Community Health System

Claims Examiner, Healthcare Insurance Services

Community Health System  •  Fresno, CA (Onsite)  •  9 hours ago
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Job Description

Opportunities for you!

  • Consecutively recognized as a top employer by Forbes, and in 2025 by Newsweek
  • Free Continuing Education and certification
  • Tuition reimbursement, education programs and scholarships
  • Vacation time starts building on Day 1, and builds with your seniority
  • Free money toward retirement with a 403(b) and matching contributions
  • Great food options with on-demand ordering
  • Free parking and electric charging

Commitment to diversity and inclusion is a cornerstone of our culture at Community. All are welcome as valued members of our community.

We know that our ability to provide the highest level of care is through taking care of our incredible teams. Learn more on our Benefits page.

Responsibilities

The Claims Examiner is responsible for accurately processing professional and hospital claims for Community Care Health (CCH) for in-network and out-of-network providers. This role will review and analyze claims: verifying coverage, assessing eligibility, and determining the validity of claims based on policy terms.

Qualifications

Education

  • High School Diploma, High School Equivalency (HSE) or Completion of a CHS Approved Individualized Education Plan (IEP) Certificate required
  • Associate's Degree preferred

Experience

  • 1 year of medical claims processing/adjudication experience
  • Experience working with claims system/applications and troubleshooting preferred
  • Trizetto/QNXT software experience preferred
  • Experience using Blue Shield or Anthem portals (e.g., verifying member eligibility, checking claim statuses, or tracking payments).
  • Medical Coding/Billing knowledge

  • Medical Terminology knowledge

Disclaimers

• Pay ranges listed are an estimate and subject to change.• If any bonuses are noted, they are only applicable to external hires meeting criteria.

Community Health System

About Community Health System

Community Health System is a private, not-for-profit, health system that employs more than 11,000 people. We've grown a lot since 1897 and we're not done yet.

We have affiliations of nearly 2,500 physicians, a partnership with UCSF Fresno, and one of central California's largest HMO health plans. Being a part of the Community family means being a part of the innovation that cares for more residents in the Central Valley than any other healthcare system in the area. And we do it for everybody, regardless of their ability to pay.

​​​​​​​If you want to be a part of a team that operates like a family and challenges each other to constantly improve and grow together, you belong here.

Industry
Healthcare & Social Services
Company Size
1,001-5,000 employees
Headquarters
Fresno, CA
Year Founded
Unknown
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