Job Description
Job Description
We are in need of a Medical Claims Examiner immediately for a local union! The individual in this role will be responsible for processing medical, dental and vision claims. Ideal candidates will have 2+ years experience, and will have familiarity with CPT/HCPCS, medical terminology and ICD-9/ICD-10 codes.
About the Role:
- Answer all inquiries pertaining to status, eligibility, benefits, etc.
- Process routine medical, dental and vision claims
- Maintain working knowledge of CPT/HCPC and ICD-9/ICD-10 codes and guidelines
- Maintain all plan documents, plan provisions and other plan materials
- Abide by HIPAA guidelines
- This is not a comprehensive list of duties.
About the Candidate:
- 2+ years of experience in a Medical Claims Adjuster role (MUST)
- PPO claims processing experience (MUST)
- Knowledge of medical terminology, ICD-9/ICD-10 codes, and CPT/HCPCS codes (MUST)
- MS Office Experience (MUST)
- Strong customer service skills (MUST)
- Strong organization skills (MUST)
- Excellent attention to detail (MUST)
- High School Education (MUST)
- Personality, Characteristics and Skills: friendly, professional, honest, reliable, excellent interpersonal communication, advanced written and oral communication, able to multi-task, independent worker, highly organized, efficient, team player, meticulous, detail oriented, positive “can-do” attitude, problem solver
Equal Opportunity Employer considering qualified applicants in accordance with applicable state and federal laws, including those with criminal histories, in a manner consistent with the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance.