Job Description
Job Description
LHH is seeking a dedicated and detail-oriented Medical Claims Examiner to join our healthcare client's team in Folsom, CA.
This is an excellent direct hire opportunity for professionals with experience in claim adjudication, submissions, or reviews.
If you are dedicated and passionate about the industry, please apply today!
Responsibilities
Ensure proper procedures are followed for adjudications and payments, coordination of benefits and final determination on claims.
Verifying member benefits, conduct research for proper eligibility requirements.
Properly adjudicate claims, respond to inquiries while conducing problem resolution techniques on service issues.
Oversee and review the entire claims process from submission to resolution.
Conclude commercial claim adjudication processes, either for payment or denial, within 45 business days from receipt.
Qualifications
Prior experience in claim adjudication, claim submissions, or claim reviews is required.
Strong analytical and problem-solving skills, attention to detail, and ability to work in a fast-paced environment.
Must be highly proficient in ICD-10, CPT, and HCPCS codes
Minimum 2+ years of experience in Full Cycle Medical Claims in the healthcare industry
Pay Details : $20.00 to $25.00 per hour
Benefit offerings include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and 401K plan.
Our program provides employees the flexibility to choose the type of coverage that meets their individual needs. Available paid leave may include Paid Sick Leave, where required by law;
any other paid leave required by Federal, State, or local law; and Holiday pay upon meeting eligibility criteria.
Pay Details : $20.00 to $25.00 per hour
Search managed by : Jessica Roberts
Equal Opportunity Employer / Veterans / Disabled
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 subject to federal contractor requirements and / or security clearance requirements.
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