California Licensed Claim Examiner
Company: VirtualVocations
Location: Vista
Posted on: May 16, 2025
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Job Description:
A company is looking for a Business Analyst specializing in
claims examination.
Key Responsibilities
Review, process, and adjudicate high-complexity healthcare claims
in compliance with policies and regulations
Ensure accurate application of relevant medical codes including
CPT, ICD-10, and HCPCS
Investigate and resolve complex claim discrepancies and issues
Required Qualifications
5-6 years of experience with EZ-CAP
Experience with Medi-Cal (California Medicaid)
Knowledge of healthcare claims processing and adjudication
Familiarity with medical coding standards
Ability to assess medical necessity and coverage eligibility
Keywords: VirtualVocations, Pomona , California Licensed Claim Examiner, Other , Vista, California
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