Motion Picture Industry Pension & Health Plans (MPI) is looking for a Senior Medical Claims Examiner to join our Medical Claims team! The Examiner will contribute to the timely and accurate processing of participant’s medical claims by auditing adjudicated medical claims, responding to internal audit rebuttals, and reviewing outside audit errors among other things.
Qualifications:

• Minimum 2 years verifiable claims processing experience with quality average of 95%

• Knowledge of CPT, HCPCs, ICD-9, COB, and Medical Terminology

• In depth knowledge of QNXT configuration and processing, WGS processing, and Health Eligibility systems

• Good organizational skills with strong attention to detail

• Clear and effective oral and written communication skills

• Good interpersonal skills with the ability to interact with individuals at all levels of the organization

• Excellent attendance with the ability to work overtime/extended hours as needed

Your responsibilities would include:

• Audit both manually and automatically adjudicated medical claims

• Maintain random and high dollar audit records

• Respond to internal audit rebuttals

• Review outside audit errors

• Test configuration changes

• Collect and compile monthly audit data for interdepartmental communication

• Participate in development and maintenance of departmental procedures

• Act as resource to department staff

• Process complex or technically difficult claims

• Actively execute appropriate claim activities to ensure consistent quality/configuration of claims processing

Job Type: Full-time

Pay: $25.46 per hour

Benefits:

• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Paid time off
• Tuition reimbursement
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

COVID-19 considerations:
All employees are required to be fully vaccinated against Covid-19. Workspaces are socially distanced and high touchpoint areas are sanitized frequently.

Ability to commute/relocate:

• Studio City, CA 91604: Reliably commute or planning to relocate before starting work (Preferred)

Work Location: One location

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