Claim Examiner

Duties include: Reviewing & processing all types of medical & facility claims from contracting & non-contracting providers & from subscribers & enrollees for payment in accurate & timely manner; Denying inappropriate claims following policy guidelines; Preparing claims that must be routed to other departments for further review; Obtaining eligibility verification & other health insurance coverage by Internet or POS; Identifying possible CCS eligible claims for further investigation; Maintaining productivity & quality in accordance with established guideline. Required qualifications: High school diploma from accredited school or equivalent; Min. 1 yr. Medical Claims Examiner processing exp. 1st shift. Wage: $22.00 hr. (#6.0108.509 – Bakersfield)