Claims Processor – Healthcare

The CSI Companies
Published
January 9, 2021
Location
Buena Park, CA
Category
Job Type

Description

The CSI Companies are hiring a Healthcare Claims Processor for one of our Fortune 500 healthcare clients in La Palma, CA. As one of the most respected healthcare companies, not only do they have a great company culture they offer incentives such as pay raises, benefits, and internal growth!

Title of Job: Healthcare Claims Processor

Pay: $20-25.50 an hour

Shift: M-F 7:30am-4pm

Status: Full Time; Temp to Perm (outstanding benefit package once permanent)

Location: La Palma, CA

Effective Date / Tentative Start Date: Interviewing Immediately

Position Summary:

This position is responsible for batching and prioritizing claims processing utilizing the Company’s in-house claims processing system

Day-to-day activities include, but are not limited to, all the essential functions listed below:

  • To batch and prioritize claims processing utilizing the Company’s in-house claims processing system.
  • Verify patient’s accounts for eligibility and benefits
  • Accurately process complex claims that have been accepted for payment.
  • Request and follow-up on additional information as needed for incomplete claims.
  • Complete all steps above within designated timeframes (production quotas) and notify management if claims cannot be processed within the designated time frame.
  • Assemble denial letter background information and generate denial letters.
  • Read, interpret and summarize medical contracts/division of responsibility.
  • Identify claims that is not our financial risk and forward to appropriate entity for payment.
  • Review claims that is pending and follows through for payment in a timely manner.
  • Treat peers, superiors, subordinates clients and vendors with fairness, courtesy and professionalism and contribute to the overall positive work environment of the department.
  • Complete other production projects as assigned.
  • Ability to process both IPA and Hospital claims.

What qualifications do I need to have?

  • 3 plus years claims adjudicating experience preferably ideally in a managed care setting
  • High school diploma or GED

What Will My Day Look Like?

  • We offer a competitive weekly salary and an opportunity for ongoing development that will further your career in the healthcare industry.
  • Participate in various projects to help you grow in your career path in the fast-paced healthcare industry.
  • You, your team and your manager will share goals, customer feedback and metrics to help you reach all of your weekly goals.
  • Attend staff meetings and participate in discussions
  • Required to maintain confidentiality and security of documents.

About Us

The CSI Companies is a recruiting firm established in 1994 that has been awarded “Best of Staffing” for 5 years in a row. We provide outstanding services to the world’s leaders in the healthcare field as well as other organizations. For consideration, please submit your resume with all of your relevant experience included on it for immediate consideration. Only those candidates identified for an interview will be contacted.

Benefits Offered:

  • Weekly pay
  • Medical, dental, and vision coverage
  • Voluntary Life and AD&D coverage
  • Paid Training
  • Opportunity for advancement upon performance and availability

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