Medical Claims Specialist - Ontario California

Company: VirtualVocations
Location: Ontario, California
Posted On: 02/02/2025

A company is looking for a Medical Claims Specialist to research and process claims while providing expertise for departmental and corporate projects.



Key Responsibilities

Process claims pending for various hold reasons to assist in final determination
Research complex claims issues and collaborate with other departments for resolution
Act as subject matter expert and primary liaison for claims-related content


Required Qualifications

High school diploma or equivalent is required
5+ years of experience in claims processing for commercial and Medicare claims
3+ years of experience in researching and resolving operational issues
EZ-CAP software experience is highly preferred
Previous visibility into Medicare and Medicare Advantage programs is highly preferred More...

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