APR Consulting
APR Consulting, Inc. has been engaged to identify a
Claims Examiner . Location:
Whittier, CA 90601 Position:
Claims Examiner Pay Rate:
$29.10 Duration:
13 weeks Expected Shift:
Day 5x8-Hour 07:00 AM - 3:30 PM Note:
ON-SITE INTERVIEW REQUIRED. Orientation time may differ from shift times. Position Summary:
The claims examiner reports directly to the claims manager. They are primarily responsible for processing functions (operation, adjudication, and payment) of UB-92 and HCFA-1500 claims received from PHP affiliated medical groups and hospitals for HMO patients. Qualifications: High school diploma or equivalent; proof required if background check cannot verify education. Minimum of 2 years claims adjudication experience in ambulatory, acute care hospital, HMO, or IPA environment. Knowledge of payment methodologies for professional (MD), hospital, skilled nursing facilities, and ancillary services. Understanding of timeliness and payment accuracy guidelines for commercial, senior, and Medi-Cal claims. Knowledge of compliance issues related to claims processing. Experience in interpreting provider contract reimbursement terms is desirable. Ability to identify non-contracted providers for Letter of Agreement consideration. Data entry experience. Training in basic office automation and managed care computer systems. About our client:
One of the largest healthcare staffing providers in the U.S., assigned at affiliated hospitals/healthcare facilities. All new hires must show proof of vaccination, with accommodations possible for disabilities or religious reasons. About APR:
Since 1980, APR Consulting, Inc. has provided professional recruiting and workforce solutions nationwide. We are an equal opportunity employer. Don't miss out!
If your experience matches, apply today. We look forward to working with you! #J-18808-Ljbffr
Claims Examiner . Location:
Whittier, CA 90601 Position:
Claims Examiner Pay Rate:
$29.10 Duration:
13 weeks Expected Shift:
Day 5x8-Hour 07:00 AM - 3:30 PM Note:
ON-SITE INTERVIEW REQUIRED. Orientation time may differ from shift times. Position Summary:
The claims examiner reports directly to the claims manager. They are primarily responsible for processing functions (operation, adjudication, and payment) of UB-92 and HCFA-1500 claims received from PHP affiliated medical groups and hospitals for HMO patients. Qualifications: High school diploma or equivalent; proof required if background check cannot verify education. Minimum of 2 years claims adjudication experience in ambulatory, acute care hospital, HMO, or IPA environment. Knowledge of payment methodologies for professional (MD), hospital, skilled nursing facilities, and ancillary services. Understanding of timeliness and payment accuracy guidelines for commercial, senior, and Medi-Cal claims. Knowledge of compliance issues related to claims processing. Experience in interpreting provider contract reimbursement terms is desirable. Ability to identify non-contracted providers for Letter of Agreement consideration. Data entry experience. Training in basic office automation and managed care computer systems. About our client:
One of the largest healthcare staffing providers in the U.S., assigned at affiliated hospitals/healthcare facilities. All new hires must show proof of vaccination, with accommodations possible for disabilities or religious reasons. About APR:
Since 1980, APR Consulting, Inc. has provided professional recruiting and workforce solutions nationwide. We are an equal opportunity employer. Don't miss out!
If your experience matches, apply today. We look forward to working with you! #J-18808-Ljbffr