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Kern Family Health Care

Claims Examiner - Temporary

Kern Family Health Care, Bakersfield, California, United States, 93399

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Claims Examiner - Temporary

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Kern Family Health Care .

Kern Family Health Care provided pay range This range is provided by Kern Family Health Care. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range $22.00/hr - $22.00/hr

This is a full‑time temporary position. If selected, onboarding will be completed through a staffing agency.

About us

Kern Health Systems is dedicated to improving the health status of our members through an integrated managed health care delivery system.

Essential Duties and Responsibilities Resolve system suspended claims for:

PCPs

Labs

Radiology

Less complicated specialists

Physical Therapy

Prepare claims that must be routed to other departments for further review.

Review difficult claims with guidance from Claims Supervisor.

Responsible for identifying billing errors and possible fraudulent claims submissions.

Obtain eligibility verification and other health insurance coverage by Internet or POS.

Responsible for correct manual calculation of benefits when applicable.

Responsible for identifying possible CCS eligible claims for further investigation.

Report overpayment refund requests on SharePoint log.

Maintain productivity and quality in accordance with established guideline.

Perform other job-related duties as required.

Regular predictable attendance.

Adheres to all company policies and procedures relative to employment and job responsibilities.

Employment Standards High School Diploma from an accredited school or equivalent.

Minimum of one (1) year medical Claims Examiner processing experience.

Seniority Level Not Applicable

Employment Type Full‑time

Job Function Finance and Sales

Industries Hospitals and Health Care

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