Claims Examiner

Job TitleDuration: 3+ months contractResponsibilitiesReview, adjudicate, and process medical claims for HMO patientsWork closely with affiliated medical groups and hospitalsEvaluate provider reimbursement terms and flag non-contracted providersEnsure claims are processed accurately and timely per policy guidelinesExperience2+ years of experience in claims adjudication (HMO, IPA, or hospital environment)SkillsClaims reimbursement knowledgeExperience working with DOFR (Division of Financial Responsibility)Hands-on experience processing lab claimsFamiliar with UB-92 and HCFA-1500 formsUnderstanding of provider contracts, Medi-Cal, commercial, and senior plan claimsStrong knowledge of timeliness, payment accuracy, and compliance standardsBasic computer and data entry skillsEducationHigh school diploma, GED, or higherAbout Us Tech SolutionsUS Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. 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.