Claims Examiner
US Tech Solutions
Medical Claims Adjudication Specialist
Duration: 3+ months contract
Responsibilities:
- Review, adjudicate, and process medical claims for HMO patients
- Work closely with affiliated medical groups and hospitals
- Evaluate provider reimbursement terms and flag non-contracted providers
- Ensure claims are processed accurately and timely per policy guidelines
Experience:
2+ years of experience in claims adjudication (HMO, IPA, or hospital environment)
Skills:
- Claims reimbursement knowledge
- Experience working with DOFR (Division of Financial Responsibility)
- Hands-on experience processing lab claims
- Familiar with UB-92 and HCFA-1500 forms
- Understanding of provider contracts, Medi-Cal, commercial, and senior plan claims
- Strong knowledge of timeliness, payment accuracy, and compliance standards
- Basic computer and data entry skills
Education:
High school diploma, GED, or higher
About US Tech Solutions:
US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
US Tech SolutionsVacancy posted 5 days ago
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