Claims Examiner

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Vision insurance
• Wellness resources
• Company parties
• Employee discounts
• Free food & snacks
• Opportunity for advancement
• Paid time off
• Parental leave
• Savings bank
• Training & development

About the Role:
MedPOINT Management in Sherman Oaks, CA is looking for a detail-oriented Claims Examiner to join our growing team. This is a great opportunity to play a key role in the healthcare management space, ensuring accurate and timely processing of medical claims. If you thrive in a fast-paced environment and have a passion for precision, we want to hear from you!



Responsibilities:

• Review, analyze, and process medical claims in accordance with plan benefits and company guidelines
• Verify member eligibility, provider information, and coverage details prior to claims adjudication
• Identify and resolve claims discrepancies, duplicates, and billing errors
• Apply ICD-10, CPT, and HCPCS coding knowledge to ensure accurate claims processing
• Coordinate with providers, members, and internal departments to resolve claims inquiries
• Maintain accurate records and documentation in claims management systems
• Ensure compliance with state and federal healthcare regulations, including HIPAA

Requirements:

• 2+ years of experience in medical claims processing or claims examination
• Proficiency in ICD-10, CPT, and HCPCS coding
• Familiarity with HMO, PPO, and managed care plan structures
• Strong knowledge of EOB (Explanation of Benefits) and claims adjudication processes
• Experience with claims management software and healthcare information systems
• Excellent attention to detail and strong analytical skills
• Effective written and verbal communication skills
• Knowledge of HIPAA regulations and healthcare compliance standards

About Us:
MedPOINT Management is a leading Independent Physician Association (IPA) management company based in Sherman Oaks, CA, dedicated to delivering high-quality healthcare administrative services. Our clients trust us to manage their operations with integrity, efficiency, and a patient-first mindset. We foster a collaborative and supportive work environment where employees are empowered to grow and make a meaningful impact in the healthcare industry.

This is a remote position.