Claims Processor, Specialist

Your Role

The Medi-Cal Operations team is responsible for ensuring claims are processed accurately and timely. The Claims Processor, Specialist will report to the Medi-Cal Operations Supervisor. In this role you will be responsible for interfacing with other departments and vendors involved in the Claims process and will also serve as the primary point of contact for priority claim cases.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Knowledge and Experience

• Requires a high school diploma or GED

• Requires at least 7 years of experience

• Minimum of 3 years of experience in claims processing and/or auditing experience in a manage care setting required

• Experience examining multiple claim types in the Medi-Cal/Medicare environment preferred

• Knowledge of medical claims regulatory guidelines such as AB1455 and Medicare preferred

• Proficiency in Microsoft Office programs such as Excel, Word and Outlook required

Hybrid Virtual Work

This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need.