Temporary Claims Customer Service Representative

New Today

ABOUT THIS TEMP POSITION This is a temporary position and the length of assignment is estimated to go for 3-6 months. The length of the assignment is always dependent on business need and dates may change. While the assignment would be at the Alliance, if selected, you would be an employee of a temporary employment agency that we would connect you with.
We have an opportunity to join the Alliance as Temporary Claims Customer Service Representative.
WHAT YOU'LL BE RESPONSIBLE FOR Reporting to the Claims Manager, this position:
Acts as a frontline customer service representative and researches, resolves, and responds to inquiries regarding claims issues from providers and Alliance staff
Processes various claim types and conducts research and analysis related to claims resolution
Maintains current knowledge of claims processes, procedures, and related documentation, assistsin developing and maintaining internal operating procedures, and recommends coding and reimbursement changes in the Alliance's claims processing system
ABOUT THE TEAM
We handle billing-related inquiries and issues from providers concerning treatment, services and care of our members.:
WHAT YOU'LL NEED TO BE SUCCESSFUL
To read the full position description, and list of requirementsclick here.
Knowledge of:
Methods and techniques of medical claims processing
General administrative procedures and standard business office practices and equipment
Principles and practices of customer service
Reading medical insurance Explanation of Benefits
Ability to:
Effectively and clearly document, summarize and resolve concerns and inquiries related to claims issues and recognize those issues requiring escalation to a higher-level staff member
Gather and evaluate information, ask appropriate questions, and utilize problem solving skills *
Utilize a variety of computer systems, including the Alliance information system and external websites and databases
Understand and communicate the complex operations and processes of the Alliance, particularly the Utilization Management, Care Management, and Member Services departments
Education and Experience:
High School Diploma or equivalent and a minimum of two years of experience performing claims processing in a Medi-Cal or managed care environment (an Associate's degree maysubstitute for one year of the required experience); or an equivalent combination of education and experience may be qualifying
OTHER INFORMATION
We are in a hybrid work environment and we anticipate that the interview process will take place remotely via Microsoft Teams.
While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected.
In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process.
The full compensation range for this position is listed by location below.
The actual compensation for this role will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferrable experience related to the position, education or training), as well as other factors (internal equity, market factors, and geographic location).
Typical areas in Zone 1: Bay Area, Sacramento, Los Angeles area, San Diego area
Typical areas in Zone 2: Fresno area, Bakersfield, Central Valley (with the exception of Sacramento), Eastern California, Eureka area
Santa Cruz County Pay Range $27.21—$43.54 USD Merced County Pay Range $24.76—$39.62 USD Monterey County Pay Range $27.21—$43.54 USD San Benito County Pay Range $24.76—$39.62 USD
OUR BENEFITS Available for all regular Alliance employees working more than 30 hours per week.Some benefits are available on a pro-rated basis for part-time employees. These benefits are unavailable to temporary employees while on an assignment with the Alliance.
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
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 Mariposa, Merced, Monterey, San Benito 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. We are an E-Verify participating employer
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.
Apply
Location:
Merced, CA, United States
Job Type:
PartTime

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