Job Description
Description We are looking for a Medical Claims Representative to join our team in Pleasanton, California in a Contract to Permanent role. This position is ideal for someone with experience handling medical claims, billing activity, and insurance-related documentation in a fast-paced environment. The person in this role will support accurate claim review and member-related processing while communicating clearly with Spanish-speaking members and internal teams. Success in this position requires strong knowledge of medical terminology, benefit plans, and claims administration procedures.
Responsibilities:
• Review, evaluate, and process medical claims with close attention to accuracy, completeness, and applicable coverage details.
• Enter and maintain member, enrollment, beneficiary, and medical information within internal claims systems while following established procedures.
• Verify insurance details and confirm benefit eligibility to support timely and correct claim...
Responsibilities:
• Review, evaluate, and process medical claims with close attention to accuracy, completeness, and applicable coverage details.
• Enter and maintain member, enrollment, beneficiary, and medical information within internal claims systems while following established procedures.
• Verify insurance details and confirm benefit eligibility to support timely and correct claim...