Claims Adjuster
$33 - $35 per hourLHH
Claims Adjuster
Location: Pleasanton, CA
Pay: $33$35 per hour
Schedule: MondayFriday, 8:30 AM5:00 PM (30-minute lunch + two 15-minute breaks)
Employment Type: Contract (6 months+, potential for extension or conversion)
Key Responsibilities
- Handle high-volume inbound calls (up to 40 calls/day) regarding medical claims
- Review and interpret medical claims, coding, and benefits information
- Verify accuracy of coding and supporting documentation
- Assist members in understanding claims and next steps
- Route or escalate claims to appropriate parties when needed
- Input and maintain accurate data in internal systems
- Collaborate with team members and proactively ask questions when needed
Qualifications
- Required: Bilingual in Spanish
- Experience with medical terminology, medical coding, and/or claims processing
- Ability to assess and make judgment calls on claim accuracy
- Strong attention to detail and problem-solving skills
- Comfortable handling high call volumes in a fast-paced environment
- Confident communicator who is not hesitant to ask questions
Systems & Tools
- Microsoft Teams
- Microsoft Excel
- Basis (data entry for member information)
- Phone systems (daily use)
Vacancy posted 17 hours ago
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