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Claims Technician I

We have an opportunity to join the Alliance as a Claims Technician I in the Claims Department.


WHAT YOU'LL BE RESPONSIBLE FOR

Reporting to the Claims Supervisor, you will

  • Open, sort, prepare, batch and scan claim forms and other documents
  • Data enter, verify, validate, and process claims in Perfect Claim
  • Process Level I claim types
  • Assist with training of new hires in the claims control function and with cross-training other Claim Technicians as needed
  • Provide support to the Claim Control Clerk

ABOUT THE TEAM

We support Alliance members' access to care by ensuring medical services are paid to network providers accurately and on time.


WHAT YOU'LL NEED TO BE SUCCESSFUL

To read the full position description, and list of requirements click here.

  • Knowledge of:
    • Basic knowledge of and ability to operate general office equipment, including scanner, personal computer, telephone, photocopier, fax, etc.
    • Some knowledge of medical terminology and related procedure and diagnostic coding (CPT/ ICD, HCPCS), as well as knowledge of how to access available resource tools
  • Ability to:
    • keep current with claims processing practices and procedures
    • read and understand medical insurance Explanation of Benefits
  • Education and Experience:
    • High School Diploma or equivalent with one year of relevant experience with claims processing in an automated claim environment; or an equivalent combination of education and experience may be qualifying

OTHER DETAILS

  • While this position is connected to one of our Alliance offices, we are in hybrid remote/in-office work environment right now and we anticipate that the interview process will take place remotely.
  • Our Alliance office locations have officially re-opened as of May 2, 2022 and while some employees may work in full-time telecommute schedules, attendance at quarterly company-wide events or department meetings will be expected.
  • Based on the nature of work, this position may require onsite presence, which is dependent on business need. Details about this can be reviewed during the interview process.


Scotts Valley pay range

$18.69—$29.90 USD

Additionally, all positions at the Alliance are required to meet these minimum qualifications.

OUR BENEFITS

  • Medical, Dental and Vision Plans
  • Ample Paid Time Off
  • 12 Paid Holidays per year
  • 401(a) Retirement Plan
  • 457 Deferred Compensation Plan
  • Robust Health and Wellness Program
  • Onsite EV Charging Stations
  • And many more

ABOUT US

We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us.

Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve members in Merced, Monterey and Santa Cruz counties. To learn more about us, take a look at our Fact Sheet.

The Alliance is an equal employment opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national origin, age, marital status, protected veteran status, or disability status.

At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.

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CEO of Central California Alliance for Health
Central California Alliance for Health CEO photo
Michael Schrader
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Accessible, quality health care guided by local innovation.

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DATE POSTED
August 6, 2023

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