Claims Data Specialist Job

CLAIMS DATA SPECIALIST needed for a CONTRACT opportunity with Yoh's client located in South San Francisco, CA.

TOP SKILLS YOU SHOULD POSSESS:

- Claims experience
- Knowledge of Medicare and Medi-Cal

WHAT YOU'LL BE DOING:

- Propose, monitor, develop, test, and document claims as well as related procedural changes that are directed by state, federal, and internal policy
- Communicate changes to staff and provider community, as well as provide support in the testing of all system enhancements and internal configuration updates to ensure accurate adjudication and adherence with state and federal guidelines
- Resolve provider disputes and research and resolve claim issues for providers and internal staff
- Research, analyze, and recommend claims system configuration modifications
- Develop and maintain updates of all internal and external documentation related to Claims configuration and policy changes
- Develop provider education/training materials as related to configuration and policy changes
- Continually review/audit system configuration rules to ensure accurate application of policies

WHAT YOU NEED TO BRING TO THE TABLE:

- Bachelors Degree preferred
- Equivalent to five (5) years work experience in a health care or managed care environment with an emphasis on coding and billing policy
- Coding Certificate preferred
- Knowledge of medical claims processes and procedures
- Knowledge of Medicare and Medi-Cal programs

WHAT'S IN IT FOR YOU?

- Medical, Dental & Vision Benefits
- 401K Retirement Saving Plan
- Life & Disability Insurance
- Direct Deposit & weekly EPayroll
- Employee Discount Programs
- Referral Bonus Programs

WHAT ARE YOU WAITING FOR? APPLY NOW!

RECRUITER:Jennifer Andersen

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

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