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Claims Examiner

San Leandro, CA

Order: 143212

A local, federally qualified, community health center organization in the San Leandro area is seeking a long term Claims Examiner to join their team in February 2020. This is a 6-12 month contract opportunity with the possibility for extension. The successful Claims Examiner will be responsible for examining all type of specialty & clinic claims based on a comprehensive knowledge of benefit package, utilization guidelines and appropriate division of financial responsibility. Provides support for coding and provider dispute reviews. Supporting the supervisor in various health plan audit preparations and reporting. Contact provider office for additional information on claims inquiries and resolve issues. Claims Examiner will perform other duties as assigned.

Claims Examiner Requirements:

  • 3-4 years of proven medical claims examiner experience

  • Comprehensive knowledge of PCP, Capitation, Specialty, Ancillary, ER and Facility claims processing in an IPA / HMO setting

  • Competent in CPT and ICD-9 & ICD-10 coding

  • Excellent communication skills (written and verbal)

  • Ability to prioritize and manage multiple projects and maintain deadlines


Start: February 2020

Duration: 6-12 Months with the possibility of extension

Compensation: $27 hourly + Medical + CA Paid Sick Leave + 401k

Call to Action: Email qualified resume to tpgsr@theplusgroup.com


Best of Staffing Diamond Award ~ 2019~

The Plus Group, Inc. has been named one of Inavero’s 2019 Best of Staffing® Award winners and has also earned the 2019 Best of Staffing Diamond Award for achieving the highest client and talent service quality scores for ten consecutive years. Presented in partnership with CareerBuilder, the tenth annual Best of Staffing Award provides the only statistically valid and objective service quality benchmarks in the industry, revealing which staffing agencies are providing the highest satisfaction to their clients and talent.