AltaMed Health Services · 10 hours ago
Claims Examiner I
Montebello, CA
Full-time
Hybrid
New Grad, Entry Level
$25/hr - $29.32/hrAltaMed Health Services is dedicated to providing exceptional care to the community. The Claims Examiner is responsible for analyzing and adjudicating medical claims, resolving payment issues, and collaborating with departments to address claims-related inquiries.
FitnessHealth CareWellness
Responsibilities
Analyzing and adjudication of medical claims as it relates to managed care
Performs payment reconciliations and/or adjustments related to retroactive contract rate and fee schedule changes
Resolve claims payment issues as presented through the Provider Dispute Resolution (PDR) process or from claims incidents/inquiries
Identifies root causes of claims payment errors and reports to Management
Responds to provider inquiries/calls related to claims payments
Collaborates with other departments and/or providers in the successful resolution of claims-related issues
Qualification
Required
HS Diploma or GED
Must have some knowledge of Medi-Cal regulations
Must have some Knowledge of medical terminology
Must understand to read and interpret DOFRs and Contracts
Must have an understanding of how to read a CMS-1500 and UB-04 form
Must have strong organizational and mathematical skills
Must be able to multi-task
Preferred
Preferred knowledge of Medicare and Commercial rules and regulations
Benefits
Medical, Dental and Vision insurance
403(b) Retirement savings plans with employer matching contributions
Flexible Spending Accounts
Commuter Flexible Spending
Career Advancement & Development opportunities
Paid Time Off & Holidays
Paid CME Days
Malpractice insurance and tail coverage
Tuition Reimbursement Program
Corporate Employee Discounts
Employee Referral Bonus Program
Pet Care Insurance
Company
AltaMed Health Services
AltaMed is one of the nation’s largest community health networks.
Founded in 1986
5001-10000 employees
H1B Sponsorship
AltaMed Health Services has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (9)
2024 (5)
2023 (10)
2022 (5)
2021 (2)
2020 (5)
Funding
Current Stage
Late StageTotal Funding
$0.05MKey Investors
Latino Community FoundationSoutheast Los Angeles (SELA) CollaborativeExact Sciences
2025-01-14Grant
2024-03-06Grant
2023-07-26Grant· $0.05M
Leadership Team
Castulo de la Rocha
President & CEO
Efrain Talamantes
Chief Operating Officer
Recent News
HealthCareIT News
2025-11-19
exactsciences.com
2025-01-20
Company data provided by crunchbase