Claims Assistant (Temporary- 9 Months)
About The Position
The Claims Assistant supports the handling and routing of documents received through the claims mailroom and the scanning of paper claims into electronic format. This onsite position opens, accurately counts, sorts, and prepares claims for scanning; assists with scanning claims and documents; and enters tracking data. The role processes incoming mail, including date stamping, sorting, counting, scanning, tracking, and routing claims and other documents. It also photocopies and mails correspondence, performs scanning and optical character recognition (OCR) verification, maintains departmental filing systems, answers phone inquiries, provides clerical assistance, orders supplies, and helps determine workloads and process flows to support regulatory compliance. Other duties may be assigned.
Requirements
- High school diploma or high school equivalency certificate.
- At least 6 months of mailroom, data entry, and clerical experience in a healthcare or managed care environment.
- Very detail-oriented, with the ability to count accurately and track claim documents throughout the mailroom process.
- Proficiency in Microsoft Excel, including the ability to create calculations and charts.
- Proficiency in Microsoft Word.
- Ability to work effectively within the mailroom and mentor and coach mailroom staff on correct procedures.
Responsibilities
- Open incoming mail and date stamp it.
- Sort and count mail receipts and claims.
- Scan paper claims and documents into electronic format, including scanning/OCR and verification against document images.
- Track claims receipts and inform the department manager of high volumes.
- Forward misdirected mail to the correct entity and route paper claims and nonstandard documents to Plan Partners and internal departments within required timeframes.
- Ensure incoming mail is counted, date stamped, and delivered to the correct party within 24 hours of receipt.
- Photocopy and mail correspondence to internal departments, Plan Partners, submitting providers, Participating Physician Groups (PPGs), members, and other parties.
- Dispose of mail and claims within 3 to 5 working days of receipt by the department.
- Maintain the departmental filing system and file claim-related information within seven working days; coordinate moving information to off-site storage.
- Answer phone inquiries, provide clerical assistance to the claims department, and order supplies.
- Determine workloads and process flows to ensure compliance with regulatory agencies.
- Mentor and coach mailroom staff on correct procedures.
- Perform other duties as assigned.
Benefits
- Medical, dental, and vision
- Wellness Program
- Paid Sick Leave
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What This Job Offers
Education Level
High school or GED
