Job description
We have an opportunity to join the Alliance as a Claims Technician II in the Claims Department.
WHAT YOU'LL BE RESPONSIBLE FOR
Reporting to the Claims Supervisor - Claims Technician, you will:
- Verify, process, and/or, adjudicate claims, including applying detailed consideration, standards in pending and releasing claims from pend edits and for proper application of program policy related to claim entry and analysis
- Assist with training new hires and cross-training other Claims Technicians
ABOUT THE TEAM
We coordinate, manage and evaluate the claims processing system.
WHAT YOU'LL NEED TO BE SUCCESSFUL
To read the full position description, and list of requirements click here.
- Knowledge of:
- Medical terminology and related procedure and diagnostic coding (CPT/ICD, HCPCS), as well ask knowledge of how to access available resources
- Medical insurance Explanation of Benefits
- Ability to:
- Operate general office equipment, including personal computer, telephone, fax etc.
- Understand current software programs and screens that are required in the daily processing of claims
- Keep current on claims processing practice and procedures
- Education and Experience:
- High school diploma or equivalent and two years (or an Associate's degree and a minimum of one/two years) of relevant experience with claims processing in an automated claim environment; or a combination of education and relevant experience may be qualifying
OTHER DETAILS
- While this position is connected to one of our Alliance offices, we are in hybrid remote/in-office work environment right now and we anticipate that the interview process will take place remotely.
- Our Alliance office locations have officially re-opened as of May 2, 2022 and while some employees may work in full-time telecommute schedules, attendance at quarterly company-wide events or department meetings will be expected.
- Based on the nature of work, this position may require onsite presence, which is dependent on business need. Details about this can be reviewed during the interview process.
COVID-19 Vaccine Requirement: At this time, the Alliance is requesting the vaccination status of its workforce for COVID-19. While this position doesn't require vaccination as a condition of employment, all employees are required to report their vaccination status, and, if vaccinated, provide proof of vaccination.
Merced pay range
Scotts Valley pay range
Salinas pay range
Additionally, all positions at the Alliance are required to meet these minimum qualifications.
OUR BENEFITS
- Medical, Dental and Vision Plans
- Ample Paid Time Off
- 11 Paid Holidays per year
- 401(a) Retirement Plan
- 457 Deferred Compensation Plan
- Robust Health and Wellness Program
- Onsite EV Charging Stations
- And many more
ABOUT US
We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us.
Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve members in Merced, Monterey and Santa Cruz counties. To learn more about us, take a look at our Fact Sheet.
At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.
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