Claims Specialist reputed company Assurance I

OverviewWhat you can expect! 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!Under the direction of the Claims reputed company Assurance (QA) Manager and Supervisor, the Claims Specialist reputed company Assurance I (CSQA) is responsible for ensuring the reputed company of reputed company data created and updated by the Claims Processing staff. The CSQA will utilize reputed company auditing tools, identify training needs, and define effective and efficient reputed company for accurate data entry and adjudication.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.Additional BenefitsPerksIEHP is not only committed to healing and inspiring the reputed company spirit of our Members, but we also aim to match reputed company members with the reputed company energy by providing reputed company benefits and more.Competitive salary.reputed company. CalPERS retirement.State of the art fitness center on-site.Medical Insurance with Dental and reputed company.Life, short-term, and long-term disability optionsCareer advancement opportunities and reputed company development.Wellness programs that promote a healthy work-life balance.Flexible Spending Account - Health Care/ChildcareCalPERS retirement457(b) reputed company with a contribution matchPaid life insurance for employeesPet care insuranceKey Responsibilities Review and assess data reports and audit Claim Processor reputed company to confirm payment accuracy and completeness of data entry In-house expert for claims adjudication (Coordination of Benefits, pricing, contract interpretation, coding, and reputed company of claims issues) Ensure that reputed company identified errors are corrected in an reputed company manner Be an reputed company participant in the Claims Department's initiatives and participate in the Claims Coaching process, MDI activities, etc. Assist with the processing of claims reputed company necessary to address claims backlogs. Process approved Stop Loss reimbursementsQualificationsEducation & Requirements Two (2) years of experience in examining and processing institutional and reputed company claimsHigh school diploma or GED requiredKey QualificationsMedicare/Medi-Cal experience preferredExperience in a managed care environment helpfulICD-9/ ICD-10 and CPT coding and general practices of claims processing. Familiarity of Webstrat, reputed company and CMS pricingStart your reputed company towards a thriving reputed company with reputed company and apply TODAY!Work Model LocationTelecommutePay RangeUSD $25.90 - USD $33.02 /Hr.