Claims Examiner III
CommonSpirit Health•Bakersfield, CA
10d
About The Position
The Claims Examiner III is an advanced-level role responsible for the detailed and accurate processing, review, and adjudication of complex healthcare claims. This position requires expert knowledge of claims processing, coding, and regulatory compliance. The Claims Examiner III will handle the most challenging cases, mentor junior staff, and contribute to the development of policies and procedures.
Requirements
- 3-5 years of experience in healthcare claims processing, with at least 2 years in a senior or advanced role
- Expert knowledge of CPT, ICD-10, HCPCS coding, and medical terminology.
- Associate’s Degree - Associate’s Degree in healthcare administration, business, or related field preference or experience in lieu of.
Nice To Haves
- 5-7 years of experience in healthcare claims processing, with at least 4 years in a senior or advanced role
- EZCAP: 2 year experience
- Bachelor’s degree in healthcare administration, business, or a related field preferred. Equivalent work experience will be considered.
- Certified Medical Reimbursement Specialist (CMRS), or similar certification is preferred.
- CPC - Certified Professional Coder (CPC)
Benefits
- competitive pay
- Health & Welfare benefits package
- medical, dental and vision plans
- Health Spending Account (HSA)
- Life Insurance and Long Term Disability
- 401k retirement plan with a generous employer-match
- Paid Time Off and Sick Leave
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
Number of Employees
5,001-10,000 employees
