Providence Health & Services Claims Support Specialist ( Full Time - Days ) in Mission Hills, California

Description:

Providence is calling a Claims Support Specialist ( Full Time / Day Shift ) to our Facey HMO Claims Processing Department location in Mission Hills, CA.

In this position you will:

  • Be responsible for clerical functions such as copying, filing, mailing claims correspondence to various external customers.

  • Follow-up on claims forwarded to internal departments for review such as UM, contracts, eligibility, UM Physician and Medical Director Review.

  • The primary goal of this position is to perform clerical functions to make the production staff more efficient and reach higher production levels.

  • Be responsible for entering Claims into the GE Centricity/IDX database, following up on routine pended claims when needed such as those pending for request of Medical records or notes, TAX ID information, etc.

  • Will interact closely with Claims Department Leadership and Claims staff in regards to these claims functions.

Qualifications:

Required qualifications for this position include:

  • Three or more years HMO claims and Claims Correspondence processing experience required in a managed care environment, preferably PMG/IPA setting within the last three years or any combination of education and/or experience which produces an equivalency.

  • Knowledge of medical terminology and coding.

  • Familiar with CMS and Department of Managed Care mandates.

  • Ability to type 35 WPM uses a ten‑key adding machine, perform data entry and make mathematical calculations.

  • Effective communication and follow-through skills.

Preferred qualifications for this position include:

  • Spanish bilingual

About the organization you will serve:

Facey Medical Group is a multi-specialty medical group with over 160 physicians providing care to the growing population in the North & East regions of Los Angeles & Ventura Counties. Twelve medical clinics, including two urgent care centers and dedicated women's centers, are located across the San Fernando, Santa Clarita and Simi Valleys. The group began as a single medical practice over 90 years ago.

Facey is part of Providence Health & Services, an integrated, not-for-profit 5-state network of hospitals, care centers, medical clinics, affiliated services and educational facilities spanning from California to Alaska.

We offer a full comprehensive range of benefits - see our website for details

http://www.providenceiscalling.jobs/rewards-benefits/

Our Mission

As people of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service.

About Us

Providence Health & Services is the third largest not-for-profit health system in the United States. Providence employs more than 76,000 caregivers (employees) across a five-state area; AK, WA, MT, OR, and CA. Our facilities include 34 hospitals, 475 physician clinics, senior services, supportive housing and other health and educational services. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

Schedule: Full-time

Shift: Day

Job Category: Administrative Support (Clinical)

Location: California-Mission Hills

Req ID: 147884