Cash/Claims Processor

Title: Cash/Claims Processor
Location: Whittier CA - Hybrid: 2days a week in Office
1-2 Months and Temp to Hire role
Hours: 9am - 5pm (Mon-Fri)
Pay Rate - $25 Per hour


Responsible for b illing 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.

Specific Skills Needed:
o Top 3-5 mandatory and/or minimum requirements: experience with vision claims coding and billing and cash apply experience

Top 3-5 desirable attributes/qualifications?
o Required levels/ Years of Experience education discuss whether there is flexibility: 3 years vision billing experience, preferably medical billing. HS 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 for 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 EFT s (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 application
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