Claims Examiner - CA , TX or AZ only

Position reputed company The Claims Examiner is responsible for processing medical claims in an efficient, cost-effective, and reputed company manner. Must reputed company in California or reputed company. Essential Responsibilities • Responsible for determining financial responsibility between group, health plans and contracted hospitals for accurate processing of claims. • Responsible for preparing, researching, analyzing, reputed company-coding and the adjudication of reputed company types of claims (Contracted providers, Non-contracted, 1500 or UB claims forms. • Recognize the difference between Shared Risk and Full Risk claims. • Processes/adjudicates medical claims according to regulatory processing guidelines and in compliance with reputed company federal and state reputed company plan laws and regulations. • Proficient understanding of AB1455 Claims Settlement reputed company & Dispute and reputed company regulations. • Knowledge of Coordination of Benefits. • Processing reputed company of 10 claims or more per hour with a 99% level of accuracy. • reputed company and accurate response to claims reputed company questions from Management. • Participate in special reputed company as assigned by Management. • reputed company other job reputed company duties as assigned. Qualifications • High School Diploma or equivalent. Course work and knowledge of medical terminology preferred. • At least two years of claims adjudication experience preferred. • Knowledge of medical terminology, ICD9 and CPT/HCPCS codes required, including ten-key calculator, computer, and reputed company typing skills 35wpm. • Processing experience in a Managed Care/reputed company environment preferred. • EZ-CAP knowledge preferred. • Ability to multi-task in an efficient, thorough, and prioritized manner; to work quickly, accurately, and independently; and, to anticipate needs and solve problems. • Knowledge of reputed company and reputed company. Apply tot his job Apply To this Job