Remote Temporary Claims Technician II

Summary

Join us at Central California Alliance for Health (the Alliance) is an award-winning regional Medi-Cal managed care plan that provides health insurance for children, adults, seniors and people with disabilities in Mariposa, Merced, San Benito and Santa Cruz counties. We currently serve more than 418,000 members.

Requirements

• 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
• Knowledge of: Medical insurance Explanation of Benefits, General office equipment, including personal computer, telephone, photocopier, fax, etc., Windows-based PC systems, including Microsoft Word, Excel, and Outlook
• Ability to: Understand current software programs and screens that are required in the daily processing of claims, Keep current on claims processing practices and procedures

Responsibilities

• 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
• Assists with training new hires and cross-training other Claims Technicians

Benefits

• Medical, Dental and Vision Plans
• Ample Paid Time Off
• 12 Paid Holidays per year
• 401(a) Retirement Plan
• 457 Deferred Compensation Plan
• Robust Health and Wellness Program
• Onsite EV Charging Stations