Claims Processor II
About The Position
Under the direction of the Claims Production Manager and Supervisor, the Claims Processor Level II will be processing outpatient professional and institutional claims. This includes but is not limited to; lab, radiology, ambulance, behavior health, outpatient COB, dialysis, oncology/chemo, hospital exclusions etc., in an accurate and expedient manner. Commitment to Quality: The IEHP Team is committed to incorporate IEHP's Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.
Requirements
- Minimum of two (2) years of experience adjudicating outpatient professional and/or institutional claims preferably in an HMO or Managed Care setting
- Processing of Medicare, Medi-Cal, or Commercial claims required
- Proficient in rate applications for Medi-Cal and/or Medicare pricers
- High school diploma or GED required
Nice To Haves
- ICD-9 and CPT coding and general practices of claims processing
- Prefer knowledge of capitated managed care environment
- Microcomputer skills, proficiency in Windows applications preferred
- Excellent communication and interpersonal skills, strong organizational skills
- Professional demeanor
- Must be computer literate, maintain good attendance, and have the right attitude and discipline to work from home
Benefits
- Competitive salary
- Telecommute schedule
- State of the art fitness center on-site
- Medical Insurance with Dental and Vision
- Life, short-term, and long-term disability options
- Career advancement opportunities and professional development
- Wellness programs that promote a healthy work-life balance
- Flexible Spending Account - Health Care/Childcare
- CalPERS retirement
- 457(b) option with a contribution match
- Paid life insurance for employees
- Pet care insurance
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Industry
Religious, Grantmaking, Civic, Professional, and Similar Organizations
Education Level
High school or GED
Number of Employees
1,001-5,000 employees
