Claims Processor II

Top Job

Located in Visalia, CA

Salary: 20.00-22.00

Claims Processor II – Full Time 

Location: Visalia, CA Schedule: Monday–Friday, 8:00 AM–5:00 PM Employment Type: Full-Time, On-Site

 

A respected healthcare organization in Visalia is seeking an experienced Claims Processor II to join its Blue Cross Operations team. This role is ideal for someone who is detail-oriented, analytical, and confident processing professional and facility claims with accuracy and consistency.

Position Overview

The Claims Processor II is responsible for adjudicating claims in accordance with company policies, procedures, and regulatory guidelines. Work is performed independently within established instructions, with support from leadership when needed. The environment is friendly, collaborative, and non-competitive.

Key Responsibilities

• Accurately process professional and facility claims.

• Read and interpret provider contracts and LOAs to ensure payment accuracy.

• Identify trends and report findings to management.

• Meet productivity, timeliness, and quality standards consistently.

• Handle reprocessing projects and cross-functional claim resolution.

• Manage most claim types/issues submitted to the supported team.

• Attend weekly department meetings.

• Maintain regular and predictable on-site attendance.

Required Skills & Abilities

• Strong clerical and administrative skills.

• Proficiency with computers, electronic systems, and claims-related software.

• Solid understanding of ICD-9 and ICD-10.

• Active listening and clear verbal/written communication.

• High attention to detail and accuracy.

• Ability to monitor processes and identify issues.

• Dependability, integrity, and a cooperative attitude.

Education & Experience

• High school diploma or GED required.

• Minimum one year of experience actively working as a Claims Processor handling both professional and hospital claims.

• Cross-trained in all lines of business (LOBs).

Work Environment & Physical Requirements

• Indoor office environment, 100% on-site.

• Ability to walk, sit, stand, stoop, crouch, and climb stairs.

• Ability to lift up to 10 lbs.

Apply Now