Claims Processor III at IEHP

What you can expect!

Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!

Under the direction of the Claims Production Manager and Supervisor, the Claims Processor Level III must have experience in processing complex professional and institutional claims. This includes, but is not limited to, inpatient high dollar claim types, COB, home health, transplant, dialysis, oncology/chemo, hospital exclusions, and claim adjustments in an accurate and expedient manner.

Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Perks

IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more.

• Competitive salary
• Telecommute schedule
• State of the art fitness center on-site
• Medical Insurance with Dental and Vision
• Life, short-term, and long-term disability options
• Career advancement opportunities and professional development
• Wellness programs that promote a healthy work-life balance
• Flexible Spending Account – Health Care/Childcare
• CalPERS retirement
• 457(b) option with a contribution match
• Paid life insurance for employees
• Pet care insurance
  
  
  

Education & Requirements

• Minimum of three (3) years of experience processing inpatient and outpatient professional and institutional claims preferably in an HMO or Managed Care setting
• Processing of Medicare, Medi-Cal, or Commercial claims required
• Proficient in rate applications for Medi-Cal and/or Medicare pricers
• High school diploma or GED required
  
  
  

Key Qualifications

• ICD-9 and CPT coding and general practices of claims processing
• Prefer knowledge of capitated managed care environment
• Microcomputer skills, proficiency in Windows applications preferred
• Excellent communication and interpersonal skills, strong organizational skills
• Professional demeanor
• Must be computer literate, maintain good attendance, and have the right attitude and discipline to work from home
• All IEHP positions approved for telecommute work locations may periodically be required to report to IEHP’s main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership
  
  
  

Start your journey towards a thriving future with IEHP and apply TODAY!

Pay Range

• $25.90 USD Hourly - $33.02 USD Hourly