Job Description
Job Description Job Title: Claims Adjuster
Location: Pleasanton, CA
Pay: $33-$35 per hour
Schedule: Monday-Friday, 8:30 AM-5:00 PM (30-minute lunch + two 15-minute breaks)
Employment Type: Contract (6 months+, potential for extension or conversion)
Key Responsibilities
- Handle high-volume inbound calls (up to 40 calls/day) regarding medical claims
- Review and interpret medical claims, coding, and benefits information
- Verify accuracy of coding and supporting documentation
- Assist members in understanding claims and next steps
- Route or escalate claims to appropriate parties when needed
- Input and maintain accurate data in internal systems
- Collaborate with team members and proactively ask questions when needed
Qualifications
- Required: Bilingual in Spanish
- Experience with medical terminology, medical coding, and/or claims processing
- Ability to assess and make judgment calls on claim accuracy
- Strong attention to detail and problem-solving skills
- Comfortable handling high call volumes in a fast-paced environment
- Confident communicator who is not hesitant to ask questions
Systems & Tools
- Microsoft Teams
- Microsoft Excel
- Basis (data entry for member information)
- Phone systems (daily use)
Pay Details: $33.00 to $35.00 per hour
Search managed by: Joyce Reyes
Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.
Equal Opportunity Employer/Veterans/Disabled
Military connected talent encouraged to apply
To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.lhh.com/us/en/candidate-privacy
The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:
- The California Fair Chance Act
- Los Angeles City Fair Chance Ordinance
- Los Angeles County Fair Chance Ordinance for Employers
- San Francisco Fair Chance Ordinance
Massachusetts Candidates Only: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.