Claims Examiner

Orange | www.governmentjobs.com | 4/9/24

CalOptima Health is seeking a highly motivated an experienced Claims Examiner to join our team. The Claims Examiner will be responsible for analyzing and validating claim data elements and claims processing. The incumbent will be responsible for adhering to the regulatory and internal processing guidelines in conjunction with CalOptima Health policies and procedures related to claims adjudication.
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• Processes claims based upon CalOptima Health contractual agreements or pricing agreements, applicable regulatory legislation, claims processing guidelines and CalOptima Health policies and procedures...

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