Description
AppleOne is proud to present:
Claims Examiner – Temp-to-Hire Opportunity in Whittier
Are you an experienced claims adjudicator looking for a new opportunity? We are seeking a Claims Examiner to join our team in Whittier. This temp-to-hire role offers a competitive pay and provides a great opportunity to work in a dynamic health care environment.
Key Responsibilities:
– Process, adjudicate, and ensure accurate payment of UB-92 and HCFA-1500 claims from PHP-affiliated medical groups and hospitals for HMO patients
– Collaborate with the claims manager to maintain compliance and efficiency in claims processing
– Apply knowledge of professional (MD), hospital, skilled nursing facility, and ancillary service payment methodologies
– Ensure timeliness and accuracy of payments for commercial, senior, and Medi-Cal claims
– Interpret provider contract reimbursement terms and assist with non-contracted provider agreements
– Perform data entry and utilize office automation and managed care systems effectively
Qualifications:
– High school diploma or GED (physical proof required if verification is unavailable)
– Minimum of 2 years of claims adjudication experience in an ambulatory, acute care hospital, HMO, or IPA environment
– Strong understanding of compliance issues related to claims processing
– Experience in training and utilizing basic office automation and managed care computer systems
Schedule & Work Details:
– Hours: 7:00 AM – 3:30 PM
– Location: Whittier
– Job Type: Temp-to-Hire
If you’re detail-oriented, knowledgeable in health care claims processing, and ready to contribute to a great team, apply today!
EEO/AA Employer/Vet/Disabled.
The Know Your Rights poster is available here:
https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12.pdf
The pay transparency policy is available here:
https://www.dol.gov/sites/dolgov/files/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf
For temporary assignments lasting 13 weeks or longer, the Company is pleased to offer major medical, dental, vision, 401k and any statutory sick pay where required.
We are committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation for any part of the employment process, please contact your staffing representative who will reach out to our HR team.
AppleOne participates in the E-Verify program in certain locations as required by law. Learn more about the E-Verify program.
https://e-verify.uscis.gov/web/media/resourcesContents/E-Verify_Participation_Poster_ES.pdf
We also consider qualified applicants regardless of criminal histories, consistent with legal requirements. Pursuant to applicable state and municipal Fair Chance Laws and Ordinances, we will consider for employment-qualified applicants with arrest and conviction records. For Los Angeles, CA applicants: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.
#1031
Experienced (Non-Manager)