HMO Claims Examiner - Claims Processing - Position #2021-333

HMO CLAIMS EXAMINER - CLAIMS PROCESSING - Position #2021-333

Date Posted:
Classification:
Administrative
Type
Full Time
Location
OPEN UNTIL FILLED Redlands Monday - Friday 6:00a.m. - 2:30p.m.

Job Description

The HMO Claims Examiner administers HMO contracts by processing medical claims in an efficient, cost-effective, and timely manner. Responsible for determining financial responsibility between group, health plans and contracted hospitals for accurate processing of claims. 

Qualifications

High School Diploma or equivalent. Course work and knowledge of medical terminology preferred. One year of claims adjudication or claims data entry processing experience in a Managed Care/IPA environment. Two years of experience preferred. Knowledge of medical terminology, ICD9 and CPT/RVS codes required; clerical ability necessary, including ten-key calculator, computer, and light typing skills 35wpm. Ability to multi-task in an efficient, thorough, and prioritized manner; to work quickly, accurately and independently; and, to anticipate needs and solve problems. 

Applications must be complete and demonstrate that the minimum qualifications are met. Resumes may be attached to completed application form as supplemental information, but will not be accepted in lieu of an official application form. Applications will be screened and the most qualified candidates who best match the needs of the position will be invited to compete further in the recruitment process.  Due to the large volume of applications received, we are unable to track for individual applications or discuss the application process.

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