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    Claims Inquiry Unit Representative - Los Angeles, United States - MedPOINT Management

    MedPOINT Management
    MedPOINT Management Los Angeles, United States

    1 week ago

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    Description

    Job Description

    Job Description

    Summary:

    To serve as a liaison between IPA and its Members and Providers. Ensures that all Members and Providers receive a level of service that exceeds their expectations. Respond to and resolve questions and problems from current Providers/Members, or their representative and other appropriate parties.

    Duties and Responsibilities:

    Be proficient in discussion and execution including, but not limited to, the following:

    1. Multi-Task in a very busy Call Center Environment

    2. Explanation of how the plan works and how to utilize the service

    3. Explanation of the Claim process, payment, denials, etc.

    4. Provide Appeal Status

    5. Assist with Benefit clarification and eligibility with correspondence from appropriate department

    6. Participate as a team player by demonstrating support to peers, management, and the department's goals

    7. Attend meetings and training sessions as scheduled

    8. Assist with training new employees as needed

    9. Show flexibility in meeting performance objectives consistent with IPA and department objectives

    10. Document all Provider/Member inquiries and complaints in appropriate systems and either handle, redirect, or defer to the appropriate department for resolution.

    11. Proficiently review and respond to Web Portal Inquires for Claims related issues through the portal.

    Minimum Job Requirements:

    High school diploma. Two years of Customer Service/Call Center in related field preferred. Knowledge of Medi-Cal, Managed Care plans, CPT Codes, ICD-10, HFCA1500 Forms, UB94 Claim Forms

    Knowledge, Skills and Abilities Required:

    · Must be computer literate, typing 30 wpm

    · Excellent telephone techniques

    · Excellent interpersonal and communication skills; strong writing skills

    · Medical Front and Back Office as well as Claims/Billing experience preferred

    · Bilingual in Spanish preferred

    Salary Range:

    $18 - $20 hourly

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