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!
