Job Openings in Sacramento County and Beyond

Claims Analyst

Sacramento, CA

Posted: 09/21/2020 Employment Type: Temp-to-Hire Position Industry: Healthcare/Medical Job Number: 42759.1

Job Description

A busy healthcare organization is looking to hire a Claims Analyst to support their corporate office in Sacramento.This is a great temporary 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 andtimely processing of HCFA and UB claims and adjustments to previously processed claims, and completing of denied claims on eligibility and coding.

Responsibilities: Reviews and processes medical claims in accordance with company policies and procedures. Determines coverage, completed eligibility verifications, and identified discrepancies. Reviews 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. Checks for erroneous items or codes and missing information and corrects according to policies and procedures. Maintains claims production standard, and consistently meets quality standards. Receives, sorts and organizes incoming claims for scanning. Updates and corrects denied claims. Prepares and mails out claims correspondence daily. Researches and updates and/or corrects member eligibility.

Requirements: 3 years of claims adjudication or claims processing experience. 3 year in managed care claims processing. HMO/IPA experience strongly preferred. Familiarity with ICD-9/10, 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. Work is thorough, accurate, and effective. Excellent communication skills, including both oral and written. Must have mid-level skills in Microsoft software (Word, Excel, Outlook.) Ability to pass on boarding requirements including both drug and background screening.

Meet Your Recruiter

Elizabeth Mann

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