Claims Clerk - Johnson Service Group
Irvine, CA 92618
About the Job
Johnson Service Group (JSG) is seeking Claims Clerks in Irvine, CA. These positions are onsite.
Monday- Friday 6:30am-3:00pm
Hourly pay- $17.00-$18.00 per hour DOE
The ideal candidate will have office experience.
Claims experience is a plus but not required.
JOB DESCRIPTION SUMMARY
This position reports to the Supervisor, Claims Operations in a production environment and is responsible for supporting the claims department by preparing claim receipts and all related correspondence for the department.
QUALIFICATIONS
High school diploma or equivalent and one (1) to three (3) years of Business experience with knowledge of generally accepted procedures, analytical abilities or equivalent combination of education and experience preferred.
Knowledge of generally accepted health care eligibility and billing procedures as well as Health Insurance Portability and Accountability Act (HIPAA).
Computer aptitude with Word, Excel and Outlook and the ability to develop a strong proficiency working with a proprietary Health Care system.
Experience providing Customer Service to a variety of client contacts via email and telephone.
Ability to research and resolve technical issues and/or client problems as they arise with minimal direction.
Proficient written and oral communication skills to include modern business communications, formatting of professional letters, reports, and phone etiquette.
Skills to establish priorities, multi-task, work under pressure and deadlines, work independently with minimal supervision or in team environment.
General knowledge of health insurance operations and industry.
Ability to work overtime as needed, based on department needs
Spanish bilingual (verbal/written) abilities a plus.
DUTIES AND RESPONSIBILITIES
Clerical Support
Review and sort incoming USPS mail for distribution to outside vendors or internal personnel
Review and sort claims and supporting documents, received via fax and email.
Prescreen, prep and scan documentation for distribution to examiners.
Organize, log and process special handling checks which are returned to department, in accordance with clients specified requirements.
Review and return incomplete claims which are unidentifiable and cannot be processed by Examiners.
Serve as daily support for company receptionist.
Serve as pre-processor of medical and dental claims.
Review and post claim payment information from outside vendor as needed.
Upload, from Wellpoint Anthem system, claims for priority distribution for end of contract.
Department Operations
Maintain department standards and production goals.
Monitor logs, prescreening daily for timely processing.
Log and process, in accordance with client specifications, checks requiring client second signature and mail accordingly.
Sort, log and distribute various specialty checks.
Log, Monitor and report daily paper, correspondence claims inventory.
Keep record of work complete for weekly inventory reports.
All other duties as assigned.
** Johnson Service Group (JSG) is an Equal Opportunity Employer. JSG provides equal employment opportunities to all applicants and employees without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, marital status, protected veteran status, or any other characteristic protected by law. #D800
Monday- Friday 6:30am-3:00pm
Hourly pay- $17.00-$18.00 per hour DOE
The ideal candidate will have office experience.
Claims experience is a plus but not required.
JOB DESCRIPTION SUMMARY
This position reports to the Supervisor, Claims Operations in a production environment and is responsible for supporting the claims department by preparing claim receipts and all related correspondence for the department.
QUALIFICATIONS
High school diploma or equivalent and one (1) to three (3) years of Business experience with knowledge of generally accepted procedures, analytical abilities or equivalent combination of education and experience preferred.
Knowledge of generally accepted health care eligibility and billing procedures as well as Health Insurance Portability and Accountability Act (HIPAA).
Computer aptitude with Word, Excel and Outlook and the ability to develop a strong proficiency working with a proprietary Health Care system.
Experience providing Customer Service to a variety of client contacts via email and telephone.
Ability to research and resolve technical issues and/or client problems as they arise with minimal direction.
Proficient written and oral communication skills to include modern business communications, formatting of professional letters, reports, and phone etiquette.
Skills to establish priorities, multi-task, work under pressure and deadlines, work independently with minimal supervision or in team environment.
General knowledge of health insurance operations and industry.
Ability to work overtime as needed, based on department needs
Spanish bilingual (verbal/written) abilities a plus.
DUTIES AND RESPONSIBILITIES
Clerical Support
Review and sort incoming USPS mail for distribution to outside vendors or internal personnel
Review and sort claims and supporting documents, received via fax and email.
Prescreen, prep and scan documentation for distribution to examiners.
Organize, log and process special handling checks which are returned to department, in accordance with clients specified requirements.
Review and return incomplete claims which are unidentifiable and cannot be processed by Examiners.
Serve as daily support for company receptionist.
Serve as pre-processor of medical and dental claims.
Review and post claim payment information from outside vendor as needed.
Upload, from Wellpoint Anthem system, claims for priority distribution for end of contract.
Department Operations
Maintain department standards and production goals.
Monitor logs, prescreening daily for timely processing.
Log and process, in accordance with client specifications, checks requiring client second signature and mail accordingly.
Sort, log and distribute various specialty checks.
Log, Monitor and report daily paper, correspondence claims inventory.
Keep record of work complete for weekly inventory reports.
All other duties as assigned.
** Johnson Service Group (JSG) is an Equal Opportunity Employer. JSG provides equal employment opportunities to all applicants and employees without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, marital status, protected veteran status, or any other characteristic protected by law. #D800
Source : Johnson Service Group