Sr Examiner, Claims

Sr Examiner, Claims

18 Oct 2024
California, Longbeach 00000 Longbeach USA

Sr Examiner, Claims

Vacancy expired!

Job DescriptionJob Summary

Responsible for administering claims payments, maintaining claim records. Monitors and controls backlog and workflow of claims. Ensures that claims are settled in a timely fashion and in accordance with cost control standards.Knowledge/Skills/Abilities

Meets and consistently maintains production standards for Claims Adjudication.

Supports all department initiatives in improving overall efficiency.

Identifies and recommends solutions for error issues as it relates to pre-payment of claims.

Oversees the reduction of defects by identifying error issues as they relate to pre-payment of claims through adjudication and recommending solutions to resolve these issues.

Monitors the medical treatment of claimants. Keeps meticulous notes and records for each claim.

Manages a caseload of various types of complex claims. Procures all medical records and statements that support the claim.

Meets department quality and production standards.

Meet State and Federal regulatory Compliance Regulations on turnaround times and claims payment for multiple lines of business Job QualificationsRequired Education

High School or GED

Required Experience

3-5 years claims processing required

Preferred Education

Bachelor's Degree or equivalent combination of education and experience

Preferred Experience

5-7 years claims processing preferredTo all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.Job: Claims Organization: Corporate Title: Sr Examiner, Claims Location: CA-Long Beach-HUGHES Requisition ID: 1903534

Related jobs

  • Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

Job Details

Jocancy Online Job Portal by jobSearchi.