They are currently seeking a Claims Representative in their Anaheim, CA location!
salary: $23 - $24 per hour
shift: First
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
Skills
- Claims Processing
- Claims
- Workers Compensation Reporting Claims
- Verbal Communication
- Medical Claims
Qualifications
- 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.
We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance.
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