Our client is seeking experienced Remote Medical Claims Examiners for a stable, long-term opportunity. While this position is primarily remote, it is strictly limited to candidates who currently reside within the Kern County area. This residency requirement is essential because all new hires must be able to attend two weeks of mandatory, in-person training at our offices in Bakersfield, CA. Please do not apply unless you are available to commute to Bakersfield daily for the initial two-week training period.

Technical compatibility is a non-negotiable requirement for this role. To successfully access client systems, Citrix, and various claims platforms, candidates must already own and use a personal PC or laptop equipped with Windows 11. This equipment must be in your possession at the time of application, as Windows 11 is the only operating system that supports our specific security and processing protocols.

Professional experience is vital for success in this role. We require candidates to have at least three years of recent experience processing medical claims specifically on the payer side. This experience must include hands-on claims adjudication, as you will be responsible for reviewing and processing medical claims, verifying eligibility, checking coding accuracy, and applying correct benefits according to policy guidelines. Applicants should possess a high school diploma or GED and demonstrate a strong mastery of medical terminology, ICD, CPT, HCPCS, EOBs, and standard adjudication procedures.

The ideal candidate will thrive in a high-volume environment, maintaining high accuracy while meeting strict production standards. While the role is fully remote after the initial training phase, we are looking for dedicated professionals with a background in managed care or experience reviewing medical records and processing Medi-Cal, Medicare, or commercial claims. This is an excellent opportunity for an experienced examiner looking for a long-term, stable career with a reputable organization.

Apply for this great position as a REMOTE CLAIMS EXAMINER
Send resume to Yarely Villalpando - yvillalpando(@)appleone.com


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For temporary assignments lasting 13 weeks or longer, AppleOne is pleased to offer major medical, dental, vision, 401k and any statutory sick pay where required.

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