Claims Processing Clerk, Sr. jobs in Riverside, CA

Claims Processing Clerk, Sr. receives and inputs new healthcare claims, processes payments, conducts billing research, and responds to telephone inquires. Evaluates claims and administers payment, denies, or returns claims according to policy provisions and organizational guidelines. Being a Claims Processing Clerk, Sr. produces routine and ad hoc reports. Requires a high school diploma. Additionally, Claims Processing Clerk, Sr. typically reports to a supervisor. The Claims Processing Clerk, Sr. works independently within established procedures associated with the specific job function. Has gained proficiency in multiple competencies relevant to the job. To be a Claims Processing Clerk, Sr. typically requires 3-5 years of related experience. (Copyright 2024 Salary.com)

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Manager, Claims Processing - Covered California
  • Inland Empire Health Plan
  • Rancho Cucamonga, CA FULL_TIME
  • Overview

    What you can expect! 

     

    Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!

     

    The Manager, Claims Processing - Covered California is responsible for oversight and direction of claims and auditing activities of the Covered California (CCA) vendor and personnel.  This position requires excellent communication, collaboration and leadership skills and the ability to provide detailed instructions to vendor and staff while monitoring inventory and compliance metrics within the department to ensure that our provider and member needs are met in a timely manner.

    Additional Benefits

    Perks

     

     

    IEHP is not only committed to healing and inspiring the human spirit of our Members; we also aim to match our Team Members with the same energy by providing prime benefits and more.

     

    • CalPERS retirement
    • 457(b) option with a contribution match
    • Generous paid time off- vacation, holidays, sick
    • State of the art fitness center on-site
    • Medical Insurance with Dental and Vision
    • Paid life insurance for employees with additional options
    • Short-term, and long-term disability options
    • Pet care insurance
    • Flexible Spending Account – Health Care/Childcare
    • Wellness programs that promote a healthy work-life balance
    • Career advancement opportunities and professional development
    • Competitive salary with annual merit increase
    • Team bonus opportunities

    Qualifications

    Education & Experience

    • Five (5) years of claims processing experience, at least (3) three of which was in a management capacity
    • Three (3) years of experience in an HMO or managed care environment.
    • Experienced in benefit and interpretation, regulatory payment appeals, and claim adjudication
    • The Manager must have past Covered California or Commercial claims processing experience
    • Bachelor’s degree from an accredited institution required, degree preferably in Business Administration, Accounting or Healthcare from an accredited institution required

     

     

     

     

    Key Qualifications

    • Excellent communication, collaboration, and leadership skills.

     

    Start your journey towards a thriving future with IEHP and apply TODAY!

     

     

    Pay Range

    USD $50.02 - USD $66.27 /Hr.
  • 9 Days Ago

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Workers Compensation Claims Examiner
  • TheBest Claims Solutions
  • Riverside, CA FULL_TIME
  • We are currently sourcing candidates for a Claims Examiner position. This position is direct-hire and remote. For this position we are looking for candidates with 3 years of experience handling Califo...
  • 14 Days Ago

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MD Telephone Claims Representative Trainee, I, II or Sr.
  • Direct Auto Insurance
  • Ontario, CA FULL_TIME
  • Job Description Job Summary:The Claims Inside Auto Trainee Analyst II is responsible for investigating and confirming the facts of loss for automobile accidents. This role determines coverage, liabili...
  • 9 Days Ago

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Business to Business Sales Consultant
  • Southland Data Processing
  • Upland, CA FULL_TIME
  • The Business Sales Consultant is responsible for supporting the sales department with sourcing new sales opportunities. Fostering relationships with individuals and companies in the community in order...
  • 17 Days Ago

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Customer Service Representative
  • Southland Data Processing
  • Upland, CA FULL_TIME
  • Customer Service Representative is expected to make day to day decisions regarding Client Services, scheduling, processing, training, solving customer problems, and other related matters that are with...
  • 17 Days Ago

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Director of Regional Sales
  • Southland Data Processing
  • Upland, CA FULL_TIME
  • The Director of Regional Sales primary mission is to identify new prospects and sell our human resources, time and attendance, payroll, benefits administration and other modular SaaS solutions. The Di...
  • 17 Days Ago

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0 Claims Processing Clerk, Sr. jobs found in Riverside, CA area

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Accounts Receivable Accountant
  • Del Real Foods
  • Mira Loma, CA
  • Job Description Job Description Hello! We are looking for a dedicated Accounts Receivable Clerk to join the family! Del ...
  • 3/28/2024 12:00:00 AM

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Produce Clerk
  • Superior Grocers
  • Fontana, CA
  • Produce Clerk is responsible for the proper stocking and rotation of merchandise in the produce and floral department, i...
  • 3/28/2024 12:00:00 AM

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Hot Foods Clerk
  • Superior Grocers
  • Fontana, CA
  • Hot Foods Clerk takes customer orders, ring up Hot Foods sales while providing 5 Star customer service. Responsible for ...
  • 3/28/2024 12:00:00 AM

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Receiving Clerk
  • Superior Grocers
  • Fontana, CA
  • Receiving clerk must maximize sales potential through effective and proper procedures for receiving all products enterin...
  • 3/28/2024 12:00:00 AM

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Meat Service Clerk
  • Superior Grocers
  • Fontana, CA
  • Meat Service Clerk main focus will be delivering great customer service to secure store's financial success. Meat Servic...
  • 3/28/2024 12:00:00 AM

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Receiving Clerk
  • Superior Grocers
  • Rialto, CA
  • Receiving clerk must maximize sales potential through effective and proper procedures for receiving all products enterin...
  • 3/28/2024 12:00:00 AM

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Grocery Night Crew Clerk
  • Superior Grocers
  • Moreno Valley, CA
  • Grocery Night Crew Clerk is responsible for maintaining shelves filled with stock, and keeping shelves neat. Focus on de...
  • 3/27/2024 12:00:00 AM

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Grocery Clerk
  • Superior Grocers
  • Fontana, CA
  • Grocery Clerk will maintain stocking and rotation of merchandise in the grocery area and to perform other functions as r...
  • 3/25/2024 12:00:00 AM

Riverside is a city in Riverside County, California, United States, located in the Inland Empire metropolitan area. Riverside is the county seat of the eponymous county and named for its location beside the Santa Ana River. It is the most populous city in the Inland Empire and in Riverside County, and is located about 55 miles (89 km) east of downtown Los Angeles. It is also part of the Greater Los Angeles area. Riverside is the 59th most populous city in the United States and 12th most populous city in California. As of the 2010 Census, Riverside had a population of 303,871. Riverside was fou...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Processing Clerk, Sr. jobs
$51,258 to $63,225
Riverside, California area prices
were up 3.0% from a year ago

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Claims Processing Clerk, Sr. in Asheville, NC
When you’re in the beginning stages of writing your insurance claims processing clerk job description, you’ll need to review common qualifications for this job.
January 12, 2020