Claims Examiner

Claims Examiner in Los Angeles, CA. 6+ Month contract Opportunity! This Jobot Consulting Job is hosted by: Robert Reyes Are you a fit? Easy Apply now by clicking the "Apply Now" button and sending us your resume. Salary: $30 - $35 per hour A bit about us: Prestige Hospital System Advancing new knowledge and improving health outcomes through research Why join us? Competitive compensation Medical Insurance Dental Insurance Vision Insurance Life Insurance Flexible Schedule Job Stability Career growth If you are passionate, thrive in a fast-paced environment and are ready to take your career to the next level, we would love to hear from you. Job Details Job Details We are seeking a dynamic and experienced Consulting Claims Examiner III to join our growing team in the healthcare industry. This position requires an individual who is detail-oriented, highly analytical, and adept at handling a high volume of claims. The successful candidate will be responsible for the accurate and timely data entry, review, and adjudication of professional, ancillary, and institutional claims for services rendered in various healthcare settings. This role requires a deep understanding of regulatory guidelines, contract provisions, and established policies and procedures. The incumbent will be responsible for meeting quality, productivity, service-level, and turn-around requirements in accordance with the department's performance standards and regulatory requirements. Responsibilities Accurate and timely data entry, review, and adjudication of all types of healthcare claims. Ensuring compliance with regulatory guidelines, contract provisions, and established policies and procedures. Meeting quality, productivity, service-level, and turn-around requirements. Receiving work assignments via batch, report, in-basket pools, work queues, or other methods. Researching and resolving complex claim issues. Training others on claims processes and workflows. Collaborating with other departments to ensure the accuracy of claims processing and resolve any discrepancies. Continuously updating knowledge on industry trends and regulations to ensure the company's compliance. Qualifications 5+ years of experience in claims examination, preferably in the healthcare industry. Proficient in data entry, review, and adjudication of healthcare claims. Strong knowledge of regulatory guidelines, contract provisions, and established policies and procedures related to healthcare claims. Excellent analytical skills with the ability to research and resolve complex claim issues. Proven experience in meeting quality, productivity, service-level, and turn-around requirements. Strong training skills with the ability to effectively train others on claims processes and workflows. Excellent communication and interpersonal skills. Strong computer skills, including proficiency in Microsoft Office Suite and claims management software. Ability to work independently and collaboratively within a team environment. Bachelor's degree in healthcare administration, business, or a related field is preferred. Interested in hearing more? Easy Apply now by clicking the "Apply Now" button. Jobot is an Equal Opportunity Employer. We provide an inclusive work environment that celebrates diversity and all qualified candidates receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. Sometimes Jobot is required to perform background checks with your authorization. Jobot will consider qualified candidates with criminal histories in a manner consistent with any applicable federal, state, or local law regarding criminal backgrounds, including but not limited to the Los Angeles Fair Chance Initiative for Hiring and the San Francisco Fair Chance Ordinance.

Created: 2025-09-27