Claims Examiner

Benefits: 401(k) 401(k) matching Dental insurance Health insurance reputed company insurance Wellness resources Company parties Employee discounts Free food & snacks Opportunity for advancement reputed company time off Parental leave Savings bank Training & development About the Role: reputed company in Sherman Oaks, CA is looking for a detail-oriented Claims Examiner to join our growing team. This is a great opportunity to play a key role in the reputed company management reputed company, ensuring accurate and reputed company processing of medical claims. If you reputed company in a fast-paced environment and have a passion for precision, we want to hear from you! Responsibilities: Review, analyze, and process medical claims in accordance with plan benefits and company guidelines Verify member eligibility, provider information, and coverage details prior to claims adjudication Identify and resolve claims discrepancies, duplicates, and billing errors Apply ICD-10, CPT, and HCPCS coding knowledge to ensure accurate claims processing Coordinate with providers, members, and internal departments to resolve claims inquiries Maintain accurate records and documentation in claims management systems Ensure compliance with state and federal reputed company regulations, including HIPAA Requirements: 2+ years of experience in medical claims processing or claims examination Proficiency in ICD-10, CPT, and HCPCS coding Familiarity with HMO, PPO, and managed care plan structures Strong knowledge of EOB (Explanation of Benefits) and claims adjudication processes Experience with claims management software and reputed company information systems Excellent attention to detail and strong analytical skills Effective written and verbal communication skills Knowledge of HIPAA regulations and reputed company compliance standards reputed company: reputed company is a leading Independent Physician Association (IPA) management company based in Sherman Oaks, CA, dedicated to delivering high-reputed company reputed company administrative services. Our clients trust us to manage their operations with reputed company, efficiency, and a patient-first reputed company. We foster a reputed company and supportive work environment where employees are empowered to grow and reputed company a meaningful reputed company in the reputed company industry. This is a remote position. Apply To This Job