PPO Claims Examiner I Job in Monterey Park 91756, California US
Essential Job Functions: -Maintain all required documentation of claims processed and claims onhand.
-Manually adjudicate claims in accordance with departmental policies and procedures and other rules applicable to specialty claims.
-Maintain production standards established by claims management.
Standards of 115 claims per day-Coordinate resolution of claims issues with other Departments or Payers.
-Provide backup for other examiners within the Department.
-Ability to handle provider/Health Plan Appeals-Ability to read/interpret benefit contracts-Ability to interpret the Division of Financial Responsibility-Promote a spirit of cooperation and understanding among all personnel.
-Attend organizational meetings as required.
-Adhere to organizational policies and procedures.
-Accurately review all incoming Provider claims to verify necessary information is available.
Required Skills: PROFESSIONAL CLAIMS, HEAVY VOLUME CLAIMS, HMO CLAIMS, PPO CLAIMS, MANUAL ADJUDICATION EXPERIENCEJoin Aerotek Professional Services.
Our customized employment solutions and personalized approach give job seekers access to great opportunities with competitive salaries.
Aerotek offers comprehensive benefits that can include medical, dental, optical, and optional 401k.
Don't put your career in the hands of just anyone; put it in the hands of a specialist.
Launch or rejuvenate your career today with Aerotek Professional Services! Allegis Group and its subsidiaries are equal opportunity employers.
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