Medical Claims Examiner

Needed in Bakersfield, CA. 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; Preparing claims that must be routed to other departments for further review; Identifying billing errors & possible fraudulent claims submissions; Reporting overpayment refund requests; Identifying possible CCS eligible claims for further investigation. Required qualifications: High school diploma from accredited school/equivalent; Min. 1 yr. Medical Claims Examiner processing exp. Exp. with Claims Processing & Med-Cal preferred. Temporary position. Wage: $22.00 hr. (#5.1106.109 – Bakersfield)