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Claims Representative

Claims Representative

Robert HalfOntario, CA, US
16 hours ago
Job type
  • Temporary
Job description

Job Description

Job Description

We are looking for a detail oriented Entry-level Claims Representative to join our clients' team in Ontario, California. In this role, you will provide critical support in managing claims-related tasks, ensuring accuracy and efficiency in processing, reconciling, and auditing claims. This is a long-term contract position ideal for professionals with strong organizational skills and a background in medical office operations.

Responsibilities :

  • Match checks with remittance advice, prepare and insert them into envelopes for mailing.
  • Reconcile processed batches within the audit database to ensure accuracy.
  • Create and mail denial trailers and letters to providers.
  • Print and send out claim requirement letters for Covered California members.
  • Forward claims to the appropriate health plan when necessary.
  • Process and mail claims deemed unable to process, including generating the necessary correspondence.
  • Batch trailers created by various departments and ensure proper documentation.
  • Audit the batch log key to confirm claims have been assigned and logged correctly.
  • Verify member information to determine line of business and coordination of benefits in the system.
  • Collaborate on process adjustments and work independently or as part of a team.
  • High school diploma or equivalent education.
  • Minimum of six months of experience in a medical office setting.
  • Proficiency in data entry with accuracy and speed, typing 35-40 words per minute.
  • Familiarity with Microsoft Excel, Word, and Outlook.
  • Knowledge of claim forms, including UB-04 and CMS-1500.
  • Strong attention to detail and ability to adapt to changing processes.
  • Excellent communication skills and ability to work collaboratively.
  • Understanding of benefits coordination and health plan operations.
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Claim Representative • Ontario, CA, US