Claims Processor II
California
What you can expect!
Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!
Under the direction of the Claims Production Manager and Supervisor, the Claims Processor Level II will be processing outpatient professional and institutional claims. This includes but is not limited to; lab, radiology, ambulance, behavior health, outpatient COB, dialysis, oncology/chemo, hospital exclusions etc., in an accurate and expedient manner.
Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.
Perks
IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more.
- Competitive salary
- Telecommute schedule
- CalPERS retirement
- State of the art fitness center on-site
- Medical Insurance with Dental and Vision
- Life, short-term, and long-term disability options
- Career advancement opportunities and professional development
- Wellness programs that promote a healthy work-life balance
- Flexible Spending Account – Health Care/Childcare
- CalPERS retirement
- 457(b) option with a contribution match
- Paid life insurance for employees
- Pet care insurance
Education & Requirements
- Minimum of two (2) years of experience adjudicating outpatient professional and/or institutional claims preferably in an HMO or Managed Care setting
- Processing of Medicare, Medi-Cal, or Commercial claims required
- Proficient in rate applications for Medi-Cal and/or Medicare pricers
- High school diploma or GED required
Key Qualifications
- ICD-9 and CPT coding and general practices of claims processing
- Knowledge of capitated managed care environment preferred
- Microcomputer skills, proficiency in Windows applications preferred
- Excellent communication and interpersonal skills, strong organizational skills
- Professional demeanor
- Must be computer literate, maintain good attendance, and have the right attitude and discipline to work from home
- Data entry involving computer keyboard and screens, filing, and copying of records and/or correspondence
- Position is eligible for telecommuting/remote work location upon completing the necessary steps and receiving HR approval. All IEHP positions approved for telecommute or hybrid work locations may periodically be required to report to IEHP’s main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership
Start your journey towards a thriving future with IEHP and apply TODAY!
Pay Range
- $23.98 USD Hourly - $30.57 USD Hourly
Working at IEHP is always about helping our members and helping our team members and for me to address anything that they need from me. It’s something that I take pride in every day.
Maynard Mungcal Learning & Development Analyst 2
I love working for IEHP. I really think they not only care about their members, but they also care about their employees … I've been here for eight years, and I just love it!
Mayra Gomez Senior Pharmacy Medication Management Specialist
It’s not just clocking in and clocking out, but being thoughtful and being proud and being an advocate for the work that we do … When people ask me how my day was or how my work is, it’s something that I’m profoundly proud of because I know that I’m making a difference.
Phillip Lo Director of Business Continuity
