OneMain Financial Jobs

Job Title: Claims Examiner

Job Description

· The claims examiner reports directly to the claims manager.

· They are primarily responsible for the processing functions (operation, adjudication, and payment) of UB-92 and HCFA-1500 claims that are received from PHP affiliated medical groups and hospitals for HMO patients.

· Responsible for the accurate review, input and adjudication of specialists, ancillary, and electronic claims in accordance with outside regulations, internal production standards, and contractual obligations of the organization

· May enter claims data information into the computerized claims adjudication system.

· Maintain all required documentation of claims processed and claims on hand.

· Processes medical claims (CPT, ICD, and Revenue Coding) at production standards, including timely follow-up on inquiries received and correctly logs all incoming calls and emails

· Responsible for inbound calls from providers and health plans and adjudicates physician claims, in a timely and accurate manner

· Provides superior customer service consistent with company standards and goals, including inbound calls from providers and

health plans.

· Maintains the minimum accuracy standard and follows up timely to meet compliance standards for claims, pends, and tasks.

Additional Skills & Qualifications

· High school graduate or equivalent required.

· Knowledge of compliance issues as they relate to claims processing

· Minimum of 2 years claims ADJUDICATION related experience in ambulatory, acute care hospital, HMO, or IPA environment

· Knowledge of resolution methodologies for: Professional (MD), Hospital, Skilled Nursing Facilities, and Ancillary Services

· Knowledge and understanding of timeliness and resolution accuracy guidelines for commercial and Medi-Cal claims

· Experience in interpreting provider contract reimbursement terms desirable

· Ability to identify non-contracted providers for Letter of Agreement consideration

· Data entry experience

· Training on basic office automation and managed care computer systems

Work Environment

SHIFT: Monday - Friday - 07:00am -03:30pm PLEASE NOTE ORIENTATION TIME MAY DIFFER THAN SHIFT TIMES LISTED

Job Type & Location

This is a Contract to Hire position based out of Whittier, CA.

Pay and Benefits

The pay range for this position is $21.00 - $25.00/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully onsite position in Whittier,CA.

Application Deadline

This position is anticipated to close on Mar 13, 2026.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email actalentaccommodation@actalentservices.com (%20actalentaccommodation@actalentservices.com) for other accommodation options.