Location
San Diego
Job Type
Full-time
Posted
June 28, 2026
Job Description
JOB SUMMARY:
The primary purpose of this position is to examine & process claims from the UB04 & CMS-1500 claim forms into the claims adjudication system for all capitated & shared services accounts. This position is responsible for the accurate review, input & adjudication of claims using payment policies & methodologies that are consistent with and recognized by Health Plans nationally recognized medical organizations federal regulatory bodies & contractual obligations of the organization.
SKILLS REQUIRED:
- Excellent critical thinking skills
- Strong decision-making ability
- Administrative and interpersonal skills
- Outstanding customer service skills
- Ability to work under pressure
MINIMUM QUALIFICATIONS:
High School Diploma, G.E.D. or Equivalent
Two years of experience
PREFERRED QUALIFICATIONS:
Three years of experience
**The current salary range for this position...
The primary purpose of this position is to examine & process claims from the UB04 & CMS-1500 claim forms into the claims adjudication system for all capitated & shared services accounts. This position is responsible for the accurate review, input & adjudication of claims using payment policies & methodologies that are consistent with and recognized by Health Plans nationally recognized medical organizations federal regulatory bodies & contractual obligations of the organization.
SKILLS REQUIRED:
- Excellent critical thinking skills
- Strong decision-making ability
- Administrative and interpersonal skills
- Outstanding customer service skills
- Ability to work under pressure
MINIMUM QUALIFICATIONS:
High School Diploma, G.E.D. or Equivalent
Two years of experience
PREFERRED QUALIFICATIONS:
Three years of experience
**The current salary range for this position...
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