We’re seeking a self-motivated, detail-oriented, deadline-driven individual with:

·        Bachelor's degree and/or equivalent experience

·         Five or more years of medical claims payment experience in Medicare Advantage or combination of equivalent years of education, training and experience

·         Expertise in industry-standard claims adjudication policies, procedures, and processes

·         Knowledge of fee schedule and pricing methodologies for outpatient/inpatient institutional, ancillary, professional claims, and Medicare fee schedules

·         Understanding of CPT, HCPCS, ICD-10, ASA, Revenue Codes

·         Experience researching and resolving provider dispute resolutions, adjustments, appeals, and reopen guidelines

·         Understanding of Claim Adjustment Reasons and Remittance Advice Remark codes

·         Knowledge of medical terminology

·         Ability to accurately key between 6,000 and 8,000 keystrokes or type 40 - 50 WPM

·         Strong analytical, mathematical, organizational, and problem-solving skills

·         Computer proficiency with Microsoft Word and Excel

·         Knowledge of claims adjudication systems (e.g., EPIC-Tapestry, QNXT, IDX Facets)

·         Willingness to learn new technologies, practices, and procedures

UCLA Health is a world-renowned health system with four award-winning hospitals and more than 260 community clinics throughout Southern California. We’re also home to the world-class medical research and clinical education capabilities of the David Geffen School of Medicine. Through the efforts of our outstanding people, we have become Los Angeles’ trusted provider of exceptional, compassionate patient care. If you’re looking to experience greater challenge and fulfillment in your career, you can at UCLA Health.