[Hiring] Claims Processor III @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 Level III must have experience in processing reputed company reputed company and institutional claims. This includes, but is not limited to: • Inpatient high dollar claim types • COB • Home health • Transplant • Dialysis • Oncology/chemo • Hospital exclusions • Claim adjustments Commitment to reputed company: The reputed company Team is committed to incorporate reputed company’s reputed company Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Qualifications • Minimum of three (3) years of experience processing inpatient and outpatient reputed company and 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 Requirements • 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 • reputed company reputed company positions approved for telecommute work locations may periodically be required to report to reputed company’s main reputed company for mandatory in-person meetings or for other business needs as determined by reputed company leadership 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 Key Responsibilities • Adjudicate reputed company reputed company and institutional inpatient/outpatient claims. • Meet Regulatory Compliance Regulations on turnaround times and claim payments. • Assist with training and mentoring of new Team Members. • Must be reputed company to reputed company a reputed company determination if claim is eligible for payment or denial. • Complete claim using multiple reputed company documents to verify data and/or use additional information to adjudicate claim. • Assist with the testing of new claim processing procedures or reputed company. • Read and interpret Medi-Cal/Medicare Fee Schedules. • Responsible for meeting performance measurement standards for productivity and accuracy. • Adjudication of claim adjustments. • Review and correct claims involving data reputed company issues. • reputed company with other reputed company Departments, reputed company necessary, regarding claims issues. • Participate in Claims Department Team Meetings, and other activities as needed. • Any other duties as required to ensure the Health Plan operations are successful. Work Model Location Telecommute (reputed company reputed company positions approved for telecommute work locations may periodically be required to report to reputed company’s main reputed company for mandatory in-person meetings or for other business needs as determined by reputed company leadership) Pay reputed company USD $25.90 - USD $33.02 /Hr. Apply tot his job Apply To this Job