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Claims Examiner III
Company : Catholic Health Initiatives
Location : Bakersfield, CA, 93301
Job Type : Full Time
Salary : 24.15-34.12 HOUR
Date Posted : 1 January 2026
Job Summary and Responsibilities
The Claims Examiner III is an advanced-level role responsible for the detailed and accurate processing, review, and adjudication of complex healthcare claims. This position requires expert knowledge of claims processing, coding, and regulatory compliance. The Claims Examiner III will handle the most challenging cases, mentor junior staff, and contribute to the development of policies and procedures.
Job Requirements
Minimum Qualifications:
- 3-5 years of experience in healthcare claims processing, with at least 2 years in a senior or advanced role
- Expert knowledge of CPT, ICD-10, HCPCS coding, and medical terminology.
- Associate’s Degree - Associate’s Degree in healthcare administration, business, or related field preference or experience in lieu of.
Preferred Qualifications:
- 5-7 years of experience in healthcare claims processing, with at least 4 years in a senior or advanced role
- EZCAP: 2 year experience
- Bachelor’s degree in healthcare administration, business, or a related field preferred. Equivalent work experience will be considered.
- Certified Medical Reimbursement Specialist (CMRS), or similar certification is preferred.
- CPC - Certified Professional Coder (CPC)
The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric, full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health’s Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first.
Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art, flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options, including medical, dental and vision plans, for the employee and their dependents, Health Spending Account (HSA), Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.
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Frequently asked questions
Claims Examiner III positions require advanced expertise in coding, regulatory compliance, and adjudicating challenging healthcare claims, unlike entry-level roles focused on basic processing. In Bakersfield, this senior role demands deeper knowledge of CPT, ICD-10, and HCPCS codes to ensure accurate claim resolution and mentoring junior staff.
Certifications like Certified Medical Reimbursement Specialist (CMRS) and Certified Professional Coder (CPC) greatly enhance credibility for Claims Examiner III roles in Bakersfield. These credentials demonstrate mastery of medical coding and claims auditing, aligning well with local healthcare industry's high standards and regulatory requirements.
Claims Examiner III professionals can progress toward managerial roles overseeing claims departments or specialize as claims analysts focusing on fraud detection or compliance. Advanced certifications and mastery of complex claims processing open pathways to leadership within healthcare organizations or consulting opportunities.
Catholic Health Initiatives emphasizes integrated patient care and policy development, so their Claims Examiner III not only processes claims but also mentors juniors and contributes to system-wide improvements. This role blends technical expertise with leadership in a mission-driven environment.
Employees enjoy a flexible benefits package including medical, dental, vision, and a 401(k) plan with employer match. Catholic Health Initiatives also fosters career growth through training and mentoring, reflecting their commitment to employee well-being and professional advancement.
Claims Examiner III salaries in Bakersfield generally range between $65,000 and $85,000 annually, influenced by experience and certifications. This compensation aligns with regional healthcare market rates for advanced claims processing roles requiring expert coding knowledge.
Bakersfield's growing healthcare sector drives steady demand for experienced Claims Examiner III candidates. While competition exists due to the specialized skill set required, candidates with certifications and multiple years of senior-level experience typically find favorable hiring opportunities.
Bakersfield's traffic is moderate compared to larger metro areas, but peak hours can extend commutes. Many Claims Examiner III roles at Catholic Health Initiatives may offer flexible schedules or partial remote options, supporting a better work-life balance in this region.
While primarily focused on healthcare claims, Claims Examiner III roles in Bakersfield often interact with workers' compensation cases. This adds complexity requiring knowledge of specific regulations and coding, expanding the scope of claim adjudication responsibilities.
At the Claims Examiner III level, professionals tackle the most complex claims, lead mentoring efforts, and influence policy development. This contrasts with earlier levels that focus more on routine claim processing and less on supervisory or strategic duties.