Examiner, Claims (Special Projects)

Work Boldly. Live Brilliantly.
At AltaMed, we don’t just serve our communities, we are part of them. We have raised the expectations of what a community clinic can deliver because we think quality care is for everyone. And, we are determined to provide it no matter the challenges because this is more than a job. It’s the calling of our lives and it compels us to keep moving forward.

Job Overview

The Claims Examiner III performs advanced administrative/operational/customer support duties that require independent initiative and judgement. This position is responsible for analyzing the adjudication of medical claims as it relates to managed care, performs payment reconciliations and/or adjustments related to retroactive contract rates and fee schedule changes, as well as identifies root causes of claims payment errors and reports to Management. This position is responsible for responding to provider inquiries/calls related to claims payments and collaborates with other departments and/or providers in successful resolution of claims related issues.

Minimum Requirements

1. HS Diploma or GED required.

2. Minimum of 5 years of Claims Processing experience in a managed care environment required.

3. Must be knowledgeable of Medi-Cal regulations.

4. Ability to process both professional and institutional claims.

Benefits & Career Development

• Medical, Dental and Vision insurance
• 403(b) Retirement savings plans with employer matching contributions
• Flexible Spending Accounts
• Commuter Flexible Spending
• Career Advancement & Development opportunities
• Paid Time Off & Holidays
• Paid CME Days 
• Malpractice insurance and tail coverage
• Tuition Reimbursement Program
• Corporate Employee Discounts
• Employee Referral Bonus Program
• Pet Care Insurance

Salary Range

$26.13 - $32.55 hourly