Claims Specialist
Whittier, CA 90601
13 Weeks Contract
Shift -Monday - Friday - 07:00am - 03:30pm
Must Have skills
POSITION SUMMARY:
The claims examiner reports directly to the claims manager. They are primarily responsible for the processing functions (operation, adjudication, and payment) of UB-92 and HCFA-1500 claims that are received from PHP affiliated medical groups and hospitals for HMO patients.
EDUCATION/EXPERIENCE/TRAINING:
• High school graduate or equivalent required. Must have physical proof on hand if background check is unable to verify your education background.
• Minimum of 2 years claims ADJUDICATION related experience in ambulatory, acute care hospital, HMO, or IPA environment
• Knowledge of payment methodologies for: Professional (MD), Hospital, Skilled Nursing Facilities, and Ancillary Services
* Knowledge and understanding of timeliness and payment accuracy guidelines for commercial, senior and Medi-Cal claims
* Knowledge of compliance issues as they relate to claims processing
• Experience in interpreting provider contract reimbursement terms desirable
• Ability to identify non-contracted providers for Letter of Agreement consideration
• Data entry experience
• Training on basic office automation and managed care computer systems
Recruiter Details:
Vishakha Singh
Sr IT Recruiter
E-mail: vishakha.singh@ustechsolutionsinc.com
Internal ID-25-43050
About US Tech Solutions:
US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit .
US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
TITLE: Administrative Assistant LOCATION: Culver City, CA (hybrid) ANTICIPATED DURATION: 12 Month Contract Responsibilities: We are looking for an enthusiastic and motivated Administrative Assistant to join our team to support the marketing team. Responsibilities...
...outcomes Requirements What You'll Need: Education: A graduate of an accredited Occupational Therapy program. Experience:... ...Clinical and leadership opportunities ~ Comprehensive Benefits : Medical, dental, vision, 401(k) with match ~ Generous Time Off :...
...promise to life with heart every day and our US Non-Accredited Foreign Graduates play a critical role in supporting our pharmacy teams to... ...escalating patient problems+ Offering to counsel, fielding medical questions, and soliciting information on a patient's medical...
...more about B. Braun Medical, visit Position Summary: This position will be responsible for providing control system engineering support to troubleshoot, maintain and improvement projects of Automation and Controls systems for the Automated Equipment in a dynamic...
...serve as the Recruitment Lead at Kanak-IT INC. I am reaching out to share an excellent career opportunity for the role of Cyber Security Engineer with our esteemed client. If you are interested then please share your updated resume at ****@*****.*** ....