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Claim examiner Jobs in Vacaville, CA

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Claim examiner • vacaville ca

Last updated: 5 days ago

Claims Trainer

Partnership HealthPlan of CaliforniaFairfield, CA, United States
Full-time

Claims Examiner Training Specialist.Train examiner and customer service level I staff on all related claim types for all Partnership lines of business using AMISYS Advance system and Claims Operati... Show more

Remote A/R Follow-up Manager - AI Trainer ($75-$75 per hour)

MercorFairfield, California, US
$75.00 hourly
Remote
Full-time

Mercor is working with a leading AI research lab to improve the capabilities of next-generation AI systems.We are seeking experienced A/R Follow-Up Managers to evaluate AI tools designed to automat... Show more

Remote Denials Management & Appeals Manager - AI Trainer ($70-$93 per hour)

MercorVacaville, California, US
$70.00 hourly
Remote
Full-time

Mercor is working with a leading AI research lab to improve the capabilities of next-generation AI systems.We are seeking experienced Denials Management and Appeals Managers to evaluate AI tools de... Show more

1071 Senior Contract Manager

Harvest Technical Services, Inc.Vacaville, CA, United States
$75.00 hourly
Full-time

Senior Contracts & Claims Manager.As a member of the Global Capital Sourcing team, a Senior Contracts & Claims Manager is sought to be responsible for the commercial management of a variety of proj... Show more

Senior Commercial Contracts Manager

TekWissen LLCVacaville, CA, United States
Full-time
Quick Apply

Overview:</b></p> <p style="text-align: justify;">TekWissen is a global workforce management provider headquartered in Ann Arbor, Michigan that offers strategic talent s... Show more

Mobile Phlebotomy/Paramedical Examiner

Quest DiagnosticsVacaville, California, United States
$24.00 hourly
Part-time
Quick Apply

As a Mobile Collector, you would be a part-time, on-call, and at-will employee.On-Call and At-Will equal Flexibility! You will choose the days and hours you wish to work and the areas you wish to w... Show more

Contract Manager

Tailored ManagementVacaville, CA, United States
$90.00 hourly
Full-time

Senior Contracts & Claims Manager.Location: Vacaville, CA Contract length: 6+ months with potential for extension and/or permanent placement Pay Rate: $90/hour + Benefits.Job Summary: As a member o... Show more

Patient Account Representative, Billing (On-Site, Hybrid, Remote)

NorthBay HealthcareFairfield, CA, US
Remote
Full-time

At NorthBay Health, the Patient Account Representative III Ambulatory is responsible for the timely and accurate billing, follow-up and collection of ambulatory patient accounts.Each account repres... Show more

Remote Intellectual Property Expert - AI Trainer ($90-$100 per hour)

MercorFairfield, California, US
$90.00 hourly
Remote
Full-time

Role Overview** - Mercor is seeking senior intellectual property professionals to build evaluation tasks for AI systems operating in patent prosecution, licensing, and IP enforcement contexts.The w... Show more

Multi-Line Representative - State Farm Agent Team Member

Gigi Horton - State Farm AgentFairfield, CA, US
$36,000.00 yearly
Full-time

You May Be a Great Fit as a Multiline Representative at.Gigi Horton - State Farm Agent.You’re the person people call first when life goes sideways.You genuinely care about your community.You’re a n... Show more

Medical Billing Supervisor

Solano CountyFairfield, CA, United States
Full-time

The Medical Billing Supervisor plans, organizes and supervises the medical insurance billing functions and accounting/clerical staff for the Department of Health and Social Services' Medical Billin... Show more

Operational Buyer Indirect III

HireTalentVacaville, CA, United States
Full-time

Senior Contracts & Claims Manager.As a member of the Global Capital Sourcing team, a Senior Contracts & Claims Manager is sought to be responsible for the commercial management of a variety of proj... Show more

Contract Manager

Sunrise SystemsVacaville, CA, United States
$80.00 hourly
Full-time

Senior Contracts & Claims Manager.As a member of the Global Capital Sourcing team, a Senior Contracts & Claims Manager is sought to be responsible for the commercial management of a variety of proj... Show more

Remote Psychiatry Expert - AI Trainer ($150-$150 per hour)

MercorVacaville, California, US
Remote
Full-time

Psychiatrist** Mercor is seeking board-certified psychiatrists for a project with one of the world's top AI labs.We welcome applications from psychiatrists across all practice settings, with partic... Show more

Remote Insurance Verification & Benefit Manager - AI Trainer ($105-$105 per hour)

MercorFairfield, California, US
Remote
Full-time

Mercor is working with a leading AI research lab to improve the capabilities of next-generation AI systems.We are seeking experienced Insurance Verification and Eligibility & Benefits Managers to e... Show more

Contract Manager

Tailored Management ServicesVacaville, CA, United States
Full-time

Senior Contracts & Claims Manager.As a member of the Global Capital Sourcing team, a Senior Contracts & Claims Manager is sought to be responsible for the commercial management of a variety of proj... Show more

Contract Manager

MindlanceVacaville, CA, United States
Full-time

Senior Contracts & Claims Manager.As a member of the Global Capital Sourcing team, a Senior Contracts & Claims Manager is sought to be responsible for the commercial management of a variety of proj... Show more

Remote Patient Access Leader - AI Trainer ($80-$80 per hour)

MercorVacaville, California, US
$80.00 hourly
Remote
Full-time

Mercor is working with a leading AI research lab to improve the capabilities of next-generation AI systems.We are seeking experienced Patient Access leaders to support the evaluation and improvemen... Show more

Building Inspector

BPR Consulting Group LLCFairfield, California, United States
$25.00 hourly
Full-time

Building Inspectors to join our growing company and serve our clients.The successful candidates must possess the ability to work independently, communicate effectively and maintain professional wor... Show more

People also ask
Claims Trainer

Claims Trainer

Partnership HealthPlan of CaliforniaFairfield, CA, United States
30+ days ago
Job type
  • Full-time
Job description

Claims Examiner Training Specialist

Train examiner and customer service level I staff on all related claim types for all Partnership lines of business using AMISYS Advance system and Claims Operating Instruction Memorandums.

Responsibilities

  • Train all levels of staff on all claim types on-site or regional site(s).
  • Train all levels of staff on CIF processing, generating and processing adjustments both on-site and regional site(s)
  • Provide feedback and recommendation to the Claims Audit Supervisor and Associate Director of Claims on staff training needs and system adjustments.
  • Create and maintain training materials
  • Maintain current knowledge of Partnership Claims Policy and Procedures for all lines of business, Medi-Cal Provider Manual, Title 22 regulations, Knox Keene regulations, and CMS Medicare regulations.
  • Draft Claims Operating Instruction documentation for the Claims Director as assigned.

Secondary duties and responsibilities

  • Assist with system testing as needed.
  • Other duties as assigned.

Qualifications

Education and Experience

Minimum two (2) years of claims examining experience and completion of Partnership Claims training; or equivalent combination of education the experience.

Special Skills, Licenses and Certifications

Familiar with Medi0Cal and/or managed care claims processing. Knowledge of CPT, HCPC procedure coding, and ICD -9/ICD10 diagnostic coding. Typing speed 30 wpm and proficient use of 10-key calculator. Familiar with AMISYS or similar claims systems. Understanding of claims examining requirements. Valid California driver's license and proof of current automobile insurance compliant with Partnership policy are required to operate a vehicle and travel for company business.

Performance Based Competencies

Excellent oral and written communication skills. Ability to effectively exercise good judgment within scope of authority and handle sensitive issues with tact and diplomacy. Ability to work on multiple tasks within established time frames and sometimes conflicting priorities. Good organizational skills with ability to maintain accurate records and documentation of actions and decisions.

Work Environment And Physical Demands

Ability to use a computer keyboard. More than 60% of work time is spent in front of a computer monitor. When required, ability to move, carry or list objects of varying size, weighing up to 5 lbs.

All HealthPlan employees are expected to:

  • Provide the highest possible level of service to clients;
  • Promote teamwork and cooperative effort among employees;
  • Maintain safe practices; and
  • Abide by the HealthPlan's policies and procedures, as they may from time to time be updated.

Hiring Range:

$ 33.65 - $ 40.38

Important Disclaimer Notice

The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.