Medical claims processor Jobs in USA

Crystal Stairs, Inc.

Improving the Lives of Families through

Child Care Services, Research, and Advocacy

Crystal Stairs is committed to building and sustaining a diverse workforce and culture. As part of this commitment, Crystal Stairs does not and shall not discriminate on the basis of race, color, religion (creed), gender, gender expression, age, national origin, disability, marital status, sexual orientation, or military status, in any of activities or operations.

Provider Services - Claims Processor

100% Onsite - Location: Los Angeles, CA 90056

What We're Looking For:

We are seeking a qualified candidate for the Claims Processor position. The Claims Processor will provide excellent client service by accurately processing provider claims in a timely manner while adhering to the contractual requirements of the California Department of Education and LA County Department of Public Social Services as well as Crystal Stairs, Inc. policies and procedures. The selected qualified candidate will have the following responsibilities:

RESPONSIBILITIES:

• Process attendance records and provider payment requests in accordance with department quality standards based upon the funder's payment rules and regulations in addition to the agency's policies.
• Effectively communicate with providers, parents, and CSI staff, as needed.
• Assist parents, providers, and staff in completing attendance records and/ or provider payment requests by responding to incoming inquiries regarding payment or claims submission.
• Communicate with case managers to resolve payment authorization issues on pending claims.
• Contribute to a team atmosphere by participating in monthly staff meetings, training, and assisting department co-workers as needed.
• Other duties as assigned.

EXPERIENCE, KNOWLEDGE, SKILLS AND ABILITIES YOU SHOULD POSSESS:

• High School Diploma or GED Equivalent required. An AA/AS Degree in Accounting, Business, or Human Services preferred/or a minimum of two years of verifiable college coursework with a focus on accounting or business; verifiable work experience may be substituted for college level education
• Minimum of two years experience processing claims, billing or adjustment payments required. Experience in an entry level accounting role preferred.
• Experience with child care providers and parents receiving subsidized child or social support services preferred.
• Must have Knowledge of the Department of Public Social Service Stage 1 Child Care Services Contract or CDE Alternative Payment Program or experience working with social support services preferred.
• Must have strong customer service, organization, written and verbal communication skills.
• Requires excellent data entry and processing skills within a fast paced environment.
• Requires considerable accuracy, attention to details and ability to adhere to strict processing deadlines.
• Must be flexible and possess a strong ability to multi-task while working in a collaborative, team environment.
• Must have the ability to perform basic mathematical computations to verify and confirm payment calculations.
• Must have ability to work with diverse groups.
• Must have technical proficiencies working with Microsoft Excel and Microsoft Word
• Ability to understand and master complex program requirements and processes as they relate to provider payment
• Able to work flexible hours as needed to complete required tasks in a timely manner. Overtime may be required to assure timely and compliant processing of provider payments; and
• Able to work under pressure and with time-sensitive deadlines.

Total Package of Benefits

• Medical/ Dental/ Vision - 95% paid by employer
• Pet Insurance
• Employee Assistance Program
• Voluntary Life and AD&D for Employee, Spouse and Children
• 401k Matching Options
• Flex Spending (Health Care and Dependent Care)
• Mutual of Omaha (STD, Accident, & Critical Illness)
• Generous Sick and Vacation Time
• Paid Holidays + Paid Winter Break from 12/24 - 1/1 (for select positions)
• Opportunity for Growth and Development
• Robust Learning Management System offering the following continuing education units: PDC, HRCI, CEU, CPE, PDU, SHRM

Qualified applicants with arrest or conviction records will be considered for Employment in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act.

Crystal Stairs, Inc. is committed to building and sustaining a fully vaccinated, diverse workforce and culture. As part of this commitment, Crystal Stairs, Inc. provides equal opportunity in all of our employment practices, including selection, hiring, promotion, transfer, and compensation, to all qualified applicants and employees without regard to race, color, medical condition as defined by state law, ancestry, religion, sex, national origin, age, marital status, sexual orientation, gender, ethnic group identification, mental or physical disability, pregnancy, childbirth and related medical conditions, or any other legally protected status.

For more information about Crystal Stairs, please visit our website at: