Examiner Salary at Eoc Co Ltd BETA

WHO WE ARE: AMAZING INDIVIDUALS WORKING FOR POSITIVE PEOPLE at AIDS Healthcare Foundation! Does the idea of doing something that really makes a difference in peoples lives while being well-compensated intrigue you? Are you looking to work for an organization that encourages growth and success from each and every one of its employees? If so, AIDS Healthcare Foundation is the place for you! Founded in 1987, AIDS Healthcare Foundation is the largest specialized provider of HIV/AIDS medical care in the nation. Our mission is to provide cutting edge medicine and advocacy, regardless of ability to pay. Through our healthcare centers, pharmacies, health plan, research and other activities, AHF provides access to the latest HIV treatments for all who need them. AHFs core values are: Patient-Centered Value Employees Respect for Diversity Nimble Fight for Whats Right STILL INTERESTED? Please continue! YOUR CONTRIBUTION TO OUR SUCCESS!: The Claims Department is a dynamic department that provides

Medical Claims Examiner - Remote - Fresno, CA *100% Remote for Central Valley candidates* Candidates are required to attend occasional trainings/meetings in Fresno, CA The Company: A well-respected insurance company in California with over 25 years in the business is looking to add a Medical Claims Examiner! This company is dedicated to helping clients, providing excellent customer service, and truly investing in their employees. What’s in it for you? $18.00 - $20.00/hour depending on experience Remote position + few weeks of training in the office What we need from you: Experience - 1-2+ years reviewing and processing medical, dental, and vision claims Education - High school diploma required, college degree preferred Software - You are proficient with data entry, Microsoft Office, Outlook, carrier websites, and other software systems as needed for the position Comprehensive knowledge - You have data entry coding and medical claims processing experience What you will be doing: Compreh

Job Description Job Description Claims Examiner (Remote) Must have DOFR Must have processed lab claims POSITION SUMMARY: The claims examiner reports directly to the claims manager. They are primarily responsible for the processing functions (operation, adjudication, and payment) of UB-92 and HCFA-1500 claims that are received from PHP affiliated medical groups and hospitals for HMO patients. EDUCATION/EXPERIENCE/TRAINING: • High school graduate or equivalent required. Must have physical proof on hand if background check is unable to verify your education background. • Minimum of 2 years claims ADJUDICATION related experience in ambulatory, acute care hospital, HMO, or IPA environment • Knowledge of payment methodologies for: Professional (MD), Hospital, Skilled Nursing Facilities, and Ancillary Services * Knowledge and understanding of timeliness and payment accuracy guidelines for commercial, senior and Medi-Cal claims * Knowledge of compliance issues as they relate to claims processi

Medical Claims Examiner - Remote - Fresno, CA *100% Remote for Central Valley candidates* Candidates are required to attend occasional trainings/meetings in Fresno, CA The Company: A well-respected insurance company in California with over 25 years in the business is looking to add a Medical Claims Examiner! This company is dedicated to helping clients, providing excellent customer service, and truly investing in their employees. What’s in it for you? $18.00 - $20.00/hour depending on experience Remote position + few weeks of training in the office What we need from you: Experience - 1-2+ years reviewing and processing medical, dental, and vision claims Education - High school diploma required, college degree preferred Software - You are proficient with data entry, Microsoft Office, Outlook, carrier websites, and other software systems as needed for the position Comprehensive knowledge - You have data entry coding and medical claims processing experience What you will be doing: Compreh

Medical Claims Examiner - Remote - Fresno, CA *100% Remote for Central Valley candidates* Candidates are required to attend occasional trainings/meetings in Fresno, CA The Company: A well-respected insurance company in California with over 25 years in the business is looking to add a Medical Claims Examiner! This company is dedicated to helping clients, providing excellent customer service, and truly investing in their employees. What’s in it for you? $18.00 - $20.00/hour depending on experience Remote position + few weeks of training in the office What we need from you: Experience - 1-2+ years reviewing and processing medical, dental, and vision claims Education - High school diploma required, college degree preferred Software - You are proficient with data entry, Microsoft Office, Outlook, carrier websites, and other software systems as needed for the position Comprehensive knowledge - You have data entry coding and medical claims processing experience What you will be doing: Compreh

Job Description: To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements. Requirements: California WC claims knowledge SIP certificate Min. 3 Years of experience Remote in CA NIT001

Job Description Job Description The web inquiry examiner is responsible for the review and adjudication of claims inquiries submitted via the web portal, in accordance with outside regulations and the contractual obligations of the Health Plans and/or the IPAs. Researches, reviews and contacts provider services for problem claims and issues, as needed. Suggests process improvements to management and is a resource of information to all staff. Duties and Responsibilities · Accurately review all incoming web inquiry requests for adjudication. · Meets production standards of 20-100 claims as established by claims management. · Adjust claims in accordance with departmental policies and procedures and other rules applicable to claims. · Coordinate resolution of claims issues with other Departments. · Assist Providers and other Departments in claims research. · Assist in training claims personnel when issues are identified. · Promote a spirit of cooperation and understanding among all personn

Job Description Job Description Education and / or Experience: High School Diploma and 3 years adjudication experience in a managed care setting. Knowledge of CPT-4, HCPCS, Hospital Revenue, and ICD-9 coding. Knowledge of HMO, DHS, DMHC, and CMS claims processing guidelines. Strong knowledge of Microsoft Windows environment such as Word and Excel. Self-starter, willing to take on multiple tasks. Must meet minimal claims adjudication production standards. Strong knowledge of Coordination of Benefits (COB) applications. Must be able to interpret health plan benefits. Must be able to review, interpret and apply contract rates. Ability to communicate effectively orally and written typing 35 words per minute. Strong organizational skills with emphasis on prioritizing and attention to details Position Summary: To evaluate and determine the appropriate path and to assist in the expedited processing of all claims, special projects and escalated reconsiderations originating from various interna