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Posted: 02-May-25
Location: Los Angeles, California
Internal Number: 147330203
As the Claim Intake Coordinator, you will be responsible for the accurate and timely entry of received paper claims into the claims processing system. You will ensure compliance with all regulatory guidelines, including adhering to Claim Acknowledgement Regulatory Turnaround Time Guidelines, maintaining a 95% accuracy rate.
Key responsibilities include:
- Performing initial data entry of paper claims into the claims processing system.
- Ensuring claims are entered in compliance with regulatory guidelines, meeting the 95% accuracy rate standard.
- Identifying provider/vendor and/or eligibility maintenance claims for internal department review as needed.
- Providing back-up support for clerical tasks, such as batching, sorting, monitoring, and maintaining claim batches for audit review.
- Handling inbound claims inquiry status calls and assisting with related questions.
We are seeking a detail-oriented, self-directed individual with:
- High School Diploma, GED and/or equivalent experience
- Minimum of 2 years of medical claims customer service experience in an HMO environment (i.e. MSO, IPA, or Health Plan), required
- Minimum of 1 year of data experience, required
- Experience working in a medical billing office or health plan, highly desired
- Working knowledge of Microsoft Office, including Word and Excel
- Experience with Medical Terminology is a definite plus
- Basic Knowledge of ICD-10, HCPCS, and CPT codes
- Knowledge of basic concepts of managed care
- Excellent customer service skills with strong written and verbal communication abilities
- Able to key between 6,000 to 8,000 keystrokes or type 40-50 WPM with high accuracy for alpha and numeric data inputting
