Find Your Dream Job
Finding a Dream Job can feel a lot like searching for a needle in a haystack. We start by viewing each candidate as an individual, identifying their distinct strengths and guiding them to the right opportunities. We're also big believers in mentoring our candidates and creating long-term relationships. Helping you find your Dream Job is really just the start. We want to help you build a Dream Career!
Stop Dreaming. Start Searching.
Medical Claims Examiner (Healthcare Industry)
Woodland Hills, CA
Wollborg Michelson is partnering with a well-establish healthcare company located in Woodland Hills, CA to locate a team of Medical Claims Examiners. The position is a 6-month contract to hire role! If you meet the qualifications, please apply with an up to date resume!
Assist in activities related to the medical and psychosocial aspects of utilization and coordinated care.Will be part of the commercial case management team. Will be supporting the UM team and case management team. Support w/certain tasks. Senior PC will be assigning smaller tasks to this temporary worker. They may be assigned to a certain queue, reviewing letters/eligibility.
- A-Level professional with 3-6 years of experience in healthcare claims processing
- Processing and adjudicating medical claims.
- Maintaining integrity of claims receipts in accordance with standard claims operating and adjudication procedures.
- Accurately resolving pending claims using state and federal regulations and specific health plan criteria.
- Working within quick turnaround times to meet client performance guarantees for claims processing.
- Screen members by priority for case management (CM) assessment.
- Produces and mails routine CM letters and program educational material.
- Data entry assessments and authorizations into the system.
- Thorough knowledge of customer service, utilization review or claims processing practices in a managed care
- Familiarity talking with members/providers
- Knowledge of medical terminology.0-2 years of experience
- Strong computer skills – MS Office Ste., Data Entry, Typing
- High school diploma or equivalent.
Hours: Mon - Fri 7a-5p plus required OT and possible weekends as needed
Job Type: 6-month TEMP TO HIRE
PLEASE APPLY HERE TODAY!