Hospital Claims Examiner

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🔥 1 hour ago

🏄 California – Remote

🏄 California – Remote

💵 $21 - $26 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

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MedPOINT Management

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1988

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

MedPOINT Management is a California-based healthcare management services organization that supports independent practice associations (IPAs), provider networks, hospitals and contracted health plans with clinical quality, care management, administrative operations and technology solutions. For more than 32 years MPM has provided services including provider network operations, case management, utilization management, claims operations, credentialing, HEDIS/STARs quality measurement and analytics (via Cozeva), call center and financial management, and digital provider portals and resource libraries. The company emphasizes data security and compliance (SOC 2 and HITRUST e1 certifications for its EZ-CAP and Provider Web Portals) and focuses on enabling value-based care, quality improvement, and operational support for providers and payers.

📋 Description

• Review and analyze hospital claims for accuracy and compliance with regulations. • Investigate discrepancies and resolve issues related to claims processing. • Collaborate with healthcare providers to obtain necessary documentation. • Ensure timely submission of claims to maximize reimbursement. • Maintain detailed records of claims and communications. • Assist in the development of claims processing procedures and guidelines. • Stay updated on industry regulations and best practices. • Support team members in training and knowledge sharing.

🎯 Requirements

• Proven experience in hospital claims processing or medical billing. • Strong understanding of healthcare regulations and coding systems. • Excellent analytical and problem-solving skills. • Detail-oriented with a focus on accuracy. • Effective communication and interpersonal skills. • Proficiency in claims management software and MS Office. • Ability to work independently and as part of a team. • High school diploma or equivalent; additional certification preferred.

🏖️ Benefits

• 401(k) • 401(k) matching • Dental insurance • Health insurance • Vision insurance • Wellness resources • Company parties • Employee discounts • Opportunity for advancement • Paid time off • Parental leave • Savings bank • Training & development