Opportunities for you!
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.
The Senior Claims Examiner and Stop Loss Coordinator is responsible for reviewing and processing complex professional and hospital claims for Community Care Health (CCH) in-network and out-of-network providers. This role will review, analyze, and research healthcare claims to identify discrepancies, verify pricing, confirm prior authorization, and process them for payment. Tracks potential and existing stop loss members, timely filing of all stop loss claims with the carrier, follow-up with the carrier regarding outstanding recoveries, and reporting. Provides overall assurance that CCH is in compliance with the stop loss policy. Trains new or existing staff on any claims system enhancements.
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.
