Medical Claims Examiner

at  Robert Half

We are in search of a Medical Claims Examiner to join our team in Emeryville, California. In this role, you will be tasked with handling insurance underpayments, appeals, and aging for Work Comp and Commercial accounts. This role calls for meticulous attention to detail and a strong understanding of medical billing processes.

• Handle insurance underpayments, correspondence, appeals, and aging for Work Comp and Commercial accounts
• Review and correct errors in claims as needed
• Prepare and send appeals for incorrectly processed claims for additional benefits
• Process incoming correspondence regarding balance due and updated insurance information
• Review accounts on the status aging report and present account for collections/lien to the Billing Manager if no response is received
• Coordinate with the Billing Manager on special projects
• Attend billing office meetings as required
• Engage in educational activities and seminars to stay updated with the latest industry changes
• Use your knowledge of medical terminology, ICD-10, CPT coding, and billing software to perform your duties effectively
• Use your proficiency in Microsoft Office, particularly Word and Excel, to maintain and update records.

If you are interested in this role please call us today at (510) 470-7450

• Must possess a minimum of 3 years of experience as a Medical Claims Examiner or a similar role.
• Proficiency in software such as 3M, 3m Coding, Allscripts, Armed Forces Health Longitudinal Technology Application (AHLTA), and Cerner Technologies is essential.
• Prior experience in Auditing and Billing Functions is a prerequisite for this position.
• Familiarity with Charts and Graphs, Claim Administration, and Clinical Trial Operations is required.
• Should have a deep understanding of Medical Billing and Insurance Denials.
• Demonstrated ability to analyze and interpret complex data in a clear and concise manner.
• Excellent written and verbal communication skills.
• Strong organizational skills and the ability to prioritize tasks.
• Ability to work independently as well as part of a team.
• High attention to detail and problem-solving skills.
• Must have a strong ethical code and respect for patient confidentiality.

Robert Half is the world’s first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles.
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All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information.
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