Ezcap Claim Examiner - Remote

Overview

The Ezcap Claim Examiner is responsible for reviewing, processing, and adjudicating high-complexity healthcare claims while ensuring compliance with company policies and regulatory requirements.

In Short

• Contract position lasting 3-6 months.
• Requires 5-6 years of experience with EZ-CAP.
• Experience with Medi-Cal (California Medicaid) is essential.
• Review and process healthcare claims.
• Ensure accurate application of relevant codes.
• Validate claim forms for completeness and accuracy.
• Assess medical necessity and coverage eligibility.
• Investigate and resolve claim discrepancies.
• Work in compliance with company policies and regulations.
• Telecommute position.

Requirements

• 5-6 years of experience with EZ-CAP.
• Experience with Medi-Cal (California Medicaid).
• Strong understanding of healthcare claims processing.
• Knowledge of CPT, ICD-10, and HCPCS coding.
• Ability to assess medical necessity and coverage eligibility.
• Strong analytical and problem-solving skills.
• Attention to detail and accuracy.
• Excellent communication skills.
• Ability to work independently.
• Familiarity with regulatory requirements in healthcare.

Benefits

• Flexible work environment.
• Opportunity to work remotely.
• Gain experience in healthcare claims processing.
• Collaborate with a team of professionals.
• Potential for contract extension based on performance.