Claims Processor / PFS Claims / Full Time / Onsite - San Diego

[H.S. Diploma or Equivalent; Other

Hours

Shift Start Time:

Variable

Shift End Time:

Variable

Additional Shift Information:

between 05:00 am - 09:00 am

Weekend Requirements:

As Needed

On-Call Required:

No

Hourly Pay Range (Minimum - Midpoint - Maximum):

$20.250 - $24.050 - $28.860

The 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.

This is a full time position located onsite in Kearny Mesa (San Diego County). Must have experience with claims processing.

What You Will Do
Adjudication of referral claims and all related functions.

Required Qualifications

• 1 Year Previous claims processing experience in an HMO or indemnity insurance setting (HMO preferred)

Preferred Qualifications

• H.S. Diploma or Equivalent
• Other Some college coursework

Essential Functions

• Claims accuracy
  Process claims accurately according to established procedures/current contracts.
• Claims processing
  Maintain average adjudication production of 13 claims processed per hour.
• Customer service
  Enrollee/provider/health plan contact to be professional and courteous. Calls to be returned in a timely fashion.
• Time management
  Demonstrate ability to work independently and manage time well with any free time used to help in other areas as directed. Inform supervisor when available for additional work assignments.

Knowledge, Skills, and Abilities

• Strong organizational skills.
• Working knowledge of medical terminology and RVS/CPT/ICD-9 coding.
• Ten key by touch. C
• RT keyboard skills.
• Good verbal and written skills.
• Knowledge of standard insurance procedures (pricing, exclusions, etc.

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