Job Description
Job DescriptionSenior Medical Claims Processor/Analyst
$23 – $31
Full-Time | Monday–Friday, 8:00 a.m. – 5:00 p.m.
Bakersfield, CA 93309
Are you a detail-oriented professional with a passion for healthcare and data analysis? We’re looking for a Senior Medical Claims Processor/Analyst to join our growing team! Enjoy a collaborative work culture, competitive pay, excellent benefits, and opportunities for advancement.
Qualifications & Skills:
• Must have at least 5 years of experience in medical claims processing, medical billing, or health insurance
• Knowledge of medical coding (ICD-10, CPT, HCPCS) and claims processing systems.
• Familiarity with federal and state healthcare regulations (ACA, ERISA, Medicare, Medicaid).
Why You’ll Love Working With Us:
• Hybrid once fully trained
• Comprehensive health benefits & 401(k)
• Paid time off
• Supportive and inclusive work environment
• Room for growth
Key Responsibilities:
• Analyze and build complex medical and dental plan structures to ensure accurate claim processing
• Interpret Summary Plan Descriptions (SPDs) to create accurate plan profiles for system setup
• Investigate and resolve claims discrepancies and coding issues
• Provide data-driven recommendations to improve efficiency and accuracy
• Apply ICD-10, CPT, and HCPCS coding to ensure compliance with regulatory standards
• Lead and participate in process improvement initiatives, including automation and auto-adjudication strategies
• Partner with IT, compliance, and operations teams to optimize claims system performance
• Stay current on healthcare regulations including ACA, ERISA, Medicare, and Medicaid
Ready to make a difference in healthcare administration? Apply today and become part of a dedicated team committed to excellence in claims processing.
Equal Opportunity Employer / Disabled / Protected Veterans
The Know Your Rights poster is available here:
https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRi…
The pay transparency policy is available here:
https://www.dol.gov/sites/dolgov/files/ofccp/pdf/pay-transp_%20English_…
For temporary assignments lasting 13 weeks or longer, the Company is pleased to offer major medical, dental, vision, 401k and any statutory sick pay where required.
We are committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation for any part of the employment process, please contact your staffing representative who will reach out to our HR team.
AppleOne participates in the E-Verify program in certain locations as required by law. Learn more about the E-Verify program.
https://e-verify.uscis.gov/web/media/resourcesContents/E-Verify_Partici…
We also consider for employment qualified applicants regardless of criminal histories, consistent with legal requirements, including, if applicable, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance. Pursuant to applicable state and municipal Fair Chance Laws and Ordinances, we will consider for employment-qualified applicants with arrest and conviction records, including, if applicable, the San Francisco Fair Chance Ordinance. For Los Angeles, CA applicants: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.
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Company DescriptionThis company offers growth and a great group of people to work with.