Alignment Healthcare is a population health management company dedicated to changing the way health care is delivered in the United States. We are a fast-growing, highly dynamic organization that isn’t content with the status quo. We are looking for dedicated, innovative individuals who thrive in a fast-paced environment to join our team and help us carry out our vision - that is, to lead a movement that transformationally improves health care.

Join us today and we will give you every opportunity to succeed.

Claims Mailroom Support Clerk

Location: Orange, California US

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This position is no longer posted.

Job Number: 1359

Position Title: Claims - Mail Room Support Clerk

External Description:

Claims Clerical-Mailroom Support Clerk

 

The Claims Clerical-Mailroom Support Clerk is responsible for managing incoming mail from providers while ensuring a high level of accuracy.  Requires the ability to multi-task while providing accurate and timely mail triaging and processing.

 

Summary

 

Essential duties and responsibilities include but are not limited to:

 

  1. Responsible opening, triaging and batching incoming mail, faxes.
  2. Utilize EZ CAP claim processing system to research provider and member status.
  3. Data entry of manual claims into EZ CAP claims system.
  4. Daily logging and counting of mail.
  5. Responsible for processing daily pend, denial and claim forwarding correspondence.
  6. Accountable for providing requested documentation to internal departments and provider network (EOB, faxes, scanning, requests for letter copies).
  7. Support of research projects through claims look-up and simple documentation via Excel spreadsheets.
  8. Ability to positively support the needs of providers and claims team through professional communication that demonstrates the company culture.
  9. Participate in Claims Department team meetings and other activities as needed.
  10. Ensure the privacy and security of PHI (Protected Health Information) as outlined in department policies and procedures relating to HIPAA Compliance.
  11. Other duties and projects as assigned.

 

Supervisory Responsibilities

 

This job has no supervisory responsibilities.

 

Qualifications

 

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

  1. 1 year of mail room/clerical experience in a healthcare setting
  2. High School Diploma or GED
  3. Medicare Claim knowledge  preferred
  4. Ability to multi-task
  5. Ability to remain focused and productive each day through task.
  6. Data entry
  7. Faxing and scanning knowledge preferred

 

Skills and Abilities

 

  1. Language Skills:  Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals.  Ability to write routine reports and correspondence.  Ability to speak effectively before groups of customers or employees of the organization.
  2. Mathematical Skills:  Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume.  Ability to apply concepts of basic algebra and geometry.
  3. Reasoning Skills:  Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions.  Ability to deal with problems involving a few concrete variables in standardized situations.
  4. Computer Skills:  Knowledge of computer programs and applications required.
  1. Other Skills and Abilities:
    1. Team player.
    2. Multi-tasking capabilities.
    3. Good written and verbal communication skills required.
    4. Ability to operate a telephone, computer, copier, fax machine, and other office equipment.
    5. Ability to travel between locations is essential.

 

Physical Demands

 

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

  1. While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear.
  2. The employee is frequently required to reach with hands and arms.
  3. The employee is occasionally required to stand; walk; climb or balance and stoop, kneel, crouch, or crawl.
  4. The employee must occasionally lift and/or move up to 25 pounds.
  5. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

 

 

Working Environment

 

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

  1. The noise level in the work environment is usually moderate.

Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran.

City: Orange

State: California

Location City: Orange

Location State: California

Community / Marketing Title: Claims Mailroom Support Clerk

Company Profile:

Who is Alignment Healthcare?

  • Socially responsible
  • Technologically enabled
  • Concierge care
  • Transformation
  • Servant leadership

We are dedicated to transforming the complex and confusing process of medical treatment in the United States so that every link in the health care continuum becomes more efficient, productive, and effective. We built a team of people who want to make a difference. Come join the team that is changing health care one person at a time.

We believe that great work comes from people who are inspired to be their best. We invite you to explore our wide variety of roles based on your unique experience.

EEO Employer Verbiage:

Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran.

If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact careers@ahcusa.com.

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