Claims Analyst

Pacific Temporary Services • Sacramento, CA

7h • $23 • Hybrid

About The Position

We are recruiting for multiple Claims Analysts to support a busy healthcare department at their corporate office in Sacramento. This is a contract to hire opportunity with a progressive organization who specializes in connecting people with support resources and access to healthcare. The Claims Analyst will be responsible for the accurate and timely processing of CMS-1500 and CMS-1450 (UB-04) claims forms, adjustments to previously processed claims and completing denied claims due to eligibility and coding. Mon-Fri, onsite (hybrid opportunity after training and probationary period). The qualified candidate will have at least one year of experience with Medicare claims processing and adjudication. Pay: $23/hour

Requirements

• 1 year of Medicare claims processing experience required.
• Medicare HMO/IPA experience required.
• Familiarity with ICD-10, HCPCS, CPT coding, modifiers, DMHC regulations, facility, and professional claim billing practices.
• Ability to maintain quality goals in a production driven environment.
• Follow through on commitments and meets deadlines.
• Excellent communication skills, including both oral and written.
• Ability to pass a drug screen and background check.
• High School Diploma required

Nice To Haves

• 1 years in managed care claims processing and claims adjudication desired.
• Associate’s degree preferred.

Responsibilities

• Review and process medical claims in accordance with company policies and procedures.
• Determine coverage, complete eligibility verifications, and identify discrepancies.
• Review claims or referral submissions to determine, review, or apply appropriate guidelines, member identification processes, provider selection, and claim coding, including procedure, diagnosis, and pre-coding requirements.
• Check for erroneous items or codes, missing information and make corrections according to policies and procedures.
• Maintain claims production standard and consistently meet quality standards.
• Receive, sort, and organize incoming claims for scanning.
• Update and correct denied claims.
• Prepare and mail out daily claims correspondence.
• Research, update and/or correct member eligibility.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED