Job Description: Under the direction and supervision of the Administrative Services Manager, the Medical Claims Assistant will support the claims team with daily administrative tasks that will allow department to meet provider and client expectations.
Responsibilities:
Receive and track incoming claims from clients on a daily basis.
Completes operational requirements by scheduling and assigning administrative projects and expediting work results.
Prepare claim batches for processing.
Scan claims to vendor for data capture.
Perform a variety of clerical duties such as answering in and outbound calls, responding to provider inquires via email, sorting and filing mail, scanning appeals and correspondences.
Keeps supervisor informed verbally and in writing of activities and problems within assigned area of responsibility.
Ability to multi-task and meet deadlines.
Plan, organize, and schedule company meetings in the office, off-site, and via video conference.
Assist with keying claims into processing system and other data entry assignments
Assist with sending various letters to providers and provider call inquiries
Demonstrate understanding and ability to adhere to basic ethics and industry regulatory practices
Perform other duties and special projects as assigned
Requirements:
Basic understanding of medical claims
Intermediate Microsoft Word and Excel required
Basic understanding of CMS 1500 & UB 04 claim forms preferred
Basic knowledge of CPT, ICD-9/ICD-10, & HCPCS coding preferred
Minimum of 1 year of experience in claims processing and 3 years of experience in health plan setting with claims and customer service.
All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the California Fair Chance Act, City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, and Los Angeles County Fair Chance Ordinance. For unincorporated Los Angeles county, to the extent our customers require a background check for certain positions, the Company faces a significant risk to its business operations and business reputation unless a review of criminal history is conducted for those specific job positions.
