Claims Customer Service Coordinator

General Information

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Work Location: Los Angeles, USA Onsite or Remote Flexible Hybrid Work Schedule Monday - Friday, 8:00AM-5:00PM Posted Date 08/02/2024 Salary Range: $25.6 - 36.33 Hourly Employment Type 2 - Staff: Career Duration indefinite Job # 18083

Primary Duties and Responsibilities

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As a Claims Customer Service Coordinator, you will play a crucial role in connecting members, billers, providers, physicians, and Health Plans. Your primary responsibilities will include:

• Answering calls promptly and courteously, providing professional assistance to customers with claims-related issues.
• Ensuring timely resolution of customer inquiries.
• Handling typical inquiries such as:
  • Claim Status
  • Requests for Explanation of Benefits (EOB)
  • Requests for Denial Letters
  • Health Plan demands
  • Check tracers
  • Managing incoming faxes
• Documenting all interactions in our CRM system.
  

Salary Range: $25.60  - $36.33/hourly

Job Qualifications

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We are seeking a detail-oriented, independent individual with: 

• High school diploma, GED, or equivalent.
• Minimum of 2 years of medical claims customer service experience in an HMO environment (e.g., MSO, IPA, or health plan).
• Proficient with CPT/HCPC codes, UB04, 1500 forms, ICD-10, ASA, Medicare Guidelines, and COB.
• Extensive knowledge of professional and facility reimbursement methodologies and benefit determination.
• Demonstrated competence in medical terminology and claims adjudication systems.
• Able to handle a high volume of calls and work under pressure.
• Proficient computer skills, including Microsoft Word and Excel.
• Independent worker with the ability to meet deadlines and production standards.
• Flexible, adaptable, and goal-oriented, capable of multitasking and working with frequent interruptions.