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Providence Health & Services Claims Examiner I - HMO Claims Processing in Mission Hills, California

Description:

Providence is calling a Claims Examiner I (Full Time/Day Shift) to our Facey HMO Claims Processing location in Mission Hills, CA.

In this position you will:

  • Review and process provider claims based on provider and health plan contractual agreement, claims processing and reimbursement guidelines, and company policies and procedures.

  • Respond to and resolve provider and health plan claims inquiries and apply resolution in a timely fashion.

  • Maintain departmental standards on productivity and quality of work.

Qualifications:

Required qualifications for this position include:

  • Two years experiencing HMO claims processing experience required in a managed care environment, preferably PMG/IPA setting within the last three years or any combination of education and/or experience which produces equivalency.

  • Knowledge of medical terminology and coding

  • Familiar with CMS and Dept. of Managed Health Care mandates

  • Able to type 35 wpm

  • Use a ten key adding machine

  • Perform data entry and make mathematical calculations

  • Effective communication skills

About the organization you will serve:

Facey Medical Group is a multi-specialty medical group with over 160 physicians providing care to the growing population in the North & East regions of Los Angeles & Ventura Counties. Twelve medical clinics, including two urgent care centers and dedicated women's centers, are located across the San Fernando, Santa Clarita, San Gabriel and Simi Valleys. The group began as a single medical practice over 90 years ago.

Facey is part of Providence Health & Services, an integrated, not-for-profit 5-state network of hospitals, care centers, medical clinics, affiliated services and educational facilities spanning from California to Alaska .

We offer a full comprehensive range of benefits - see our website for details

http://www.providenceiscalling.jobs/rewards-benefits/

Our Mission

As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.

About Us

Providence Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

Schedule: Full-time

Shift: Day

Job Category: Billing/Insurance

Location: California-Mission Hills

Req ID: 224027

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