Job #2664: Healthcare
Title:Claims Processor II
Job Location:San Diego CA
Let us use our contacts are Rady’s Children’s Hospital to land you a temp job (to possible hire) as a Claims Processor II.
Department: CHOC Administration Location- Copely
Schedule: M-F 8:00 a.m. -5:00 p.m. Duration: 13 weeks, possible extension
Pay: $15 to $17/hr depending on experience
+ The primary purpose of this Claims Processor II position is to examine and process claims from the UB04 and CMS-1500 claim forms into the claims adjudication system for all capitated and shared services accounts.
+ This position is responsible for the accurate review, input and adjudication of claims using reasonable payment policies and methodologies that are consistent with and recognized by Health Plans, nationally recognized medical organizations, federal regulatory bodies, and contractual obligations of the organization.
+ Provide expertise and/or general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims
+ Authorize appropriate payment or refer claims for further investigation as appropriate
+ Analyze and identify trends
+ Consistently meet established productivity schedule, adherence, and quality standards
+ Process priority and special claims requests • Process claims adjustments and/or appeals
+ Minimum Qualifications: High School Diploma, GED or foreign equivalent;
+ 2 year experience required
+ Preferred Qualifications: High School Diploma, GED or foreign equivalent;3 year experience required.
+ Preferred knowledge of CMS-1500 and UB04 claim form types
+ Familiar with CPT, HCPC, ICD-10/ICD-9 coding structures, and Medi-cal Managed Care.
References will be requested.
Since the job needs to be filled immediately please email your resume as soon as possible.
We will contact you on receipt!
Leslie Delos Reyes
Global Service Resources, Inc.
Job Type: Contract