Ezcap claim examiner
Remote
Contracted
Experienced
Duration: 3-6 Months contract
Interview: 2 internal
Must have Skills:- EZ-CAP 5-6 years
- Medi-Cal (California Medicaid) experience
Role and Responsibilities:
- Review, process, and adjudicate high-complexity healthcare claims in compliance with company policies, contractual provisions, and regulatory requirements.
- Ensure accurate application of CPT, ICD-10, HCPCS, and other relevant codes.
- Validate and cross-check information on claim forms, ensuring completeness and accuracy.
- Assess medical necessity, coverage eligibility, and appropriateness of services provided.
- Investigate and resolve complex claim discrepancies and issues.
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