Claims Logger-PFS - 3506- Full Time- Spectrum
- Corporate Offices
- Day
- Regular
Hours
Shift Start Time:
6:30 AMShift End Time:
3 AMAdditional Shift Information:
Flexible within 1 hour of start timeWeekend Requirements:
No WeekendsOn-Call Required:
NoHourly Pay Range (Minimum - Midpoint - Maximum):
$20.000 - $22.314 - $26.777The 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
- Claims
Maintain a 2 day turnaround time on all Logging and Tracking of paper non-scannable claims. - Claims Accuracy
Manually 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 Coordination
Reporting, 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 Teamwork
Demonstrate 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 Projects
Perform 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
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View location"After nearly 10 years of working here, it's still one of the hardest jobs I've ever loved. If you find a niche here, you'll be working with some of the smartest in the industry. This is where they'll respect you for thinking outside the box and kindness matters. They expect consistency and hard work, but pay you well to do it."