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Claims Adjudicator
| Hours | Full-time, Part-time |
|---|---|
| Location | Rancho Cordova, California 95741 Rancho Cordova, California |
About this job
We are looking for Medical Claim Examiners for one of our largest healthcare clients in Sacramento!
Job Description:
Analyze claims for appropriate payer, based on combination of coding, medical groups service area, and contract per the Division of Financial Responsibility (DoFR) document.
- Make claim payment determinations established by internal policy and regulatory agencies.
- Process claims, and make payment adjustments as necessary
- Process member reimbursement claims and adhere to timeliness guidelines as established by regulatory agencies.
- Consistently maintain the department audit scores.
- Forward misdirected claims to appropriate payer within 10 business days of receipt.
- Finalize commercial claims for payment or denial within 45 business days of receipt
Qualifications:
- Medical Claims Processing/Adjusting Experience
- ICD9/10 Knowledge
- CPT Coding Knowledge
- Know how to process a claim start to finish
If you are interested in getting your foot in the door with a up and growing company, this is the job for you!
About Aerotek:
Our people are everything. As a Best of Staffing® Client and Talent leader, Aerotek® Inc. has distinguished itself as a leader in recruiting and staffing services, by having a deep understanding of the intersection of talent and business. As a strategic partner to more than 17,000 clients and 300,000 contract employees every year, Aerotek's people-focused approach yields competitive advantages for its clients and rewarding careers for its contract employees. Headquartered in Hanover, Md., Aerotek operates a network of over 230 non-franchised offices with more than 6,000 internal employees dedicated to serving our customers. Aerotek is an operating company of Allegis Group, a global talent solutions provider. To learn more, visit .
Aerotek is acting as an Employment Agency in relation to this vacancy.