Claims Examiner I/II

Duties include: Reviewing & processing all types of medical & facility claims from contracting & non-contracting providers & from subscribers & enrollees for payment in accurate & timely manner; Applying correct contract benefits, policies, & procedures; Denying inappropriate claims following policy guidelines; Identifying billing errors & possible fraudulent claims submissions; Maintaining productivity & quality in accordance with established guidelines. Required qualifications: 1-2 yrs medical claim payment or medical billing processing exp.; Exp. with investigating COB & medical terminology; Exp. in claims processing from payor standpoint; Familiarity with CPT & ICD-9 coding, COB & subrogation investigation. 1st shift. Wage: $22.00 hr. (#6.0713.209 – Bakersfield)