Claims Service Associate Job

CLAIMS SERVICE ASSOCIATE needed for a CONTRACT opportunity with Yoh's client located in San Francisco, CA.

The Big Picture - Top Skills You Should Possess:

- Experience in Managed Care
- Thorough knowledge of CPT and ICD-9 Codes

What You'll Be Doing:

- Responsible for customer-focused, effective and thorough handling of telephonic claim inquiries from customers with the objective of one call resolution
- Validate inquiries by applying claim policy appropriately and accurately in order to adjust claims when needed and resolve issue in a timely manner
- Track inquiries and provides appropriate follow-up as required
- Investigate and process claim adjustment requests including Cap deduction received from health plans and MSP requests for Medicare
- Assist with departmental daily claim edit reports and the daily production of incoming claims

What You Need to Bring to the Table:

- Minimum of three (3) years of experience with a combination of customer service and claims experience in an IPA/HMO Managed Care or HMO/Payor environment
- Excellent oral and written communication skills, professional approach to problem resolution
- Effective organizational skills and ability to prioritize projects
- Knowledge of CPT Codes and ICD-9 Codes and healthcare insurance claims transaction systems experience is required
- Thorough knowledge of medical terminology, membership enrollment activities and claims adjudication processing procedures is required

WHAT ARE YOU WAITING FOR? APPLY NOW!

RECRUITER: Jennifer Andersen

Yoh, a Day & Zimmermann company, is an Equal Opportunity Employer, M/F/D/V. If you are an individual with a disability and you require an accommodation in the application process, please email.

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