Claims Coordinator

Job Title: Claims Coordinator
Location: Whittier, CA – Hybrid (2x a week in office)
Contract: 4 Months+ – (Temp to Hire Role)

Hours: 9:00 AM – 5:00 PM (Mon–Fri)
Pay Range: $22 - $25 per hour. on W2
 
Overview:
Responsible for billing medical claims, applying cash, and working the aged trial balance (fix and resubmit claims to insurance). Must have recent/relevant experience, or will be declined.
Note: Interviews will be onsite in CA.
 
Specific Skills Needed:

• Top 3–5 mandatory and/or minimum requirements:
  • Experience with vision claims coding and billing
  • Cash apply experience
• Top 3–5 desirable attributes/qualifications: (Not specified)
• Required education/experience (flexibility discussed):
  • 3 years vision billing experience, preferably medical billing
  • High school diploma

 
Major Duties and Responsibilities:

• Manage the flow of processes completed by Cash Processors to ensure all cash is applied in a timely manner to outstanding invoices and provide Cash Supervisor with daily updates.
• Document and track stats of all processes within Cash and report results to Cash Supervisor.
• Train associates on how to process transactions, which include researching and applying cash for both Payers and Members, identifying and documenting partial payments and denials, and scanning completed batches into Filebound.
• Complete and submit applications and documentation necessary for setting up EFTs (report any issues to Cash Supervisor).
• Provide a point of contact for any questions/issues regarding Cash for other areas of Assignment.
• Provide a point of contact for any questions/issues regarding Filebound.
• Attend meetings and/or conference calls at the request of Cash Supervisor to provide insight on Cash processes for internal or external customers.
• Schedule and coordinate monthly team meetings.
• Support relationships with designated Payers, including frequent updates to Management team.
• Work pre-bill queries weekly to ensure claims are sent accurately to minimize denials.
• Analyze open receivable trends, including payment frequency and root cause analysis.
• Research and resolve insurance denials for proper submission of claims within a given time frame.
• Resolve/escalate any Provider, plan set-up, store, and/or system issues accurately and in a timely manner.
• Run and work various AS400 queries for research each week to analyze in Microsoft Excel.
• Quickly summarize outstanding AR issues and provide recommendations/solutions.
• Analyze collections data quarterly and develop projects based on P&L risk by Payer, forecasting expected payments and providing line of sight to resolution.
• Support the collection of receivables for Canada, including write-offs (adjustments), monthly ATB analysis, and resolution of issues.
• Assist Supervisor as needed with special projects and training.

 
Knowledge and Skills:

• Knowledge of vision and/or insurance benefits
• Knowledge or experience in claims processing
• Proficient in Microsoft Excel
• Understand and honor high level of confidentiality
• Promote integrity and a strong work ethic
• Able to quickly grasp and retain information and concepts
• Able to multi-task and prioritize handling of issues
• Team and performance oriented
• Strong communication skills, both oral and written
• Knowledgeable in continuous improvement and problem solving
• Strong analytical skills
• Strong customer service