University of California - San Diego #89844 Claims Resolution Coordinator in San Diego, California

#89844 Claims Resolution Coordinator

Filing Deadline: Fri 9/29/2017

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UCSD Layoff from Career Appointment: Apply by 09/20/2017 for consideration with preference for rehire. All layoff applicants should contact their Employment Advisor. Eligible Disability Counseling and Consulting services (DCC) or Special Selection clients should contact their Vocational Rehabilitation Counselor for assistance.

DESCRIPTION

Under general supervision and direction of the Claims/Customer Service Supervisor, the Claims Resolution Coordiantor is responsible for manual entry and pending of claims in the Epic system for review and adjudication. Performs all administrative aspects of claims inventory management including file identification and retrieval for delegation audits and associated document file-backs. Processes and prioritizes daily incoming Claims Department mail. Interprets health plan compliance requirements to ensure batches are maintained and distributed in received date order. Performs other related administrative support functions as required.

MINIMUM QUALIFICATIONS

  • High school diploma or equivalent.

  • Two (2) years providing administrative support in a managed care environment.

  • Six (6) months of recent claims data entry experience.

  • Knowledge of CPT, ICD, ASA, and HCPCS coding as it pertains to claims entry.

  • Knowledge of preparing claims for storage and retrieval.

  • Proficiency with MS Office: Excel, Word, Outlook, etc.

  • Excellent communication skills, both verbal and written.

PREFERRED QUALIFICATIONS

  • Some college coursework, or equivalent combination of education and experience.

  • Claim processing experience.

  • Epic Tapestry system proficiency.

  • Knowledge of health plan/HMO claims administration guidelines and requirements.

  • Familiarity with HMO claims data entry protocols.

SPECIAL CONDITIONS

  • Must be able to work various hours and locations based on business needs.

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UC San Diego Health is the only academic health system in the San Diego region, providing leading-edge care in patient care, biomedical research, education, and community service. Our facilities include two university hospitals, a National Cancer Institute-designated Comprehensive Cancer Center, Shiley Eye Institute, Sulpizio Cardiovascular Center, and several outpatient clinics. UC San Diego Medical Center in Hillcrest is a designated Level I Trauma Center and has the only Burn Center in the county. We invite you to join our dynamic team!

Applications/Resumes are accepted for current job openings only. For full consideration on any job, applications must be received prior to the initial closing date. If a job has an extended deadline, applications/resumes will be considered during the extension period; however, a job may be filled before the extended date is reached.

UC San Diego Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity or sexual orientation. For the complete University of California nondiscrimination and affirmative action policy see: http://www-hr.ucsd.edu/saa/nondiscr.html

UC San Diego is a smoke and tobacco free environment. Please visit smokefree.ucsd.edu for more information.

Payroll Title:

BLANK AST 2

Department:

UCSD Managed Care Claims

Salary Range

Commensurate with Experience

Worksite:

Other

Appointment Type:

Career

Appointment Percent:

100%

Union:

CX Contract

Total Openings:

1

Work Schedule:

Days, 8 hrs/day, Mon-Fri