Claims Examiner

Job Description

Quick2Hire is seeking an experienced Claims Examiner to join our team!

Assignment Details

• Location: Pomona, CA
• Duration: 13 Weeks
• Schedule: Full-Time, Day Shift
• Shift: Monday – Friday | 8:00 AM – 4:30 PM
• Pay: $27-$28/hour

Requirements

• High School Diploma or GED required
• Minimum 3 years of Claims Examiner experience
• Must have hands-on experience with the EZ Cap System
• Strong knowledge of medical claims processing, adjudication, and payer guidelines
• Ability to review, analyze, and resolve claims accurately and efficiently
• Excellent communication, organizational, and problem-solving skills
• Proficient with Microsoft Office applications

Responsibilities

• Review and process medical claims for accuracy and compliance with payer guidelines
• Examine claims for completeness and determine appropriate payment or denial
• Investigate and resolve claim discrepancies, denials, and payment issues
• Utilize the EZ Cap System to manage and process claims efficiently
• Communicate with providers, health plans, and internal departments regarding claim status and resolutions
• Maintain accurate documentation of all claim activities and follow-up actions
• Meet productivity and quality standards while ensuring timely claim processing
• Ensure compliance with HIPAA regulations and company policies

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