Claims Review Specialist
Location: 5767 Century Blvd Suite 400, Los Angeles, CA 90045
Duration: 25 week contract
Additional Details
5767 Century Blvd Suite 400, Los Angeles, CA 90045. Must have High school diploma, GED or equivalent required, Two year degree preferred. Minimum of 3 years previous experience working for a Health Plan, IPA, or other Managed Care Organization. Minimum of 2 years previous direct experience that included verifying and maintaining provider information and provider contract configuration in a managed care transaction system.
Required Experience:
• High school diploma, GED or equivalent required, Two year degree preferred.
• Minimum of 3 years previous experience working for a Health Plan, IPA, or other Managed Care Organization.
• Minimum of 2 years previous direct experience that included verifying and maintaining provider information and provider contract configuration in a managed care transaction system.
• Working knowledge of one or more of the following managed care transaction systems: EPIC (Tapestry Module), EZ Cap, Facets, QNXT.
• Working knowledge of CPT-4, ICD-9/ICD-10, and HCPCS codes.
• Must have the ability to interpret a variety of instructions furnished in written, oral, diagram and schedule form including provider contracts and contract summaries.
• Ability to adhere to detailed data entry procedures in a complex Managed Care Transaction System with high accuracy for alpha and numeric data inputting.
• Strong organizational skills and the ability to manage aggressive timelines and prioritize multiple concurrent tasks while maintaining high quality standards.
• Proficient computer skills including Microsoft Excel and Word. Competence in navigating the internet.
• Excellent customer service and interpersonal skills, with an ability to work with internal and external representatives
• Willingness to learn new technologies, practices and procedures.
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Last updated on Oct 25, 2023