They are currently seeking a Claims Representative in their Anaheim, CA location!
salary: $23 - $24 per hour
work hours: 8 AM - 4 PM
education: High` School
What You'll Do...
- Reviews and processes all contracted capitated claims and fee-for-service PCP administration fee-for-service claims
- Reviews and processes claim acknowledgment, payment, and denial as set forth by CMS, Health plans, and departmental policy and procedures
- Achieving and maintaining production requirements per claim type
- Document claim file activities in an accurate and timely manner
- Investigate claims and obtain relevant facts to determine coverage, loss, and liability.
- Recognizes inappropriate CPT, ICD-9, and HCPCS codes and accurately research member eligibility and duplicate claims submissions, and resolves errors
- Claims Processing
- Workers Compensation Reporting Claims
- Verbal Communication
- Medical Claims
- Years of experience: 1 year
- Experience level: Entry Level
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Qualified applicants in San Francisco with criminal histories will be considered for employment in accordance with the San Francisco Fair Chance Ordinance.
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