Job Title: Claims Adjuster
Location: Pleasanton, CA
Pay: $33-$35 per hour
Schedule: Monday-Friday, 8:30 AM-5:00 PM (30-minute lunch + two 15-minute breaks)
Employment Type: Contract (6 months+, potential for extension or conversion)
Key Responsibilities
Handle high-volume inbound calls (up to 40 calls/day) regarding medical claims
Review and interpret medical claims, coding, and benefits information
Verify accuracy of coding and supporting documentation
Assist members in understanding claims and next steps
Route or escalate claims to appropriate parties when needed
Input and maintain accurate data in internal systems
Collaborate with team members and proactively ask questions when needed
Qualifications
Required: Bilingual in Spanish
Experience with medical terminology, medical coding, and/or claims processing
Ability to assess and make judgment calls on claim accuracy
Strong attention to detail and problem-solving skills
Comfortable handling high call volumes in a fast-paced environment
Confident communicator who is not hesitant to ask questions
Systems & Tools
Microsoft Teams
Microsoft Excel
Basis (data entry for member information)
Phone systems (daily use)
Pay Details: $33.00 to $35.00 per hour
Search managed by: Joyce Reyes
Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.
Equal Opportunity Employer/Veterans/Disabled
Military connected talent encouraged to apply
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The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:
Massachusetts Candidates Only: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.