Los Angeles, CA, 90006, USA
4 days ago
Claims Review Specialist
Claims Review Specialist 2797750 One of the most prestigious and well-known universities is seeking a Claims Review Specialist. The ideal candidate has three years of previous experience working for a Health Plan, IPA, or other Managed Care Organization. The company offers a great work environment! Claims Review Specialist Pay and Benefits: * Hourly pay: $40/hr * Worksite: One of the most prestigious and well-known universities (Los Angeles, CA 90024 - Hybrid) * W2 Employment, Group Medical, Dental, Vision, Life, Retirement Savings Program, PSL * 40 hours/week, 6 Month Assignment Claims Review Specialist Qualifications: * 3+ years of previous experience working for a Health Plan, IPA, or other Managed Care Organization. * 2+ years of previous direct experience that included verifying and maintaining provider information and provider contract configuration in a managed care transaction system. * High school diploma, GED or equivalent required. Two-year degree is preferred. * At least one of these 3 certifications: CPC, CPCH, CCS. * Working knowledge of one or more of the following managed care transaction systems: EPIC (Tapestry Module), EZ Cap, Facets, QNXT. * Working knowledge of CPT-4, ICD-9/ICD-10, and HCPCS codes. * Ability to interpret a variety of instructions furnished in written, oral, diagram and schedule form including provider contracts and contract summaries. * Ability to adhere to detailed data entry procedures in a complex system with high accuracy for alpha and numeric data inputting. * Strong organizational skills and the ability to manage aggressive timelines and prioritize multiple concurrent tasks while maintaining high quality standards. * Proficient computer skills including Microsoft Excel and Word. Competence in navigating the internet. * Excellent customer service and interpersonal skills, with an ability to work with internal and external representatives * Willingness to learn new technologies, practices and procedures.
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