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Claims Coordinator (California Residents)

Company: Identity MSO
Location: Camarillo
Posted on: September 16, 2022

Job Description:

*General Summary*The claims coordinator is an entry level position. The claims coordinator is responsible for processing in and outbound mailing related to the claims department. The claims coordinator will review, batch, and prepare claims for internal and external processing on same business day received. The coordinator will update the claims log to reflect claims received and shipment of claims to vendor for processing. The claims coordinator will provide primary backup coverage to full administrative duties while admin assistant is on PTO or out office. The coordinator will also assist with other general administrative and clerical work as needed. The claims coordinator is under moderate supervision, utilizes general understanding of department's operation and objectives to provide administrative support related to indexing incoming mail, claim payments, bill inquiries, coordination assistance and customer service to the claims department.*Essential Functions** Opens, reviews, and batches daily claims received (via mail)* Prepares daily claim batches and cover sheet for external processing* Prepares daily outbound batches for FEDEX pickup* Prepares daily mailing of outbound claims and letters (misdirected or processable claims)* Reviews PDR / Appeal requests against system to determine transaction number and LOB* Logs and routes PDR / Appeals to proper team member* Data entry of fast-tracked claims for examiner processing* Update daily log with total number of claims received, batches, and courier tracking number* Provide primary vacation / PTO coverage to fulfill administrative assistant duties which includes printing and mailing of member letters, process inbound mail, process outbound mail.* Perform other duties as requested by manager* Protect the security of medical records to ensure that confidentiality is maintained*Education** High school diploma (GED) or equivalent combination of education and experience*Experience** 0-1 years of claims management processes* Data entry experience - some claims need to be manually keyed (average 10-15 per day)* Experience with Microsoft Suite applications (Excel, Word, Outlook)*Other Requirements** Produce quality work* Detail oriented* Strong organizational and communication skills* Covid-19 Booster*Performance Requirements*_Knowledge: _* Knowledge of general clerical processes and procedures* Knowledge of Microsoft Office Suites applications_Skills: _* Skill in establishing and maintaining effective internal and external working relationships.* Skill in written and verbal communication and customer relations_Abilities: _* Ability to work effectively with co workers* Ability to follow oral and written instructions* Ability to produce basic logs and reports* Ability to organize and prioritize workload* Ability to work in a fast-paced environment (this is a production unit with very stringent deadlines)* Ability to seek tasks through completion_Requirements: _* Employee required to lock work station every time they step away (Control, Alt, Delete)*Equipment Operated: *Standard office equipment including computers, fax machines, copiers, printers, telephones, etc.*Work Environment: *Position is in a well-lighted office environment. Occasional evening and weekend work.*Mental/Physical Requirements: *Involves sitting approximately 90 percent of the day, walking or standing the remainder.Job Type: Full-timeBenefits:* 401(k)* 401(k) matching* Dental insurance* Employee assistance program* Flexible spending account* Health insurance* Health savings account* Life insurance* Paid time off* Parental leave* Retirement plan* Vision insurancePhysical setting:* OfficeSchedule:* 8 hour shiftWork Location: One location

Keywords: Identity MSO, Camarillo , Claims Coordinator (California Residents), Other , Camarillo, California

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