Claims Review Specialist

Claims Review Specialist 2797750

One of the most prestigious and well-known universities is seeking a Claims Review Specialist. The ideal candidate has three years of previous experience working for a Health Plan, IPA, or other Managed Care Organization. The company offers a great work environment!

Claims Review Specialist Pay and Benefits:

• Hourly pay: $40/hr
• Worksite: One of the most prestigious and well-known universities (Los Angeles, CA 90024 - Hybrid)
• W2 Employment, Group Medical, Dental, Vision, Life, Retirement Savings Program, PSL
• 40 hours/week, 6 Month Assignment

Claims Review Specialist Qualifications:

• 3+ years of previous experience working for a Health Plan, IPA, or other Managed Care Organization.
• 2+ years of previous direct experience that included verifying and maintaining provider information and provider contract configuration in a managed care transaction system.
• High school diploma, GED or equivalent required. Two-year degree is preferred.
• At least one of these 3 certifications: CPC, CPCH, CCS.
• 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.
• 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 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.