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Processor, Claims

Long Beach, California Job ID 2001280
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Job Description


Job Summary
Responsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage amount and benefit interpretation. Monitors and controls backlog and workflow of claims. Ensures that claims are settled in a timely fashion and in accordance with cost control standards.

Knowledge/Skills/Abilities
• Logs and edits claims via the claims system, and researches submitted claims if applicable.
• Handles more complex requests for claims processing; escalates where needed.
• Contacts appropriate parties to request missing information from requests or for additional information as requested.
• Participates in interdepartmental collaboration to enhance the claims processing function.
• Meets department quality and production standards.


Qualifications

Job Qualifications



Required Education
HS Diploma or GED
Required Experience
1-3 years
Preferred Education
Associate's Degree or equivalent combination of education and experience
Preferred Experience
3-5 years
Preferred License, Certification, Association
Certification in Coding, auditing or billing

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

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