Claims Examiner

Company: US Tech Solutions
Location: Whittier
Posted on: January 5, 2026

Job Description:

Job Description Job Title: Claims Examiner Job Location: 9557 Greenleaf Avenue, Job Title: Claims Examiner Job Location: 9557 Greenleaf Avenue, Whittier, CA 90601 Duration: 13 weeks SHIFT : Monday - Friday - 07:00am - 03:30pm Job Description: Must have listed claims reimbursement experience Must have DOFR Must have processed lab claims * Will Need References to Submit. * Will Need References to Submit. * Will Need References to Submit. ONSITE INTERVIEW REQUIRED PLEASE NOTE ORIENTATION TIME MAY DIFFER THAN SHIFT TIMES LISTED 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 environment • Knowledge of payment methodologies for: Professional (MD), Hospital, Skilled Nursing Facilities, and Ancillary Services * Knowledge and understanding of timeliness and payment accuracy guidelines for commercial, senior and Medi-Cal claims * Knowledge of compliance issues as they relate to claims processing • Experience in interpreting provider contract reimbursement terms desirable • Ability to identify non-contracted providers for Letter of Agreement consideration • Data entry experience • Training on basic office automation and managed care computer systems Duration: 13 weeks SHIFT : Monday - Friday - 07:00am - 03:30pm Job Description: Must have listed claims reimbursement experience Must have DOFR Must have processed lab claims * Will Need References to Submit. * Will Need References to Submit. * Will Need References to Submit. ONSITE INTERVIEW REQUIRED PLEASE NOTE ORIENTATION TIME MAY DIFFER THAN SHIFT TIMES LISTED 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 environment • Knowledge of payment methodologies for: Professional (MD), Hospital, Skilled Nursing Facilities, and Ancillary Services * Knowledge and understanding of timeliness and payment accuracy guidelines for commercial, senior and Medi-Cal claims * Knowledge of compliance issues as they relate to claims processing • Experience in interpreting provider contract reimbursement terms desirable • Ability to identify non-contracted providers for Letter of Agreement consideration • Data entry experience • Training on basic office automation and managed care computer systems About US Tech Solutions: US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com. US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Recruiter Details: Name: Adil Saifi Email: adil@ustechsolutionsinc.com Internal Id: 24-22803

Keywords: US Tech Solutions, Covina , Claims Examiner, Administration, Clerical , Whittier, California