The Health Plan of San Mateo (HPSM), a managed care health plan, seeks a full time Claims Assistant. Provide support to assigned area(s) in the Claims Department including, but not limited to, Operations, Recovery, Provider Service Representatives and/or Quality Control.
The essential duties and responsibilities will include the following:
- Respond to voicemails, emails, and faxes; log, distribute and track those requiring higher-level review.
- Prepare and mail appropriate letters as required.
- Maintain accuracy and integrity of data base and spreadsheets.
- Enter non-claim mail into the designated database • Facilitate the assignment and review of provider disputes
- Complete claim, TAR, PDR and check status requests from Providers as requested or required.
- Research basic claim information and handle appropriately.
- Prepare and update electronic files and records.
- Collect information and generate/distribute required reports as needed.
- As requested, gather information for audits.
- Conduct internal audits as directed.
- Maintain files including scanning and filing.
- Administrative support as requested by staff
- Maintain office supplies and prepare office supply purchase orders.
- Attend and actively participate in meetings as required.
- Perform other duties as assigned.
Education and Experience:
Equivalent to a high school diploma or GED required. One (1) or more years’ clerical experience.
Knowledge of: General clerical processes and procedure. Personal computers and proficiency in Microsoft Office Suite applications, including Outlook, Word, Excel, Access and PowerPoint.
Ability to: Work in a fast-paced, highly pressured and changing environment. Follow oral and written instructions. Operate standard office equipment and personal computers. Produce basic logs and reports. Interact well with others and be a team player. Use effective oral and written communications. Organize and prioritize workload.
Compensation and Benefits
Starting Compensation Range: Depending on experience.
Benefits Information: Excellent benefits package offered, including HPSM paid premiums for employee’s Medical, Dental and Vision coverage. Employee pays a small portion of the dependent premiums (5%) for medical and dental benefits. Additional HPSM benefits include fully paid life, AD&D, and LTD insurance; retirement plan (HPSM contributes equivalent of 10% of annual compensation); holiday and vacation pay; tuition reimbursement plan; onsite fitness center and more.