Benefits:
401(k)
401(k) matching
Bonus based on performance
Dental insurance
Employee discounts
Free food & snacks
Health insurance
Opportunity for advancement
Paid time off
Parental leave
Savings bank
Training & development
Vision insurance
Wellness resources
About the Role:
MedPOINT Management in Sherman Oaks, CA is looking for a detail-oriented Hospital Claims Adjuster to join our dynamic healthcare team. In this role, you'll play a critical part in reviewing and processing hospital claims with accuracy and efficiency. If you're passionate about healthcare operations and thrive in a fast-paced environment, we want to hear from you!
Responsibilities:
Review, analyze, and adjudicate inpatient and outpatient hospital claims in accordance with plan guidelines
Verify patient eligibility, benefits, and coverage prior to claims processing
Identify and resolve claim discrepancies, denials, and underpayments
Apply ICD-10, CPT, and DRG coding knowledge to ensure accurate claim adjudication
Coordinate with providers, hospitals, and internal departments to resolve claim issues
Ensure compliance with state and federal healthcare regulations, including HIPAA
Maintain accurate documentation and meet productivity and quality benchmarks
Requirements:
2+ years of experience in hospital or medical claims adjudication
Proficiency in ICD-10, CPT, HCPCS, and DRG coding
Familiarity with managed care, HMO, PPO, and IPA claims processing
Strong knowledge of EOB preparation and explanation of benefits
Experience with claims management software and healthcare information systems
Excellent analytical, problem-solving, and organizational skills
Strong attention to detail with the ability to meet deadlines in a high-volume environment
About Us:
MedPOINT Management is a leading Independent Physician Association (IPA) management company based in Sherman Oaks, CA, dedicated to delivering high-quality administrative and managed care services to healthcare providers across Southern California. Our clients trust us for our expertise, responsiveness, and commitment to operational excellence. Our employees thrive in a collaborative, mission-driven workplace where their contributions directly impact the quality of patient care.
This is a remote position.