Claims Analyst

Pacific Temporary Services • Sacramento, CA

1d • $23 • Onsite

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 (6 months) opportunity with potential for hire based on performance and business needs. Our client is a progressive organization that 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. The qualified candidate will have at least one year of experience with Medicare and Medi-Cal claims processing and adjudication. Pay: $23/hour Schedule: Mon-Fri, onsite (hybrid opportunity after training and probationary period).

Requirements

• 1 year of Medicare and or/Medi-Cal claims processing experience required.
• High School Diploma required.
• Ability to maintain quality goals in a production driven environment.
• Ability to follow through on commitments and meet deadlines.
• Excellent communication skills, including both verbal and written.
• Ability to pass a drug screen and background check.

Nice To Haves

• 1 years in managed care claims processing and claims adjudication desired.
• Associate’s degree preferred.
• Medicare HMO/IPA experience preferred.
• Familiarity with ICD-10, HCPCS, CPT coding, modifiers, DMHC regulations, facility, and professional claim billing practices.

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

• Career Level: Entry Level
• Education Level: High school or GED