language All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability. • We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we're dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours. • As a job position within our Insurance division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing medical and confidential records, verifying financial information, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients