Claims Assistant

San Mateo County, California
Excellent benefits package offered
Jun 03, 2019
Aug 02, 2019
Job Type
Not Specified
Career Level
Entry Level

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.

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