Upvote
Downvote
Claims Customer Service Representative I
Share Job
- Suggest Revision
- To research and resolve provider telephone and written inquiries within established time frames, accurately screen claims, and participate in provider meetings and projects.
- To accurately research and process paper and electronic medical, outpatient, ancillary, long term care, CHDP, encounter data and paper crossover/other coverage claims within established time frames, applying appropriate program policies related to claims processing and analysis.
- Follows established PHC policies and procedures, PHC claims operating instruction memorandums, EDS provider manual guidelines, and Title 22 regulations when resolving claims and claim issues.
- Records daily production statistics and related activities on appropriate reports; turns all logs and reports in to Claims Customer Service Supervisor.
- High school diploma or equivalent; one (1) year of prior claims processing experience in an automated claim environment preferred; or equivalent combination of education and experience.
Active Job
Updated TodaySimilar Job
Relevance
Active