We are looking for an experienced Insurance Claims Examiner to join our team on a contract basis in Oakland, California. In this role, you will analyze and process medical claims, ensuring accuracy and compliance with healthcare regulations. Ideal candidates will have a strong background in insurance claims management and coding, along with the ability to work independently in a fast-paced environment. Responsibilities:• Review and adjudicate medical claims for accuracy and compliance with Medi-Cal, Medicare, and other healthcare regulations.• Research and resolve claim discrepancies, ensuring proper payment and documentation.• Utilize coding systems such as ICD-10, CPT, and HCPCS to verify claim accuracy.• Maintain confidentiality while handling sensitive participant and family information.• Follow organizational policies and procedures to ensure compliance and attention to detail.• Exhibit consistent attendance and punctuality while meeting deadlines.• Communicate effectively with internal teams and external stakeholders to address claim issues.• Input accurate data into various computer systems and software programs.• Provide courteous and detail-oriented customer service to all stakeholders.• Perform additional duties as assigned to support claims processing activities. If you are interested in this role please apply now and call us at (510) 470-7450, it is an urgent need for our client.

• Comprehensive understanding of medical coding systems, including ICD-10, CPT, and HCPCS. • Minimum of 3 years of claims processing experience in a Medicare/Medi-Cal environment. • Proficiency in computer applications such as Outlook, Excel, and Word. • Ability to work effectively in a multidisciplinary setting. • High school diploma required; bachelor's degree preferred. • Strong auditing, billing, and claim administration skills. • Familiarity with CMS platforms and 3M systems. • Excellent organizational and communication skills, with the ability to prioritize tasks and meet deadlines.

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Oakland, CA
onsite
Temporary
26.60 - 30.80 USD / Hourly
We are looking for an experienced Insurance Claims Examiner to join our team on a contract basis in Oakland, California. In this role, you will analyze and process medical claims, ensuring accuracy and compliance with healthcare regulations. Ideal candidates will have a strong background in insurance claims management and coding, along with the ability to work independently in a fast-paced environment. Responsibilities:• Review and adjudicate medical claims for accuracy and compliance with Medi-Cal, Medicare, and other healthcare regulations.• Research and resolve claim discrepancies, ensuring proper payment and documentation.• Utilize coding systems such as ICD-10, CPT, and HCPCS to verify claim accuracy.• Maintain confidentiality while handling sensitive participant and family information.• Follow organizational policies and procedures to ensure compliance and attention to detail.• Exhibit consistent attendance and punctuality while meeting deadlines.• Communicate effectively with internal teams and external stakeholders to address claim issues.• Input accurate data into various computer systems and software programs.• Provide courteous and detail-oriented customer service to all stakeholders.• Perform additional duties as assigned to support claims processing activities. If you are interested in this role please apply now and call us at (510) 470-7450, it is an urgent need for our client.
2025-12-29T20:08:41Z

Insurance Claims Examiner Job in Oakland, CA | Robert Half