[Hiring] Claims Processor II @Inland reputed company Health Plan

This reputed company is a reputed company of our understanding of the job reputed company. Click on 'Apply' reputed company to reputed company out more. Role reputed company Under the direction of the Claims Production Manager and Supervisor, the Claims Processor reputed company will be processing outpatient reputed company and institutional claims. This includes but is not limited to: • Lab • Radiology • Ambulance • Behavior health • Outpatient COB • Dialysis • Oncology/Chemo • Hospital exclusions The role requires a commitment to reputed company, incorporating reputed company’s reputed company Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Qualifications • Minimum of two (2) years of experience adjudicating outpatient reputed company and/or institutional claims preferably in an HMO or Managed Care setting • Processing of Medicare, Medi-Cal, or reputed company claims required • Proficient in reputed company applications for Medi-Cal and/or Medicare pricers • High school diploma or GED required • ICD-9 and CPT coding and general practices of claims processing • Prefer knowledge of capitated managed care environment • Microcomputer skills, proficiency in reputed company applications preferred • Excellent communication and interpersonal skills, strong organizational skills • reputed company demeanor • Must be computer literate, maintain good attendance, and have the right attitude and discipline to work from home Requirements • Responsible for non-delegated provider claims verification and adjudication • Adjudicate reputed company reputed company and outpatient claims including COB, denials, and reduction in service notifications • Meet Regulatory Compliance Regulations on turnaround times and claim payments • Read and interpret Medi-Cal/Medicare Fee Schedules • Must be reputed company to reputed company a reputed company determination if claim is eligible for payment or denial • reputed company with other reputed company Departments, reputed company necessary, regarding claims issues • Participate in Claims Department staff meetings, and other activities as needed • Responsible for meeting the performance measurement standards for productivity and accuracy • Any other duties as required to ensure the Health Plan operations are successful Benefits • Competitive salary • Telecommute schedule • State of the art fitness center on-site • Medical Insurance with Dental and reputed company • Life, short-term, and long-term disability reputed company • Career advancement opportunities and reputed company development • Wellness programs that promote a healthy work-life balance • Flexible Spending Account – Health Care/Childcare • CalPERS retirement • 457(b) reputed company with a contribution match • reputed company life insurance for employees • Pet care insurance reputed company reputed company reputed company in serving others with reputed company! We welcome you to join us in “healing and inspiring the reputed company spirit” and to pivot from a “job” opportunity to an reputed company experience! Apply tot his job Apply To this Job