Claims Specialist

Are you passionate about making a difference in people's lives? Do you enjoy working in a service-oriented industry? If so, this opportunity may be the right fit for you!
Modivcare is looking for a Claims Specialist to assist the billing department with special projects that fall outside of an adjudicator function. You will serve as a liaison between coordination, adjudication, EOP, billing, collections and operations. You will have to learn all aspects of each department within billing and the call center. You will partner with the Leads from each department in billing. You will report to the Claims management team.
You will...

• Manage monthly OCR and report to CA Operations
• Educate providers and act as liaison
• Review possible MRU claims to determine if claim has to be sent the medical review unit of the insurance company
• Review and potentially process NET rejections claims based on volume
• Complete the month end close Medicare/Medi-Cal spreadsheet
• Run and resolve the received/not paid report
• Act as a liaison between NET and CBL claims

We are excited to speak to someone with the following...

• High School Diploma or General Education Degree
• Medical/ambulance claims coding certificate recommended
• 0-2 years experience in health care benefits or claims processing
• Prior training experience
• Minimum one year experience leading or directing staff
• LCAD or Delta Force experience

Pay: Starting at $14.42/hour
We value our team members and realize the importance of benefits for you and your family.
Modivcare offers a comprehensive benefits package to include the following:

• Medical, Dental, and Vision insurance
• Employer Paid Basic Life Insurance and AD&D
• Voluntary Life Insurance (Employee/Spouse/Child)
• Health Care and Dependent Care Flexible Spending Accounts
• Pre-Tax and Post --Tax Commuter and Parking Benefits
• 401(k) Retirement Savings Plan with Company Match
• Paid Time Off
• Paid Parental Leave
• Short-Term and Long-Term Disability
• Tuition Reimbursement
• Employee Discounts (retail, hotel, food, restaurants, car rental and much more!)

Modivcare is an Equal Opportunity Employer.

• EEO is The Law - click here for more information
• Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled
• We consider all applicants for employment without regard to race, color, religion, sex, sexual orientation, national origin, age, handicap or disability, or status as a Vietnam-era or special disabled veteran in accordance with federal law. If you need assistance, please reach out to us at [email protected].
• Modivcare requires all employees to be vaccinated for COVID-19. Modivcare is an equal opportunity employer and consistent with federal, state, and local requirements, will consider requests for exemptions from this policy as required under the law.