Claims Examiner III - Medicare Advantage
Ucla healthLos Angeles, California, United States
Posted January 20, 2026
60720 - 86980 USD
Full Time
About the Company
UCLA Health is a world-renowned health system with four award-winning hospitals and dozens of primary care practices, specialty practices, urgent care centers, and other ancillary locations throughout metro Los Angeles.
Job Description
Claims Examiner III - Medicare Advantage position available at UCLA Health in Los Angeles, CA. Responsibilities include accurate data entry, claim review, and adjudication, as well as training others on claims processes and workflows.
Requirements
- High School Diploma, GED or equivalent experience
- Four or more years of medical claims payment experience in an HMO setting
- Expertise in industry standard claims adjudication policies, procedures, and processes
- In-depth knowledge of fee schedule and pricing methodologies for outpatient/inpatient institutional, ancillary, and professional claims
- Experience processing complex institutional claims
- Understanding of CPT, HCPCS, ICD-10, ASA, and revenue codes
- Knowledge of medical terminology
- Ability to accurately key 6,000-8,000 keystrokes or type 40-50 WPM
- Computer proficiency with Microsoft Office and data visualization tools
- Knowledge of claims adjudication systems (e.g., EPIC-Tapestry, EZ Cap, QNXT, IDX)
- Willingness to learn new technologies, practices, and procedures
- Strong problem identification, resolution, and analytical abilities
- Excellent communication, interpersonal, critical thinking and organizational skills
Benefits
- Flexible hybrid work schedule
- Onsite or remote work options
- Indefinite job duration