Robert Half Office Team Medical Claims in Rancho Cordova, California
The Examiner is in daily contact with team members, clients and providers. Responsibilities: include the following. Other duties may be assigned.
Processes claims accurately, efficiently and within quality/quantity requirements
Exhibits an attention to detail and a strong work ethic
Can interpret Plan Documents
Can access research tools for accurate claims entry
can be organized and manage time and resources efficiently and effectively
Has thorough knowledge of coding structures (CPT, HCPCS, Revenue codes, ICD 9/10 etc.)
Can perform arithmetic calculations
Has knowledgeable of COB
Has familiarity with benefits and benefit calculations
Can understand all types of claims pricing (Network, Medicare, RBP (Reference
Based Pricing) and UCR (Usual, Customary and Reasonable, etc.)
Performs duties in a HIPAA compliant manner
Participates as a Team Member to ensure the smooth operation of the entire department
Maintains guidelines and notes with attention to detail to enable accurate claims processing
Maintains quantity/quality department goals regarding the number of claims entered and
Completes other projects as assigned.
Complies with company policies and procedures as outlined in the Employee Handbook
Complies with department policies and procedures
Assists in cross-training other employees at the Supervisor or Claims Manager's request
Performs special projects at the request of management
Regular, predictable attendance is required.
Can get along and work effectively with others. If interested please email your resume to Jessica.email@example.com
OfficeTeam is the world's leader in professional staffing for office support jobs, focusing exclusively on the temporary and temporary-to-full-time placement of professionals in the administrative field. We are faster at finding you work because of the depth of our client network. Specifically, our professional staffing managers connect with thousands of hiring managers in North America every week to find your office support job opportunities. We evaluate all of our OfficeTeam temporaries' skills and match them with the needs of top employers in their area.
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All applicants applying for U.S. job openings must be authorized to work in the United States. All applicants applying for Canadian job openings must be authorized to work in Canada.
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Req ID: 00393-9501130173
Functional Role: Account Executive/Staffing Manager
City: Rancho Cordova
Postal Code: 95655
Requirements: Supervisory Responsibilities: This job has no supervisory duties. Measures of Performance: The Claims Examiner shall be performing in an acceptable manner when the following have been accomplished: 1. Problem Solving – Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations; Uses reason even when dealing with emotional topics. 2. Customer Service – Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments. 3. Interpersonal Skills – Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things. 4. Oral Communication – Speaks clearly and persuasively in positive or negative situations; Listens and gets clarification; Tailors the content of speech to the level and experience of the audience; Uses appropriate grammar and choice of words in oral speech; Organizes ideas clearly in oral speech; Responds well to questions; Demonstrates group presentation skills; Participates in meetings. 5. Written Communication – Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information. 6. Teamwork – Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Contributes to building a positive team spirit; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives; Supports everyone's efforts to succeed; Listens and responds constructively to other team members' ideas