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Long Beach,
CA
(Click company name to view employer profile and all available
positions.) |
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Career Field |
Claims
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| Insurance
Discipline |
Managed Care
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| Relocation
Assistance |
Not Available
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| Job
Duration |
Full Time |
| Salary
Offered |
Open |
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Molina Healthcare Inc., is among the most experienced managed healthcare companies serving patients who have traditionally faced barriers to quality healthcare-including individuals covered under Medicaid, the Healthy Families Program, the State Children's Health Insurance Program (SCHIP) and other government-sponsored health insurance programs. Molina has health plans in California, Michigan, New Mexico, Utah, Ohio, Texas, Washington and Florida as well as 19 primary care clinics located in Northern and Southern California. The company's corporate headquarters are in Long Beach, California.
CLAIMS EXAMINER II
Job Overview:
Claims Processing and adjudication, claims research when necessary. Must meet and/or exceed qualitative production standards.
Quality Standard- Must meet and Maintain the quality rate.
Claims Adjudication- Must meet and consistently maintain production standards.
Teamwork- Rating is based upon individual contribution to both the group and the goals of the group. This area will be rated using the outcome of team goals.
Supports all Departmental Initiatives in improving overall efficiency.
Special Projects.
Supports Supervisors/Manager with Reports, Special Processes, etc.
Perform other duties as assigned.
Job Requirements:
Education:
· High School graduate at minimum
· Some college education preferred
Experience:
· General knowledge of PC usage
· Good verbal & written communication
· 3-5 years of claims processing
· Experience in processing of HCFA 1500, Outpatient/Inpatient UB92, Universal Claim Form
Additional Skills and Knowledge:
1. Must know computerized claims processing systems
2. Data entry and 10-key skills by touch and sight.
3. Knowledge of CPT, RVS, ICD-9, HCPCS or other coding
4. Comprehensive knowledge of medical terminology
Knowledge of DRG pricing, anesthesia claims, in-patient claims, COB
Molina Healthcare offers competitive benefits and compensation package.
Molina Healthcare is an Equal Opportunity Employer.(EOE). M/F/V/D
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