Customer Service Rep - Healthcare Claims | Immediate Opening!
|Title:||Customer Service Rep - Healthcare Claims | Immediate Opening!|
|Compensation:||$18.00 - $20.00|
In this position you will:
- Be responsible for clerical functions such as copying, filing, mailing claims correspondence to various external customers.
- Follow-up on claims forwarded to internal departments for review such as UM, contracts, eligibility, UM Physician and Medical Director Review.
- The primary goal of this position is to perform clerical functions to make the production staff more efficient and reach higher production levels.
- Be responsible for entering Claims into the GE Centricity/IDX database, following up on routine pended claims when needed such as those pending for request of Medical records or notes, TAX ID information, etc.
- Will interact closely with Claims Department Leadership and Claims staff in regards to these claims functions.
Required qualifications for this position include:
- Three or more years HMO claims and Claims Correspondence processing experience required in a managed care environment, preferably PMG/IPA setting within the last three years or any combination of education and/or experience which produces an equivalency.
- Knowledge of medical terminology and coding.
- Familiar with CMS and Department of Managed Care mandates.
- Ability to type 35 WPM uses a ten‑key adding machine, perform data entry and make mathematical calculations.
- Effective communication and follow-through skills.
Preferred qualifications for this position include:
- Spanish bilingual