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HomeCompaniesEgln Fa Us2 Oraclecloud Com CX 1Claims Examiner 2-Managed Care

Claims Examiner 2-Managed Care

Egln Fa Us2 Oraclecloud Com CX 1 · CA, United States; Redlands Park Plaza/1776 Park Avenue, Redlands, CA, US · Active · Oracle Recruiting Cloud / Fusion HCM

Job facts

FieldValue
CompanyEgln Fa Us2 Oraclecloud Com CX 1
TitleClaims Examiner 2-Managed Care
Normalized title-
Department / teamF03_Clerical / Office Support
LocationCA, United States
Work model-
Employment type-
Salary-
Statusactive
ATS providerOracle Recruiting Cloud / Fusion HCM
Posted / first seen2026-05-06 / 2026-05-31
Changed / last seen2026-05-31 / 2026-06-06

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ATS provider jobsActive postings observed through Oracle Recruiting Cloud / Fusion HCM.Open
Provider filtered searchThe same provider as a filtered job collection.Open
Department jobsActive postings in F03_Clerical / Office Support.Open
Lifecycle eventsOpen, update, close, and reopen events for this posting.Open
Original postingCanonical source or apply URL captured from the ATS.Open

Linked records

CompanyEgln Fa Us2 Oraclecloud Com CX 1
Sourced451ddd0-04c9-4738-aad5-6b32a3357880
ATS providerOracle Recruiting Cloud / Fusion HCM

Description

Description Department: UHC: Managed Care Job Summary: This Claims Examiner 2-Mgd Care will process professional and hospital HMO Risk claims in accordance with the individual provider contracts in an accurate and timely manner, verify system assigned risk pool determination in accordance with HMO Division of Financial Responsibility matrix, initiate check run, perform standard reporting, ensure audit readiness, and process third party claims. Performs other duties as needed. Education and Experience: High School Diploma or GED required. Bachelor's Degree in Computer Science, Business, or similar degree preferred. Minimum five years managed care claims processing experience with professional claims and institutional claims. Knowledge and Skills: Knowledge of Microsoft Office Suite. Must be well versed in medical terminology, CPT, and ICD9/10 coding guidelines. Comprehensive understanding of institutional inpatient and outpatient hospital claims processing, DRG's and all other institutional calculation standards. Comprehensive understanding of professional claims adjudication process. Understanding of the Managed Care health care delivery system. Able to keyboard 40 wpm. Able to use a computer, printer, and software programs necessary to the position (e.g., Word, Excel, Outlook, PowerPoint). Operate/troubleshoot basic office equipment required for the position. Able to work calmly and respond courteously when under pressure; collaborate and accept direction. Able to think critically; manage multiple assignments effectively; organize and prioritize workload; work well under pressure; problem solve; recall information with accuracy; pay close attention to detail; work independently with minimal supervision. Able to distinguish colors as necessary; hear sufficiently for general conversation in person and on the telephone, and identify and distinguish various sounds associated with the workplace; see adequately to read computer screens, and written documents necessary to the position. Licensures and Certifications: Certified Professional Coder preferred. Valid Driver's License at time of hire. Organization Loma Linda University Health is a Seventh-day Adventist, faith and values based Christian institution. Candidates must understand and embrace the mission, purpose, and identity of Loma Linda and its affiliated entities. We are an equal opportunity employer committed to the principles of diversity. We provide equal opportunities in all aspects of the employment process to every individual, regardless of gender, race, color, age, national origin, ancestry, physical or mental disability, marital or veteran status, genetic information or any other characteristic protected by law. In addition, we will provide reasonable accommodations for otherwise qualified individuals requesting an accommodation due to a disability. If you need accommodation assistance with accessing our job listings or completing an application, or during any other phase of employment with us, please contact Human Resources Management at (909) 651-4001. Loma Linda University Health Care is a religiously-qualified Equal Opportunity Employer under Title VII of Civil Rights Act of 1964. No question on this application is asked for the purpose of unlawfully limiting or excluding any applicant’s consideration for employment because of race, color, religion, gender, age, national origin, disability, genetic information, or any other status protected by applicable law. If you need a reasonable accommodation in the hiring process, please notify Human Resource Management. We appreciate your interest in Loma Linda and wish you success in your job search! Company Our mission is to continue the teaching and healing ministry of Jesus Christ. Our core values are compassion, excellence, humility, integrity, justice, teamwork and wholeness.

Full job record

Job IDdb791115e596ce2eeb3def72624f56ffa9e413cf
Org ID0e0551ab-1760-41ab-8d92-4432a71e7d17
Source IDd451ddd0-04c9-4738-aad5-6b32a3357880
Board IDd451ddd0-04c9-4738-aad5-6b32a3357880
Provideroracle_hcm
Provider Job Key14656
TitleClaims Examiner 2-Managed Care
Normalized Title
Statusactive
Activeyes
Location TextCA, United States; Redlands Park Plaza/1776 Park Avenue, Redlands, CA, US
DepartmentF03_Clerical / Office Support
Team
Employment Type
Workplace Type
Remote Policy
CountryUnited States
RegionCA
City
Salary RawDescription Department: UHC: Managed Care Job Summary: This Claims Examiner 2-Mgd Care will process professional and hospital HMO Risk claims in accordance with the individual provider contracts in an accurate and timely manner, verify system assigned risk pool determination in accordance with HMO Division of Financial Responsibility matrix, initiate check run, perform standard reporting, ensure audit readiness, and process third party claims. Performs other duties as needed. Education and Experience: High School Diploma or GED required. Bachelor's Degree in Computer Science, Business, or similar degree preferred. Minimum five years managed care claims processing experience with professional claims and institutional claims. Knowledge and Skills: Knowledge of Microsoft Office Suite. Must be well versed in medical terminology, CPT, and ICD9/10 coding guidelines. Comprehensive understanding of institutional inpatient and outpatient hospital claims processing, DRG's and all other institutional calculation standards. Comprehensive understanding of professional claims adjudication process. Understanding of the Managed Care health care delivery system. Able to keyboard 40 wpm. Able to use a computer, printer, and software programs necessary to the position (e.g., Word, Excel, Outlook, PowerPoint). Operate/troubleshoot basic office equipment required for the position. Able to work calmly and respond courteously when under pressure; collaborate and accept direction. Able to think critically; manage multiple assignments effectively; organize and prioritize workload; work well under pressure; problem solve; recall information with accuracy; pay close attention to detail; work independently with minimal supervision. Able to distinguish colors as necessary; hear sufficiently for general conversation in person and on the telephone, and identify and distinguish various sounds associated with the workplace; see adequately to read computer screens, and written documents necessary to the position. Licensures and Certifications: Certified Professional Coder preferred. Valid Driver's License at time of hire. Organization Loma Linda University Health is a Seventh-day Adventist, faith and values based Christian institution. Candidates must understand and embrace the mission, purpose, and identity of Loma Linda and its affiliated entities. We are an equal opportunity employer committed to the principles of diversity. We provide equal opportunities in all aspects of the employment process to every individual, regardless of gender, race, color, age, national origin, ancestry, physical or mental disability, marital or veteran status, genetic information or any other characteristic protected by law. In addition, we will provide reasonable accommodations for otherwise qualified individuals requesting an accommodation due to a disability. If you need accommodation assistance with accessing our job listings or completing an application, or during any other phase of employment with us, please contact Human Resources Management at (909) 651-4001. Loma Linda University Health Care is a religiously-qualified Equal Opportunity Employer under Title VII of Civil Rights Act of 1964. No question on this application is asked for the purpose of unlawfully limiting or excluding any applicant’s consideration for employment because of race, color, religion, gender, age, national origin, disability, genetic information, or any other status protected by applicable law. If you need a reasonable accommodation in the hiring process, please notify Human Resource Management. We appreciate your interest in Loma Linda and wish you success in your job search! Company Our mission is to continue the teaching and healing ministry of Jesus Christ. Our core values are compassion, excellence, humility, integrity, justice, teamwork and wholeness.
Salary Min
Salary Max
Salary Currency
Salary Periodday
Source URLhttps://egln.fa.us2.oraclecloud.com/hcmUI/CandidateExperience/en/sites/CX_1/job/14656
Apply URLhttps://egln.fa.us2.oraclecloud.com/hcmUI/CandidateExperience/en/sites/CX_1/job/14656
First Seen At2026-05-31 18:11:07Z
Last Seen At2026-06-06 11:15:13Z
Last Checked At2026-06-06 11:15:13Z
Last Changed At2026-05-31 18:11:07Z
Inactive At
Source Posted At2026-05-06 19:00:49Z
Source Updated At
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Event Fields
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Extensions
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