Medical Claims Processor

As a Medical Claims Examiner Processor at Fortuna, you will play a vital role in ensuring the smooth adjudication and processing of medical claims, contributing directly to the efficiency and accuracy of our operations. Located in Folsom, CA, you'll join a dynamic team dedicated to upholding the highest standards in the employee benefits industry.

Pay: $20 - $26 per hour
Location: Folsom, CA
Employment Type: Full-time

WHAT WE OFFER:

• Competitive pay rates based on experience and expertise
• Comprehensive benefits package including medical, dental, and vision coverage
• 401k with generous company match
• Ample paid time off and holidays
• Dynamic work environment with opportunities for growth and advancement

WHAT YOU'LL DO:

• Adjudicate medical claims in accordance with established guidelines, ensuring accuracy and compliance with plan regulations.
• Utilize your expertise in ICD-10, CPT, and HCPCS codes to accurately process claims and minimize errors.
• Collaborate effectively with healthcare providers to obtain necessary documentation for timely claim resolution, demonstrating strong communication skills.
• Maintain high standards of accuracy and efficiency in claim processing workflows, contributing to overall operational excellence.

WHAT YOU'LL BRING:

• 3-5 years of experience in the employee benefits industry, demonstrating a solid understanding of medical claims adjudication processes.
• Proficiency in ICD-10, CPT, and HCPCS codes, enabling accurate and efficient claim processing.
• Strong attention to detail and ability to thrive in a fast-paced environment, ensuring consistent quality in claim processing.
• Excellent communication and interpersonal skills, facilitating effective collaboration with internal and external stakeholders.

A drug and background screening is required for this position.