Description: This position is located in Cypress, CAPosition Summary
The Receptionist/Claims Support role will be the main front desk receptionist and provide clerical support to department leadership and all claims staff including but not limited to, preparing claims for audit, sorting and processing of mail, filing and storing of paper claims and other duties as assigned by the manager. Documentation of the work and confidentiality of the data are essential.Responsibilities:Receptionist duties Opening and directing of mail to appropriate areas.Provider mail backs.Create Provider Dispute letters and track their aging.Verify member eligibility with Eligibility Department as necessary.Handle physician, HMO and patient inquiries on claims status, as directed by supervisor.Learn and apply the mandated health plan and IPA procedures for denied claims.Assist with the preparation, mailing and filing of both CMS and Commercial denial letters.Maintain thorough documentation and confidentiality.Foster positive interaction and relationships with all internal departments as well as cultivating positive working relationships with external contacts.Performs other assigned duties / special projects on an as-needed basis.
- High school diploma (or equivalent)
- Knowledge of medical terminology, CPT coding and physician reimbursement methodologies such as RBRVS
- Strong computer experience (minimum 1 year experience with EZ-Cap preferred)
- Experience with computer programs (Windows, Word, Excel, Mail Merge, Fax Blast, PowerPoint)
- Excellent organizational skills
- Excellent communication and assessment skills
- Willingness to learn new tasks
Job: Clerical/AdministrativePrimary Location: Lakewood, CaliforniaHospital Location: Coast HealthcareJob Type: Full-timeShift Type: Days Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status.
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