Claim Processor with California Medicaid Experience

Immediate need for a talented Claim Processor with California Medicaid Experience. This is a Fulltime opportunity with long-term potential and is located in EST/CST(Remote). Please review the job description below and contact me ASAP if you are interested.
Job ID: 25-80737

Pay Range: $18 - $19/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).

Key Requirements and Technology Experience:

• Key skills; California Medicaid/California Mediclaim Or Medi- CAL , ICD 9/10 , CPT Codes , UB04 & CMS1500 , QNXT or TriZetto
• 3-5 years mandate claim processing (California Medicare )
• Working knowledge of computer System and Programme.
• Should be able to co-ordinate benefits with Medicare/Medicaid
• ICD-9 &10 Coding
• Experience in M&R / Medicaid Rework/Adjustment claims processing preferred.
• knowledge of Health Care Domain with minimum experience of 3 years in Health care domain and claims processing.
• Experience in Govt. Ops with a experience of Medicare and Retirement / Medicaid claims processing.
• Should able to explain the terms, Copay, Coinsurance, Deductible and out of pocket.
• Should be able to describe Medicaid and Medicare eligibility in detail.
• Should have experience working as Claim Examiner Level III for minimum 3 years.
• Should have experience working in Adjustment and Disputes (Appeals) for minimum 2 years.
• Should have experience working on California Medicare/ Medicaid Claims
• Should be able to understand California Claim's contract Language.
• Should have basic knowledge of Corrected claims processing.
• Should have knowledge of CPT codes and HCPC codes.
• Should have knowledge of UB04 & CMS1500 form.
• Should have basic knowledge of Mathematical skills and should be able to problem solve claims calculations. (Benefit/Out of Pocket)

Our client is a leading IT Industry and we are currently interviewing to fill this and other similar fulltime positions. If you are interested in this position, please apply online for immediate consideration.

Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy .