Hospital Claims Adjuster

Benefits:

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

About the Role:
MedPOINT Management in Sherman Oaks, CA is looking for a detail-oriented Hospital Claims Adjuster to join our dynamic healthcare team. In this role, you'll play a critical part in reviewing and processing hospital claims with accuracy and efficiency. If you're passionate about healthcare operations and thrive in a fast-paced environment, we want to hear from you!



Responsibilities:

• Review, analyze, and adjudicate inpatient and outpatient hospital claims in accordance with plan guidelines
• Verify patient eligibility, benefits, and coverage prior to claims processing
• Identify and resolve claim discrepancies, denials, and underpayments
• Apply ICD-10, CPT, and DRG coding knowledge to ensure accurate claim adjudication
• Coordinate with providers, hospitals, and internal departments to resolve claim issues
• Ensure compliance with state and federal healthcare regulations, including HIPAA
• Maintain accurate documentation and meet productivity and quality benchmarks

Requirements:

• 2+ years of experience in hospital or medical claims adjudication
• Proficiency in ICD-10, CPT, HCPCS, and DRG coding
• Familiarity with managed care, HMO, PPO, and IPA claims processing
• Strong knowledge of EOB preparation and explanation of benefits
• Experience with claims management software and healthcare information systems
• Excellent analytical, problem-solving, and organizational skills
• Strong attention to detail with the ability to meet deadlines in a high-volume environment

About Us:
MedPOINT Management is a leading Independent Physician Association (IPA) management company based in Sherman Oaks, CA, dedicated to delivering high-quality administrative and managed care services to healthcare providers across Southern California. Our clients trust us for our expertise, responsiveness, and commitment to operational excellence. Our employees thrive in a collaborative, mission-driven workplace where their contributions directly impact the quality of patient care.

This is a remote position.