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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