Hospital Claims Adjuster Fully Remote - US

MedPOINT Management

Hospital Claims Adjuster

Full Time • Fully Remote - US
Benefits:
  • 401(k)
  • 401(k) matching
  • Bonus based on performance
  • Dental insurance
  • Employee discounts
  • Free food & snacks
  • Health insurance
  • Opportunity for advancement
  • Paid time off
  • Parental leave
  • Savings bank
  • Training & development
  • Vision insurance
  • Wellness resources
About the Role:
MedPOINT Management in Sherman Oaks, CA is looking for a detail-oriented Hospital Claims Adjuster to join our dynamic healthcare team. In this role, you'll play a critical part in reviewing and processing hospital claims with accuracy and efficiency. If you're passionate about healthcare operations and thrive in a fast-paced environment, we want to hear from you!


Responsibilities:
  • Review, analyze, and adjudicate inpatient and outpatient hospital claims in accordance with plan guidelines
  • Verify patient eligibility, benefits, and coverage prior to claims processing
  • Identify and resolve claim discrepancies, denials, and underpayments
  • Apply ICD-10, CPT, and DRG coding knowledge to ensure accurate claim adjudication
  • Coordinate with providers, hospitals, and internal departments to resolve claim issues
  • Ensure compliance with state and federal healthcare regulations, including HIPAA
  • Maintain accurate documentation and meet productivity and quality benchmarks
Requirements:
  • 2+ years of experience in hospital or medical claims adjudication
  • Proficiency in ICD-10, CPT, HCPCS, and DRG coding
  • Familiarity with managed care, HMO, PPO, and IPA claims processing
  • Strong knowledge of EOB preparation and explanation of benefits
  • Experience with claims management software and healthcare information systems
  • Excellent analytical, problem-solving, and organizational skills
  • Strong attention to detail with the ability to meet deadlines in a high-volume environment
About Us:
MedPOINT Management is a leading Independent Physician Association (IPA) management company based in Sherman Oaks, CA, dedicated to delivering high-quality administrative and managed care services to healthcare providers across Southern California. Our clients trust us for our expertise, responsiveness, and commitment to operational excellence. Our employees thrive in a collaborative, mission-driven workplace where their contributions directly impact the quality of patient care.

This is a remote position.

Compensation: $23.00 - $26.00 per hour




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