Job Openings

Claims Coordinator

Job ID: BH350380

Category: Benefits Administrator

Specialty: Administrative

Job Title: Claims Coordinator


Job Summary:

The Claims Coordinator is responsible for pre-screening and batching correspondences received in the Hospital/Clinic MSO mailroom. The Claims Coordinator will coordinate the hand-offs and completions of retro-auth requests, provider update requests, and eligibility verification requests between the Claims team and internal and external partners.

Client JD:

  • Support the claims department by preparing claim receipts and correspondences received in the Hospital/Clinic MSO mailroom
  • Track mailroom claim receipts and assist in the paper claims OCR scanning into electronic format
  • Ensure all documents are accurately counted, date stamped, tracked, and reconciled
  • Assist with daily pick-ups and distribution of mail and correspondences from dedicated post office boxes, fax machines, e-fax, secure file transfers, as well as sending provider EOBs, member letters, misdirected claims, and other letters sent by the Claims team
  • Meet Hoag Clinic MSO quality and timeliness requirements in handling claims and correspondences in accordance with regulatory and health plan requirements
  • Assist in identifying and reporting issues working with the Claims management team to develop procedures and workflows to ensure efficient mailroom processes
  • Interact in a positive and collaborative manner with internal and external partners
  • Support the claims team in implementing initiatives in improving claims processing efficiency
  • Assist in provider customer service, member services, health plan, and other customers including making and answering phone calls to providers/billing offices when necessary based on team guidelines
  • Perform other duties as assigned

The Planet Group of Companies is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Type: Temp/Contract

Location: Remote Based