Claims Examiner

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Are you an experienced Claims Examiner looking for a new opportunity with a prestigious healthcare company in the San Fernando, CA  area? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions – this is the position for you!

The ideal person for this position would have 1+ year of Managed Care claims experience. In this role you will be responsible for the accurate & timely adjudication of all claims in accordance with applicable contracts, state & federal regulations, health plan requirements, policies & procedures.

Key Responsibilities:

Analyzes professional &/or hospital claims for accuracy according to set dollar thresholds, meets & maintains production & quality standards

Reviews authorization &/or provider's contract & adjudicates claims accordingly

Accurate input of data is requried for claims adjudication including: diagnostic & procedural coding, pricing schedules, member & provider identification & all other related information is required

Performs any correspondence, follow up & any projects delegated by claims supervisor

Knowledge, Skills & Abilities:

Understanding of health & managed care concepts & their application in the adjudication of claims

Strong working knowledge of ICD9 CM, CPT, HCPCS, RBRVS coding schemes & medical terminology

Minimum Qualifications:

Monday - Friday schedule & competitive pay!

1-3+ year experience processing of managed care health claims

Ability to type 40-45 wpm

Understanding of medical terminology

Must have excellent understanding of health & managed care concepts & their application in the adjudication of claims

Must be able to accurately assess financial responsibility & liability for claims submitted by both members & providers

High School diploma/GED required

Interested in being considered? 

If you are interested in applying to this position, please contact Blake Anderson at 407-478-0332  ext. 115 and/or click the Green I’m Interested Button to email your resume