Claim Representative - Claims
Company: Providence Health & Services
Location: Anaheim
Posted on: June 17, 2022
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Job Description:
Claim Representative - Claims
Location: Anaheim, CA
Work Schedule: Full Time - 80 Biweekly Hours
Shift: 8-hour, Days
Working under the direction of the Director, this position is
responsible for consistently and accurately adjudicating all
contracted professional capitated claims with fee- for-service
carve outs and, contracted fee-for-service claims for both
Commercial and Senior plans within the timeliness and accuracy
standards set forth by CMS, Department of Managed Care, AB1455 and
the Claims Department polices and procedures.
Required qualifications:
Preferred qualifications:
Our best-in-class benefits
(https://www.providenceiscalling.jobs/rewards-benefits/) are
uniquely designed to support you and your family in staying well,
growing professionally, and achieving financial security. We take
care of you, so you can focus on delivering our Mission
(https://www.providenceiscalling.jobs/mission-core-values/) of
caring for everyone, especially the most vulnerable in our
communities.
Providence Medical Foundation (formerly St. Joseph Heritage Health)
includes seven medical groups throughout Northern California,
Orange County, High Desert and Los Angeles County. With 175
locations and nearly 4,000 caregivers (employees), Providence
Medical Foundation has been continually recognized as a leader in
quality, receiving top honors from various organizations, including
the Orange County Medical Association for Physicians of Excellence
and the Integrated Healthcare Association with distinction in
clinical quality. Providence Medical Foundation provides equal
employment opportunities (EEO) to all employees and applicants for
employment without regard to race, color, religion, sex, national
origin, age, disability or genetics. In addition to federal law
requirements, Providence Medical Foundation complies with
applicable state and local laws governing nondiscrimination in
employment in every location in which the company has facilities.
This policy applies to all terms and conditions of employment,
including recruiting, hiring, placement, promotion, termination,
layoff, recall, transfer, leaves of absence, compensation and
training.
Company: Providence Medical Foundation
Category: Administrative ( Non-clinical)
Req ID: R360309
Keywords: Providence Health & Services, Anaheim , Claim Representative - Claims, Other , Anaheim, California
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