21 days old

Claims Review Specialist

Kelly Services
Monterey Park, CA 91755
**Claims Review Specialist Monterey Park, CA**

Kelly Services, a global leader in staffing solutions, is seeking Claims Review Specialists with an industry-leading health insurance client in the Monterey Park, CA area! Contract opportunity starting in August 2019- January 2020, with a potential to extend.

Pay Rate: Up to $23.00 per hour

Job Description:

+ Responsible for the handling of assigned provider appeals by inputting into appropriate databases, writing letters, obtaining medical records as needed, speaking with members and providers, researching cases, resolving issues and mailing and faxing resolution letters and ensuring time frames are met for acknowledgement and resolution letters. Must comply with all regulatory requirements and policies. Communicate with Providers.

+ PDR Coordinator

+ Responsible for receiving and reviewing appeals that have been submitted

+ Claims background

+ At least 1 year Or at least have worked in a hospital, medical group or doctors office

+ Hippa and UB experience

+ Be able read an appeal and research further

+ Claims experience

+ Provider dispute resolution -PDR processing will work as well

+ Claims examiners

+ Day to day

+ Reviewing provider appeals that come into the department

+ Determine if it is timely

+ Review contracts to see if additional payment is due

+ Submit to nurse if additional payment is due

Education/ Minimum Requirements:

+ High School Diploma or GED required

+ MS Office Skills: Intermediate Excel skills

+ 40 wpm minimum typing required

+ Responsible for handling Provider Claims

+ Provider dispute review experience is a plus on the **provider side** , _not_ the member side

+ MUST HAVE 2 years of healthcare claims experience; claims in healthcare-not collections, workers comps, car claims etc


+ Training 8-430

+ 1 week-classroom

+ Nesting-1 week 830-5

+ Schedule

+ Can pick a time from 7:00 am-8:30 PM

+ Overtime

+ Yes

+ Extend or go fte

Apply Today!

Important information: This position is recruited for by a remote Kelly office, not your local Kelly branch. Please submit your resume to be considered for this position. If you have questions about the opening, you may contact the recruiter for this position at .

Why Kelly?

As a Kelly Services candidate you will have access to numerous perks, including:

Exposure to a variety of career opportunities as a result of our expansive network of client companies

Career guides, information and tools to help you successfully position yourself throughout every stage of your career

Access to more than 3,000 online training courses through our Kelly Learning Center

Group-rate insurance options available immediately upon hire (Available for purchase and administered by a designated third-party vendor)

Weekly pay and service bonus plans

We invite you to bookmark our Web site and encourage you to review it regularly for new opportunities worldwide: .

Kelly Services is a U.S.-based Fortune 1000 company. With our global network of branch locations, we are uniquely positioned to provide our customers with international staffing support and our employees with diverse assignments around the world. Kelly Services is an Equal Opportunity Employer.

**Why Kelly** **** **?**

At Kelly
Services , we work with the best. Our clients include 95 of the Fortune
100 companies, and more than 70,000 hiring managers rely on Kelly annually to access
the best talent to drive their business forward. If you only make one career connection today, connect
with Kelly.

**AboutKelly Services** ****

As a workforce advocate for over 70 years, we are proud to directly employ nearly 500,000 people
around the world and have a role in connecting thousands more with work through our global network of
talent suppliers and partners. Revenue in 2017 was $5.4 billion. Visit and connect with us on Facebook, LinkedIn and Twitter .

Kelly Services is an equal opportunity employer including, but not limited to, Minorities, Females,
Individuals with Disabilities, Protected Veterans, Sexual Orientation, Gender Identity and is
committed to employing a diverse workforce. Equal Employment Opportunity
is The Law.
Posted: 2019-07-29 Expires: 2019-08-29

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Claims Review Specialist

Kelly Services
Monterey Park, CA 91755

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