Claims Administrator

BRMSFolsom, CA
$19 - $21Onsite

About The Position

Receives and inputs new healthcare claims, processes payments, researches billing issues, and responds to email and telephone inquiries. Evaluates claims and administers payment, denies, or returns claims according to policy provisions and organizational guidelines. Produces routine and ad hoc reports.

Requirements

  • Strong computer skills, including Word, Excel, Outlook, and file database systems.
  • Excellent written and verbal communication skills.
  • Must be dependable and maintain excellent attendance and punctuality.
  • Strong analytical skills and problem solving skills.
  • Ability to grow with changing demands of the position and the company.
  • Ability to work in a team environment.
  • Ability to learn and use specified and sequenced processes that require specific information and step-by-step execution.
  • Ability to use 10-key preferred.
  • Ability to read, speak, and write effectively in English.
  • Ability to interpret documents such as safety rules, memos, letters, and forms.
  • Ability to write routine reports and correspondence.
  • Ability to speak effectively before customers or employees of organization.
  • Ability to effectively address or resolve customer service issues within guidelines of the position.
  • Ability to add and subtract, multiply and divide with 10's and 100's.
  • Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.
  • Ability to deal with problems involving several concrete variables in standardized situations.

Nice To Haves

  • Ability to use 10-key preferred.

Responsibilities

  • Prepare member reimbursement
  • Electronic and outstanding issues.
  • Convert appeals into electronic images
  • Log, track, follow-up and distribute appeals electronically to examiners
  • Provide administrative support to VP of Client Services and Claims Manager.
  • Process subpoena for records requests
  • Process itemized bills, track and log
  • Maintain Claims Admin in MHB
  • Perform other duties and responsibilities as assigned by Management
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