Senior Medical Claims Examiner
PIH Health
Date: 3 hours ago
City: Whittier, CA
Contract type: Full time
Tracking Code
23508-977
Job Location
6557 Greenleaf Ave., Whittier, California
Category
Clerical/Administrative
The Senior Claims Examiner administers health plan contracts by processing medical claims in an efficient, cost-effective, and timely manner meeting all required guidelines and performs adjustments as necessary. Some of the duties include handling of Third-Party Liability requests, Out-of-pocket Maximum requests, EDI rejects and other special projects.
PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Downey Hospital, PIH Health Good Samaritan Hospital, PIH Health Whittier Hospital, 37 outpatient medical office buildings, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, digestive health, orthopedics, women’s health, urgent care and emergency services. The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nation’s top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology. For more information, visit PIHHealth.org or follow us on Facebook, Twitter, or Instagram.
Required Skills
Required:
$21.00
Maximum Salary
$3.78
23508-977
Job Location
6557 Greenleaf Ave., Whittier, California
Category
Clerical/Administrative
The Senior Claims Examiner administers health plan contracts by processing medical claims in an efficient, cost-effective, and timely manner meeting all required guidelines and performs adjustments as necessary. Some of the duties include handling of Third-Party Liability requests, Out-of-pocket Maximum requests, EDI rejects and other special projects.
PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Downey Hospital, PIH Health Good Samaritan Hospital, PIH Health Whittier Hospital, 37 outpatient medical office buildings, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, digestive health, orthopedics, women’s health, urgent care and emergency services. The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nation’s top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology. For more information, visit PIHHealth.org or follow us on Facebook, Twitter, or Instagram.
Required Skills
- Computer and 10-key skills by touch;
- Knowledge of medical terminology, CPT/RBRVS/ICD-9 codes;
- Full understanding of HMO & capitation concepts and Medicare guidelines;
- Excellent communication skills;
- Ability to work independently and function under time deadlines.
Required:
- High school diploma or General Education Development, relevant experience in lieu of education will be considered
- Minimum two (2) years medical claims processing experience
- N/A
$21.00
Maximum Salary
$3.78
How to apply
To apply for this job you need to authorize on our website. If you don't have an account yet, please register.
Post a resumeSimilar jobs
Hilton Hotel Brands - Housekeeper/Room Attendant $16-$35/hr
Dispatcher,
Whittier, CA
3 days ago
No experience requited, hiring immediately, appy now.A Room Attendant is responsible for cleaning guest rooms and responding to guest requests in the hotel's continuing effort to deliver outstanding guest service and financial profitability. Full and part time postions available. Flexible Hours....
Environmental Services Aide, Part Time Evenings
PIH Health,
Whittier, CA
$21
-
$28.35
per hour
2 weeks ago
Tracking Code23357-977Job Location12401 Washington Blvd., Whittier, CaliforniaCategorySupport ServicesThe Environmental Services Aide (Housekeeping) ensures a safe, clean, and attractive environment for patients, staff & visitors at all times.PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH...
Housekeeper
Troon,
Whittier, CA
$17
-
$18
per hour
3 weeks ago
California Country Club is excited to announce the exceptional career opportunity of Housekeeper. Qualified candidates will thrive in a hospitality environment and be highly focused on providing superior service to the clubs managed by Troon.Key Responsibilities: Provide daily cleaning for all of the operation including, but not limited to: offices, public spaces, kitchen and restroom facilities. Perform light and heavy...