Sharp HealthCare Claims Processor in San Diego, California

Summary

The Claims Processor will do adjudication of referral claims and all related functions. Department is comprised of 5 claims processing units that process HMO claims for 3 medical groups and Sharp Health Plan.

Sharp System Services have campuses located in the communities of Kearny Mesa and Serra Mesa and consist of the Spectrum location, the Ruffin Road location and Sharp Operations Center (SOC). These offices provide the centralized integrated system support services to the operating entities within the system. These services include: Strategic Planning, Business Development, Information Technology, Compliance, Internal Audit, Legal, Risk Management and Insurance, Contracts, Human Resources, Facilities Management and Development, Clinical Effectiveness, Finance, Nursing, Systems Supply Chain Services, Marketing and Communications, The Sharp Experience and Sharp University.

Essential Physical Requirements may include

  • Sitting

  • Lift up to 10 pounds

  • Push/Pull up to 10 pounds

  • Carry up to 10 pounds

Additional physical requirements of position may be discussed during interview.

Sharp HealthCare is proud to be an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, gender identity, transgender status, sexual orientation, protected veteran status or any other protected class.

Keywords: Claims Processor, Medical Claims.

Location

This position is located in Kearny Mesa, San Diego County at the Sharp Spectrum Corporate Office.

Hours:Variable 8 hour days with flexible start time between 5 am - 9 am. Weekends as needed

Required Skills and Qualifications

  • One-year previous claims processing experience in an HMO or indemnity insurance setting (HMO preferred).

  • Strong understanding of standard insurance procedures (pricing, exclusions, etc.)

  • Working knowledge of medical terminology and RVS/CPT/ICD-9 coding.

  • Ten key by touch.

  • CRT keyboard skills.

  • Good verbal and written skills.

  • Strong organizational skills.

.

Preferred Skills and Qualifications

  • High school graduate or equivalent.

  • Some college.

Job: *Business Operations Jobs

Organization: *85310 - PFS Claims Processing

Title: Claims Processor

Location: San Diego-Spectrum

Requisition ID: 87462