New

Claims Technician II

Central California Alliance for Health
medical insurance, paid time off, paid holidays, retirement plan
United States, California, Mariposa
Jan 17, 2025
Claims Technician II Location: Mariposa County, California; Merced County, California; Monterey County, California; San Benito County, California; Santa Cruz County, California We have an opportunity to join the Alliance as a Claims Technician II in the Claims Department. WHAT YOU'LL BE RESPONSIBLE FOR Reporting to the Claims Supervisor you will: Verify, process, and/or adjudicates claims, including applying detailed consideration, standards in pending and releasing claims from pend edits and for proper application of program policy related to claim entry and analysis Assists with training new hires and cross-training other Claims Technicians ABOUT THE TEAM We support Alliance members' access to care by ensuring medical services are paid to network providers accurately and on time. WHAT YOU'LL NEED TO BE SUCCESSFUL To read the full position description, and list of requirements click here. Knowledge of: medical insurance Explanation of Benefits general office equipment, including personal computer, telephone, photocopier, fax, etc. Windows-based PC systems, including Microsoft Word, Excel, and Outlook Ability to: understand current software programs and screens that are required in the daily processing of claims keep current on claims processing practices and procedures Education and Experience: High school diploma or equivalent and two years (or an Associate's degree and a minimum of one/two years) of relevant experience with claims processing in an automated claim environment; or a combination of education and relevant experience may be qualifying OTHER INFORMATION We are in a hybrid work environment and we anticipate that the interview process will take place remotely via Microsoft Teams. While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected. In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process. The full compensation range for this position is listed by location below. The actual compensation for this role will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferrable experience related to the position, education or training), as well as other factors (internal equity, market factors, and geographic location). Typical areas in Zone 1: Bay Area, Sacramento, Los Angeles area, San Diego area Typical areas in Zone 2: Fresno area, Bakersfield, Central Valley (with the exception of Sacramento), Eastern California, Eureka area Zone 1 (Monterey, San Benito and Santa Cruz) $20.76 - $33.25 USD Zone 2 (Mariposa and Merced) $18.91 - $30.36 USD OUR BENEFITS Available for all regular Alliance employees working more than 30 hours per week. Some benefits are available on a pro-rated basis for part-time employees. These benefits are unavailable to temporary employees while on an assignment with the Alliance. Medical, Dental and Vision Plans Ample Paid Time Off 12 Paid Holidays per year 401(a) Retirement Plan 457 Deferred Compensation Plan Robust Health and Wellness Program Onsite EV Charging Stations ABOUT US We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us. Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve members in Mariposa, Merced, Monterey, San Benito and Santa Cruz counties. To learn more about us, take a look at our Fact Sheet. The Alliance is an equal employment opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national origin, age, marital status, protected veteran status, or disability status. We are an E-Verify participating employer At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.