Claims Data Entry Clerk II (Temporary)

$45,760 - $55,818/Yr

L.A. Care Health Plan - Los Angeles, CA

Full-time - Entry Level

Los Angeles, CA

Administration of Human Resource Programs

About the position

The Claims Data Entry Clerk II is responsible for the accurate and timely data entry of claims and other documents within the Claims Department at L.A. Care Health Plan. This role involves keying claims for various lines of business, checking member eligibility, scanning medical records, and preparing reports. The position is crucial for ensuring that claims are processed efficiently and accurately, supporting the organization's mission to provide quality health care to low-income communities in Los Angeles County.

Responsibilities

• Accurately enter claims data into the Core adjudication system.
• Check eligibility of members to sort claims by product.
• Scan and sort medical records as needed.
• Review claims for required information and return incomplete claims to providers.
• Prepare and ensure accuracy of reports generated within specified timeframes.
• Create and send rejection letters to providers for rejected claims with 98.5% accuracy.
• Meet production standards and keep current with incoming daily receipts.
• Perform special projects and ad-hoc reporting as necessary.

Requirements

• High School Diploma or GED required.
• At least 6 months of accurate, high-volume claims data entry or claims processing experience required.
• Proficient in Microsoft Office.
• Strong verbal and written communication skills.

Nice-to-haves

• Managed care or Medi-Cal claims experience preferred.
• Claims Examiner Training preferred.

Benefits

• Dental insurance
• Paid sick time
• Vision insurance
• Wellness program