Bakersfield, California, United States · Hybrid
$22/hr–$23/hr
We appreciate your interest in our organization and assure you that we are sincerely interested in your qualifications. A clear understanding of your background and work history will help us potentially place you in a po…
Skills: Medical Claims Processing, HMO Claims Payment, CPT Coding, ICD-10 Coding, ICD-9 Coding
Bakersfield, California, United States · Hybrid
$28/hr–$44/hr
Work Location: Hybrid or Onsite About us Kern Health Systems is dedicated to improving the health status of our members through an integrated managed health care delivery system. About the role Under limited supervision,…
Skills: Claims Processing, Staff Training, Curriculum Development, Auditing, Process Improvement
Bakersfield, California, United States · On-site
$21/hr–$31/hr
Work Location: On-Site About us Kern Health Systems is dedicated to improving the health status of our members through an integrated managed health care delivery system. About the role Under management direction, respons…
Skills: Medical Claims Processing, Claims Auditing, Billing Error Identification, Eligibility Verification, Manual Benefit Calculation
Bakersfield, California, United States · Hybrid
$28/hr–$44/hr
We appreciate your interest in our organization and assure you that we are sincerely interested in your qualifications. A clear understanding of your background and work history will help us potentially place you in a po…
Skills: Claims Processing, Staff Training, Curriculum Development, Adult Learning, Auditing
Bakersfield, California, United States · Hybrid
$22/hr–$23/hr
This is a full-time temporary position. If selected, onboarding will be completed through a staffing agency. “This position may be filled at the I or II level based on experience and qualifications.” Health maintenance o…
Skills: Medical Claims Processing, HMO Claims Payment, CPT Coding, ICD-10 Coding, ICD-9 Coding
Bakersfield, California, United States · Hybrid
$22/hr–$23/hr
We appreciate your interest in our organization and assure you that we are sincerely interested in your qualifications. A clear understanding of your background and work history will help us potentially place you in a po…
Skills: Medical Claims Processing, Medical Billing, COB Investigation, CPT Coding, ICD-10 Coding
Bakersfield, California, United States · On-site
$21/hr–$31/hr
*On-Site Position* About us Kern Health Systems is dedicated to improving the health status of our members through an integrated managed health care delivery system. About the role Under management direction, responsible…
Skills: Claims Processing, Medical Billing, Claims Auditing, Eligibility Verification, Fraud Detection
Bakersfield, California, United States · Hybrid
$28/hr–$44/hr
Work Location: Hybrid About us Kern Health Systems is dedicated to improving the health status of our members through an integrated managed health care delivery system. About the role Under limited supervision, the Claim…
Skills: Claims Processing, Adult Learning, Curriculum Development, Staff Training, Auditing
Bakersfield, California, United States · On-site
$21/hr–$31/hr
We appreciate your interest in our organization and assure you that we are sincerely interested in your qualifications. A clear understanding of your background and work history will help us potentially place you in a po…
Skills: Medical Claims Processing, Claims Auditing, Billing Error Identification, Eligibility Verification, Manual Benefit Calculation
Bakersfield, California, United States • Hybrid
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Responsible for reviewing and processing various medical and facility claims for payment accurately and timely. This includes resolving suspended claims, identifying billing errors, and ensuring adherence to contract benefits and policies.
Requires a high school diploma and up to 2 years of experience in medical claim payment or billing processing. Proficiency in medical coding (CPT, ICD-10) and HMO claims processing is highly desired.
We appreciate your interest in our organization and assure you that we are sincerely interested in your qualifications. A clear understanding of your background and work history will help us potentially place you in a position that meets your objectives and those of the organization. Qualified applicants are considered for positions without regard to race, color, religion, sex (including pregnancy, childbirth and breastfeeding, or any related medical conditions), national origin, ancestry, age, marital or veteran status, sexual orientation, gender identity, genetic information, gender expression, military status, or the presence of a non-job related medical condition or disability (mental or physical).
Kern Health Systems is dedicated to improving the health status of our members through an integrated managed health care delivery system.
Under management direction, responsible for reviewing and processing all types of medical and facility claims from contracting and non-contracting providers and from subscribers and enrollees for payment in an accurate and timely manner. Responsible for applying correct contract benefits, policies and procedures.
This position is responsible for claims auditing and payment functions for a Knox-Keene licensed health maintenance organization (HMO).
Resolve system suspended claims for:
PCPs
Labs Radiology
Less complicated specialists Physical Therapy
Employment Standards:
High School Diploma from an accredited school or equivalent.
Up to (1-2) years of medical claim payment or medical billing processing experience
Experience investigating COB.
Ability to calculate usual and prevailing fees.
Health maintenance organization (HMO) claims payment-processing experience is highly desirable.
Computerized on-line data entry systems; organizational structure of medical claims processing; methods and procedures utilized in medical claims processing; medical terminology; CPT & ICD-9 coding; COB & subrogation investigation.
Adapt to a rapidly evolving work environment; work independently; communicate with a variety of personnel and providers.
Computerized on-line data entry systems; organizational structure of medical claims processing; medical terminology; HCPCS, CPT & ICD-10 coding, UB04 and CMS1500 forms.
We are an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis.
Dedicated to improving the health status of our members through an integrated, managed health care delivery system.
Kern Health Systems, known as Kern Family Health Care, was established in 1993 as a managed care health plan, and is the largest health plan in Kern County. Kern Health Systems is committed to providing quality health care to our members. It is important to ensure good health through continuity of care by connecting each member to a provider of their choice within our provider network. Our extensive provider network includes the Traditional and Safety-Net Providers that historically delivered care to Medi-Cal recipients and private providers throughout Kern County and some parts of Los Angeles County. We believe good patient/physician relationships and effective preventive care are true indicators of our success. We also offer a continuum of care that extends beyond doctor visits. With a full range of health education classes and Care/Disease Management programs, we provide quality educational and preventive services to the population we serve. We are able to achieve this through partnerships with our providers and community-based organizations within Kern County. The difference is clear: We hold the standard high when it comes to quality health care for our members. Our Mission: Kern Health Systems is dedicated to improving the health status of our members through an integrated managed health care delivery system. As Kern Health Systems continues to move forward, we will continue to uphold our mission of being dedicated to improving the health status of our members through an integrated managed healthcare delivery system. As the healthcare landscape has been transformed, we will pursue tomorrow with community and provider innovation, enhanced member access, and strengthened member health and wellbeing...Together.
Offices: 2900 Buck Owens Blvd, Bakersfield, California 93308, US
Dedicated to improving the health status of our members through an integrated, managed health care delivery system.
Kern Health Systems, known as Kern Family Health Care, was established in 1993 as a managed care health plan, and is the largest health plan in Kern County. Kern Health Systems is committed to providing quality health care to our members. It is important to ensure good health through continuity of care by connecting each member to a provider of their choice within our provider network. Our extensive provider network includes the Traditional and Safety-Net Providers that historically delivered care to Medi-Cal recipients and private providers throughout Kern County and some parts of Los Angeles County. We believe good patient/physician relationships and effective preventive care are true indicators of our success. We also offer a continuum of care that extends beyond doctor visits. With a full range of health education classes and Care/Disease Management programs, we provide quality educational and preventive services to the population we serve. We are able to achieve this through partnerships with our providers and community-based organizations within Kern County. The difference is clear: We hold the standard high when it comes to quality health care for our members. Our Mission: Kern Health Systems is dedicated to improving the health status of our members through an integrated managed health care delivery system. As Kern Health Systems continues to move forward, we will continue to uphold our mission of being dedicated to improving the health status of our members through an integrated managed healthcare delivery system. As the healthcare landscape has been transformed, we will pursue tomorrow with community and provider innovation, enhanced member access, and strengthened member health and wellbeing...Together.
Offices: 2900 Buck Owens Blvd, Bakersfield, California 93308, US
