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Senior Claims Examiner, PIH Health Physicians; Claims, Full time, 7:00 am - 3:30 pm

PIH Health

Senior Claims Examiner, PIH Health Physicians; Claims, Full time, 7:00 am - 3:30 pm

Whittier, CA
Full Time
Paid
  • Responsibilities

    We’re a nonprofit, regional healthcare network with two hospitals, numerous outpatient medical offices, a multi-specialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer and emergency services. Our leadership is dedicated to putting patients first—a cornerstone of our mission, vision and values—as we deliver top-quality healthcare.

     

    From our extensive facilities in Whittier, California and Downey, California, PIH Health serves more than two million residents in Los Angeles and Orange Counties and throughout the San Gabriel Valley.

     

    The SENIOR CLAIMS EXAMINER administers health plan contracts by processing medical claims in an efficient, cost-effective, and timely manner meeting all required guidelines and performs adjustments as necessary.

    Required Skills

    • Computer and 10-key skills by touch;
    • Knowledge of medical terminology, CPT/RBRVS/ICD-9 codes;
    • Full understanding of HMO & capitation concepts and Medicare guidelines;
    • Excellent communication skills;
    • Ability to work independently and function under time deadlines.

    Required Experience

    • Must have a high school diploma or G.E.D.
    • MUST HAVE A MINIMUM TWO (2) YEARS MEDICAL CLAIMS PROCESSING EXPERIENCE

     

    Beyond the benefits that come with working for the area's leading community healthcare provider – one that also recognizes the need to ensure patient safety and comfort – you'll enjoy an extremely competitive compensation and benefits package.  We are an equal opportunity employer and seek diversity in our workforce.   EOE M/F/D/V

  • Qualifications
    • Computer and 10-key skills by touch;
    • Knowledge of medical terminology, CPT/RBRVS/ICD-9 codes;
    • Full understanding of HMO & capitation concepts and Medicare guidelines;
    • Excellent communication skills;
    • Ability to work independently and function under time deadlines.