Job ID: BH350380
Category: Benefits Administrator
Job Title: Claims Coordinator
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.
- 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.