Claims Logger-PFS - 3506- Full Time- Spectrum

Facility: Corporate Offices

City San Diego

Department

Job Status

Regular

Shift

Day

FTE

1

Shift Start Time

Shift End Time

Hours

Shift Start Time:

6:30 AM

Shift End Time:

3 AM

Additional Shift Information:

Flexible within 1 hour of start time

Weekend Requirements:

No Weekends

On-Call Required:

No

Hourly Pay Range (Minimum - Midpoint - Maximum):

$20.000 - $22.314 - $26.777

The stated pay scale reflects the range that Sharp reasonably expects to pay for this position.? The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices.

What You Will Do

Minimal data entry from non-scanned claims into GE according to established procedures.

Required Qualifications

• 1 Year previous claims experience in an HMO or indemnity insurance setting (HMO preferred) or related experience

Essential Functions

• ClaimsMaintain a 2 day turnaround time on all Logging and Tracking of paper non-scannable claims.

• Claims AccuracyManually enter mandatory fields accurately according to established procedures.99% quality (coding).Accurately log claim to correct member file.Accurately log correct provider of service.Accurately log all mandatory fields member, provider, DOS, billed amount, and notation of attachments.

• Claims CoordinationReporting, scanning, re-indexing and routing of all logged claims.Complete batch reports according to the level of priority and plan assigned.Route and complete Enrollment and Claim Support Requests within established turnaround times.Accurately name, scan, and re-index logged batches into Onbase.

• Communication and TeamworkDemonstrate cooperation and teamwork by participating in achieving department goals, promoting cooperation with co-workers and other departments, communicating courteously with co-workers, regularly attending and contributing to unit meetings.Demonstrates ability to work independently.Inform supervisor when available for additional work assignments.Accurate and timely submission of daily deletion logs, weekly production hours and timecards.

• Special ProjectsPerform special projects as assigned by the Team Leader/Manager.

Knowledge, Skills, and Abilities

• Strong organizational skills with attention to details.

• Knowledge of standard insurance procedures including but not limited to member and vendor look ups within GE.

• Ability to read, speak and hear English clearly.

• Ability to use keys on computer terminal keyboard, ten key by touch.

Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class