Claims Clerk 2

Bakersfield Family Medical Group • Bakersfield, CA

1d • $21 - $25

About The Position

Under the direction of the Supervisor of Claims Operations and Adjudication,
this position is responsible to perform clerical functions in accordance with
internal guidelines. The Claims Clerk 2 will interact with other departments,
clinic personnel, and outside providers in a professional and friendly manner,
to create and maintain a positive relationship with our internal and external
customers.

Requirements

• High school diploma/certificate required.
• Must know how to complete Claims Clerk 1 duties.
• Must be able to communicate effectively, both written and verbally.
• Ability to organize and prioritize workload and multi-task.
• Proven ability to work with all matters of a confidential nature.
• Ability to use correct punctuation, grammar and spelling.
• Working knowledge and proficiency with Microsoft Office applications (Word, Excel, Outlook, etc.)

Responsibilities

• Review and Route Provider Disputes/Reopening’s daily.
• Review and Reconcile PDR/Acknowledgement letters.
• Research claims on the Potential Forward report and process according to the daily editing. Claims must meet the 10-day guideline. Edits include but are not limited to; Eligibility issues, Behavioral Health, Health Plan Responsibility and claims with a FORW adjustment code.
• Review and input data from the Cap Deduct reports received monthly.
• Data enter claims for GSMS vision reimbursements for payment.
• Audit preparation as needed.
• Ability to perform all Claims Clerk 1 responsibilities as needed.
• Review and clear TransUnion rejections.
• Perform other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED