Claims Examiner

Rancho Cordova, CA 95670

Job ID: 113576 Industry: Administrative Pay Rate: $15.00/hour

Claims Examiner
Rancho Cordova, CA
Our client is seeking the very best Claims Examiner. As a Claims Examiner, you ll be responsible for reviewing and adjudicating claims for services provided to members/patients enrolled through the company s clients in accordance with contract and industry standards. The Claims Examiner is an instrumental role in the department.
You re good at:
  • Review claims for covered services as defined by contract and in accordance with the established guidelines for medical optometry claims using ICD-10 and CPT-4 classification systems
  • Prepare correspondence for denied services and requests for additional information needed to support medical optometry claims submitted for processing
  • Assist medical optometry claims supervisor with the ongoing training and development of department staff; manage data collection and reporting in support of time/service and quality assurance goals per industry standards, health plan contract and the organizational standards
  • Collection of data in preparation for external client audits
  • Resolution of escalated claims inquiries in a prompt, courteous, and professional manner
Extra awesome:
  • Two or more years experience in medical optometry claims review/processing
  • Knowledge of medical terminology, ICD-9 and CPT-4 coding and managed care claims administration
  • High degree of computer proficiency with an emphasis placed upon Microsoft Office Products
  • Knowledge of medical terminology & ICD-10 & CPT-4 codes and basic insurance principles
While you may work for our client, Star Staffing will be your employer. Why is that important?
  • You get paid WEEKLY! How cool is that?!
  • You have access to benefits: medical, dental, and vision day one.
  • You have a dedicated recruiter that cares about your success.
  • You have access to dozens of jobs by applying to just one company.
Contact us today!
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