Claims Examiner, Sr. jobs in Sacramento, CA

Job Description

Looking for a medical claims examiner to join a top tier health care company here in Sacramento!

You will be responsible for adjudicating medical claims accurately and in a timely manner to ensure state regulations are met. The Claims Examiner I provides thorough review, analysis, and on-time adjudication of claim payment determinations, ensuring payments are billed at the correct contracted rate.

-Analyze claims for appropriate payer, based on combination of coding, medical group's service area

- Make claim payment determinations established by internal policy and regulatory agencies

- Process claims, and make payment adjustments as necessary

-1 year of experience, preferably with an HMO

$18.00-$20.00 an hour DOE

All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance.