Claims Processor
Company: Pacer Staffing
Location: Whittier
Posted on: January 19, 2026
|
|
|
Job Description:
Job Description Job Title - Claims Processor Job Location -
Whittier, CA 90601 Hourly Pay - $30/hr Shift - Day 5x8-Hour (07:00
- 15:30) Job Description - SPECIFIC SKILLS NEEDED Knowledge of
HMO/or IPA operations; medical terminology; ICD-10, RVS, and CPT
coding knowledge; knowledge of Medicare and Medi-Cal guidelines;
10-key skills by touch; excellent communication skills; knowledge
of system applications; ability to function effectively under time
deadlines; strong organizational skills. Required: Formal training
will be indicated by a high school diploma or equivalent; Four
years medical claims processing. DUTIES AND RESPONSIBILITIES 1.
Safeguards and preserves the confidentiality of patient’s protected
health information in accordance with State and Federal (HIPAA)
regulatory requirements, hospital and departmental policies. 2.
Ensures a safe patient environment and adherence to safety
practices per policy. 3. With consideration to age, employee
utilizes the approved process to resolve biophysical,
psychological, educational and environmental needs of
patient/significant other when administering care. 4. Assist the
Claims Director in the training and education of the Claims
department staff 5. Coordinate the generation and review of claims
audit, status and pending claims reports ensuring authorized claims
are paid in accordance with company guidelines 6. Investigate,
process and track payment adjustments including refunds,
overpayments and underpayments 7. Act as a confidential and
professional resource for group providers and other staff. 8. Act
as a resource for providers, members, insurance carriers, attorneys
and co-workers, researching and responding to questions in a timely
manner 9. Create, maintain and generate system reports 10.Review
and audit member liability denials and Provider Dispute Resolution
claims to ensure compliance with regulatory requirements and
passing audit scores from health plans
Keywords: Pacer Staffing, Long Beach , Claims Processor, Administration, Clerical , Whittier, California
