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Claims Examiner

MedPOINT Management

Claims Examiner

Sherman Oaks, CA
Full Time
Paid
  • Responsibilities

    Benefits:

    401(k)

    401(k) matching

    Dental insurance

    Health insurance

    Vision insurance

    Wellness resources

    Company parties

    Employee discounts

    Free food & snacks

    Opportunity for advancement

    Paid time off

    Parental leave

    Savings bank

    Training & development

    About the Role:

    MedPOINT Management 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 healthcare management space, ensuring accurate and timely processing of medical claims. If you thrive 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 healthcare 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 healthcare information systems

    Excellent attention to detail and strong analytical skills

    Effective written and verbal communication skills

    Knowledge of HIPAA regulations and healthcare compliance standards

    About Us:

    MedPOINT Management is a leading Independent Physician Association (IPA) management company based in Sherman Oaks, CA, dedicated to delivering high-quality healthcare administrative services. Our clients trust us to manage their operations with integrity, efficiency, and a patient-first mindset. We foster a collaborative and supportive work environment where employees are empowered to grow and make a meaningful impact in the healthcare industry.

    This is a remote position.