Claims Analyst Job

CLAIMS ANALYST needed for a contract opportunity with Yoh's client located in Santa Clara, CA.

THE BIG PICTURE - TOP SKILLS YOU SHOULD POSSESS:

- Claims Processing Experience
- Highly Organized and Self-Motivated

WHAT YOU'LL BE DOING:

- Identifies and reports possible claims processing system configuration issues or other system anomalies to the Claims Manager for evaluation
- Performs claims adjustments
- Receives, researches and responds to provider claims inquiries directed to them from the Member Services Claims call center
- Analyzes pended facility and medical claims against established claims processing system edits utilizing department desktop procedures, health plan policies, provider contracts, Medi-Cal guidelines and any other applicable state and federal guidelines
- Perform other duties as assigned

WHAT YOU NEED TO BRING TO THE TABLE:

- High School Graduation Certificate
- Five (5+) years of Claims Processing experience
- Strong Organizational Skills
- Proficient with computer and Microsoft Applications

WHAT ARE YOU WAITING FOR? APPLY NOW!

RECRUITER: Annie Gill

Yoh, a Day & Zimmermann company, is an Equal Opportunity Employer, M/F/D/V. Click here to contact us if you are an individual with a disability and require accommodation in the application process.

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