Claims Processor - Revenue Cycle Claims Processing - Sharp Corporate - Day Shift - Full Time

Sharp HealthCare • San Diego, CA

2d • Onsite

About The Position

The Claims Processor will be responsible for the adjudication of referral claims and all related functions. This role requires maintaining claims accuracy according to established procedures and current contracts, processing an average of 13 claims per hour, and providing professional and courteous customer service to enrollees, providers, and health plans. The position also requires demonstrating the ability to work independently, manage time effectively, and seek additional work assignments when available. Strong organizational skills, knowledge of medical terminology and coding, proficiency in typing and keyboarding, and understanding of standard insurance procedures are essential.

Requirements

• 1 Year Previous claims processing experience in an HMO or indemnity insurance setting (HMO preferred)
• Strong organizational skills.
• Working knowledge of medical terminology and RVS/CPT/ICD-9 coding.
• Ten key by touch.
• C RT keyboard skills.
• Good verbal and written skills.
• Knowledge of standard insurance procedures (pricing, exclusions, etc.

Nice To Haves

• H.S. Diploma or Equivalent
• Some college coursework

Responsibilities

• Adjudication of referral claims and all related functions.
• Process claims accurately according to established procedures/current contracts.
• Maintain average adjudication production of 13 claims processed per hour.
• Enrollee/provider/health plan contact to be professional and courteous.
• Calls to be returned in a timely fashion.
• Demonstrate ability to work independently and manage time well with any free time used to help in other areas as directed.
• Inform supervisor when available for additional work assignments.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed