Claims Analyst
Share
Job Location:
Sacramento, CA - USA
Monthly Salary:
Not Disclosed
Posted on:
30+ days ago
Vacancies:
1 Vacancy
Job Summary
We are recruiting for multiple Claims Analysts to support a busy healthcare department at their corporate office in Sacramento. This is a contract to hire opportunity with a progressive organization who specializes in connecting people with support resources and access to healthcare. The Claims Analyst will be responsible for the accurate and timely processing of CMS-1500 and CMS-1450 (UB-04) claims forms adjustments to previously processed claims and completing denied claims due to eligibility and coding. Mon-Fri onsite (hybrid opportunity after training and probationary period).
The qualified candidate will have at least one year of experience with Medicare claims processing and adjudication.
Pay: $23/hour
PRIMARY RESPONSIBILITIES:
Review and process medical claims in accordance with company policies and procedures.
Determine coverage complete eligibility verifications and identify discrepancies.
Review claims or referral submissions to determine review or apply appropriate guidelines member identification processes provider selection and claim coding including procedure diagnosis and pre-coding requirements.
Check for erroneous items or codes missing information and make corrections according to policies and procedures.
Maintain claims production standard and consistently meet quality standards.
Receive sort and organize incoming claims for scanning.
Update and correct denied claims.
Prepare and mail out daily claims correspondence.
Research update and/or correct member eligibility.
SKILLS & QUALIFICATIONS:
1 year of Medicare claims processing experience required.
1 years in managed care claims processing and claims adjudicationdesired.
High School Diploma required Associates degree preferred.
Medicare HMO/IPA experience required.
Familiarity with ICD-10 HCPCS CPT coding modifiers DMHC regulations facility and professional claim billing practices.
Ability to maintain quality goals in a production driven environment.
Follow through on commitments and meets deadlines.
Excellent communication skills including both oral and written.
Ability to pass a drug screen and background check.
Required Experience:
IC
Key Skills
- Corporate Paralegal
- Baan
- IT Sales and Marketing
- Civil Quality Control
- Activex
- Jboss
About Company
Pacific Staffing in Sacramento, one of the top Sacramento staffing agencies, provides temporary staffing, recruiting and employment services in Sacramento and beyond.
