Claims Clerk

Job Description

Job Description

Johnson Service Group (JSG) is seeking a Claims Clerks in Irvine, CA.

These positions are onsite.

Monday- Friday 6 : 30am-3 : 00pm

Hourly pay- $18.00+per hour DOE

The ideal candidate will have office experience. Claims experience is a plus but not required.

JOB DESCRIPTION SUMMARY

This position reports to the Supervisor, Claims Operations in a production environment and is responsible for supporting the claims department by preparing claim receipts and all related correspondence for the department.

QUALIFICATIONS

• High school diploma or equivalent and one (1) to three (3) years of Business experience with knowledge of generally accepted procedures, analytical abilities or equivalent combination of education and experience preferred.
• Knowledge of generally accepted health care eligibility and billing procedures as well as Health Insurance Portability and Accountability Act (HIPAA).
• Computer aptitude with Word, Excel and Outlook and the ability to develop a strong proficiency working with a proprietary Health Care system.
• Experience providing Customer Service to a variety of client contacts via email and telephone.
• Ability to research and resolve technical issues and / or client problems as they arise with minimal direction.
• Proficient written and oral communication skills to include modern business communications, formatting of professional letters, reports, and phone etiquette.
• Skills to establish priorities, multi-task, work under pressure and deadlines, work independently with minimal supervision or in team environment.
• General knowledge of health insurance operations and industry.
• Ability to work overtime as needed, based on department needs
• Spanish bilingual (verbal / written) abilities a plus.

DUTIES AND RESPONSIBILITIES

Clerical Support

• Review and sort incoming USPS mail for distribution to outside vendors or internal personnel
• Review and sort claims and supporting documents, received via fax and email.
• Prescreen, prep and scan documentation for distribution to examiners.
• Organize, log and process special handling checks which are returned to department, in accordance with clients specified requirements.
• Review and return incomplete claims which are unidentifiable and cannot be processed by Examiners.
• Serve as daily support for company receptionist.
• Serve as pre-processor of medical and dental claims.
• Review and post claim payment information from outside vendor as needed.
• Upload, from Wellpoint Anthem system, claims for priority distribution for end of contract.

Department Operations

• Maintain department standards and production goals.
• Monitor logs, prescreening daily for timely processing.
• Log and process, in accordance with client specifications, checks requiring client second signature and mail accordingly.
• Sort, log and distribute various specialty checks.
• Log, Monitor and report daily paper, correspondence claims inventory.
• Keep record of work complete for weekly inventory reports.
• All other duties as assigned.

Company Description

Our people and culture make JSG a great place to work. JSG’s mission is to empower people, help our clients reach their goals, and hire motivated individuals.

Johnson Service Group, Inc. (JSG) is a North American leader in the staffing and consulting services industry, with 40 years of experience investing in people and companies.

We are always looking for great people to join our team we want to see your success here at JSG! We can be found locally in more than 30 offices throughout the United States and Canada.

JSG continues to work diligently to offer our clients and candidates world-class service and diversified offerings to fit their evolving needs.

Johnson Service Group (JSG) is an Equal Opportunity Employer. JSG provides equal employment opportunities to all applicants and employees without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, marital status, protected veteran status, or any other characteristic protected by law.

Company Description

Our people and culture make JSG a great place to work. JSG’s mission is to empower people, help our clients reach their goals, and hire motivated individuals.

r n r nJohnson Service Group, Inc. (JSG) is a North American leader in the staffing and consulting services industry, with 40 years of experience investing in people and companies.

We are always looking for great people to join our team we want to see your success here at JSG! We can be found locally in more than 30 offices throughout the United States and Canada.

JSG continues to work diligently to offer our clients and candidates world-class service and diversified offerings to fit their evolving needs.

r n r nJohnson Service Group (JSG) is an Equal Opportunity Employer. JSG provides equal employment opportunities to all applicants and employees without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, marital status, protected veteran status, or any other characteristic protected by law.