Claims Examiner

Aya Healthcare has an exciting 13-week contract opportunity located in Whittier, CA!Job Details:JOB TITLE: Claims ExaminerCONTRACT DURATION: 13 weeksSHIFT: M-F 7am-3:30pmLOCATION: Whittier, CAPAY: $26-29 an hourONBOARDING TIME: Expect 2-3 weeks from offer acceptance to start date.DETAILS ABOUT THE POSITION 2 YEARS EXPERIENCE REQUIRED - MUST BE ABLE TO VERIFY HS DIPLOMA or GED or HIGHER EDUCATION POSITION SUMMARY:The claims examiner reports directly to the claims manager. They are primarily responsible for the processing functions (operation, adjudication, and payment) of UB-92 and HCFA-1500 claims that are received from PHP affiliated medical groups and hospitals for HMO patients.EDUCATION/EXPERIENCE/TRAINING:High school graduate or equivalent required. Must have physical proof on hand if background check is unable to verify your education background.Minimum of 2 years claims ADJUDICATION related experience in ambulatory, acute care hospital, HMO, or IPA environmentReimbursement experience Knowledge of payment methodologies for: Professional (MD), Hospital, Skilled Nursing Facilities, and Ancillary ServicesKnowledge and understanding of timeliness and payment accuracy guidelines for commercial, senior and Medi-Cal claimsKnowledge of compliance issues as they relate to claims processingExperience in interpreting provider contract reimbursement terms desirableAbility to identify non-contracted providers for Letter of Agreement considerationData entry experienceTraining on basic office automation and managed care computer systemsAPPLICATION REQUIREMENTS· Documentation of Covid vaccination or medical/religious exemption.· Copy of diploma for highest level of completed education.· Two manager/supervisor references who you have worked with in the last two years.o (Name, Position Held, Company, Phone Number, Email Address)· Upcoming requested time off for the duration of the contract.· Interview availability for the next 7-10 days.· Resume with last seven years of work history if applicable - all work history gaps of 90+ days must be explained.AYA DELIVERS...· Front-of-the-line access to exclusive jobs at thousands of healthcare facilities nationwide.· A robust team to support you every step of the way to ensure you start on time, have accurate payroll and an exceptional experience.· A credentialing specialist to streamline the entire compliance process.· And of course, you get the usual benefits such as:o Premium medical, dental, vision and life insurance beginning day one of your assignment.o Paid sick time. Aya provides paid sick leave in accordance with all applicable state, federal, and local laws. Aya's general sick leave policy is that employees accrue one hour of paid sick leave for every 30 hours worked. However, to the extent any provisions of the statement above conflict with any applicable paid sick leave laws, the applicable paid sick leave laws are controlling.o Generous 401k match.o Pay listed above includes taxable wages and tax-free expense reimbursements, when applicable.Aya Healthcare is an Equal Opportunity Employer and encourages all to apply!

Created: 2025-03-07