Claims Clerk


POSITION SUMMARY

Receives mail deliveries and organizes mail by category. Manages scanners and labels information for proper storage and quick access. . Takes necessary steps to get information into our operating system, including manual entry of information for all claims-business forms (UB, 1500, and home grown forms).

 

COMPLIANCE WITH REGULATIONS:

Works closely with all departments necessary to ensure that the processes, programs and services are accomplished in a timely and efficient manner in accordance with CHG policies and procedures and in compliance with applicable state and federal regulations including CMS and/or Medicare Part D and Special Needs Plan (SNP).

 

RESPONSIBILITIES

  • Sustains departmental goals on turn-arounds for labeling, scanning, and indexing processes.
  • Responsible for quality management and storage of paper information by following HIPPA complaint privacy laws.
  • Processes claims in a timely and accurate manner by meeting or exceeding established quality and production standards for data entry.  Utilizing reference materials.
  • Supports the team effort by maintaining department and corporate policies and procedures; enhancing professional growth and development through participation in education programs and reviewing current literature; attending meetings and workshops; performing other duties as assigned or requested.
  • Maintains product and company reputation and contributes to the team effort by conveying professional image and accomplishing related tasks; participating on committees and in meetings; performing other duties as assigned or requested.

 

Education:

  • High school diploma

 

Experience/Skills:

  • Clerical experience
  • Data Entry
  • Ability to operate a personal computer, scanner, copier, fax, telephone.
  • Strong mathematics, organizational and analytical skills.
  • Good verbal/written communications skills.
  • Ability to work independently.

 

Physical Requirements:

  • Prolonged periods of sitting; typing and viewing video display terminal.
  • May work alone and in confined space.
  • May be required to work evenings and/or weekends.