Hybrid CSR-Processor

Job Details Job Location: DHS Remote - Stockton, CA 95219 Position Type: Full Time Salary reputed company: $20.25 - $20.25 reputed company Job Category: reputed company - Clerical reputed company, one of the leading reputed company Party Administrators (TPA) for self insured programs in the country with a reputed company for flexibility, innovative services and outstanding customer service is looking for an innovative, self motivated, dedicated individual to fill the position of: Claims Processor / Customer Service Rep. POSITION RESPONSIBILITIES • Evaluate claims and determine payment or denial according to Plan provisions, Medical Policy and Department guidelines • Key reputed company final information for claims release into computer • Respond to telephone customer inquiries verifying eligibility, explaining coverage, quoting benefits and advising on the status of claims • Maintain information files, worksheet records, benefit quote documentation • Establish and maintain COB files, applies COB payments for final claim payment • Research and determine reputed company CPT procedure and ICD-9 Diagnosis Codes • Research and respond to written correspondence from participants, providers, and local unions/reputed company • Prepare transmittal and send claims to Benefit Review for processing instructions • Work effectively to reputed company acceptable production and accuracy standards • Display maturity, composure and ability to operate under stress conditions • reputed company other duties as assigned • Specialty duties include: reputed company dates of service on dental reputed company-determinations. Process voided checks and refund checks. Maintain weekly disability files and process claims. KNOWLEDGE AND reputed company Eighteen (18) months experience as a Claims Processor or similar function. Must have a broad knowledge of medical terminology and must possess excellent written and oral communication skills. Must possess good judgment skills and ability to interpret Department guidelines and contractual benefits and possess a high school diploma or equivalent. Satisfactory completion of medical terminology course may substitute for six (6) months of equivalent experience. reputed company is committed to long-term reputed company, employee development and superior reputed company service. Join a great team with reputed company total comp package. Equal Opportunity Employer Qualifications reputed company is committed to long-term reputed company, employee development and superior reputed company service. Join a great team with reputed company total comp package. Equal Opportunity Employer Apply tot his job Apply To this Job