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Claims Processor G4 - Full-time / Part-time
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Santa Clara, CA Santa Clara, California |
About this job
Description: Essential Functions:
* Receive incoming medical forms, disability claims and requests for release of information.
* May process state disability (SDI), private disability claims including extensions, and Paid Family Leave (PFL) applications and FMLA forms. -
* Verify that forms completed and signed correctly and appropriate fees have been collected.
* Redirect any request for information which is not complete, not signed or signed incorrectly.
* May process release of information (ROI) requests including records, forms, letters and reports.
* Identify appropriate information to be released per authorization.
* Print medical information from computer systems.
* Route as appropriate.
* Request inpatient and outpatient charts, as appropriate.
* Log in/log out requests.
* Abstract information from patient's charts and transfer to appropriate form; sign form if authorized.
* If not authorized, send completed form to attending physician for approval and signature.
* Maintain a tracking system for requests sent to physicians which are not returned completed in a timely manner.
* View/run reports as necessary for follow-up of outstanding claims and requests.
* Prioritize requests.
* Must be able to process claims and other requests in a timely and accurate manner and meet deadlines.
* Complete productivity tracking report.
* May maintain accurate accounting of all applicable HIPAA disclosures.
* Enter applicable HIPAA disclosures in designated database.
* Troubleshoot any problems that arise in completing disclosure accounting.
* Open mail, sort and prioritize requests.
* Troubleshoot issues (i.e. track records, previous correspondence, etc.).
* Research information missing in charts when necessary.
* Answer telephone inquiries and interact with members, third party entities, physicians and other staff.
* Make copies and file as necessary.
* May assist with on the job training of other employees, as required.
* Maintain excellence in service to members, physicians, other departments and fellow employees.
* Function as team member in completing work of the department.
* Perform other related duties as necessary.
Basic Qualifications:
* High School diploma or GED.
* Testing: Typing 30 WPM
* Testing: PC Skills Test (able to pass PC skills assessment)
* Testing: Medical Terminology (able to pass standardized test)
* Minimum of 1 year of release of information (ROI) experience preferred.
* Excellent attendance record required.
* Must be service oriented with strong customer service skills and ability to communicate effectively.
* Knowledge of medical terminology required and ICD-9 coding preferred.
* Must have basic PC and keyboard skills, ability to enter data into database.
* Ability to work independently, organize and complete work with minimal supervision.
* Must be able to work in Labor Management Partnership.
Skills Testing*: Typing 30 WPM or keystroke equivalent, Basic PC Skills Test (able to pass PC skills assessment), and Medical Terminology (able to pass standardized test).
* If it is determined that you need to complete testing to qualify for this position, you will receive an email inviting you to take the assessment(s) listed above. Passing test scores remain on file for one year.
This position supports Kaiser Permanente's code of conduct and compliance by adhering to all laws and regulations, accreditation and licensure requirements, and internal policies and procedures. Kaiser Permanente is proud to be an equal opportunity/affirmative action employer.
INTERNAL POSTING PERIOD: Starts 12:00AM 07/28/2017 - Ends 12:00AM 08/04/2017
Primary Location: California,Santa Clara,Santa Clara Medical Offices 710 Lawrence Express W Scheduled Weekly Hours: 0 Shift: Day Workdays: On-Call *includes coverage at satellites and scheduled days and hours are dependent on departmental needs and may include holidays and weekends Working Hours Start: On-Call Working Hours End: On-Call Job Schedule: Call-in/On-Call Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: United Healthcare Workers - West Job Level: Entry Level Job Category: Insurance / Claims Department: Medical Secretary Travel: No
Click here for additional requirements >
* Receive incoming medical forms, disability claims and requests for release of information.
* May process state disability (SDI), private disability claims including extensions, and Paid Family Leave (PFL) applications and FMLA forms. -
* Verify that forms completed and signed correctly and appropriate fees have been collected.
* Redirect any request for information which is not complete, not signed or signed incorrectly.
* May process release of information (ROI) requests including records, forms, letters and reports.
* Identify appropriate information to be released per authorization.
* Print medical information from computer systems.
* Route as appropriate.
* Request inpatient and outpatient charts, as appropriate.
* Log in/log out requests.
* Abstract information from patient's charts and transfer to appropriate form; sign form if authorized.
* If not authorized, send completed form to attending physician for approval and signature.
* Maintain a tracking system for requests sent to physicians which are not returned completed in a timely manner.
* View/run reports as necessary for follow-up of outstanding claims and requests.
* Prioritize requests.
* Must be able to process claims and other requests in a timely and accurate manner and meet deadlines.
* Complete productivity tracking report.
* May maintain accurate accounting of all applicable HIPAA disclosures.
* Enter applicable HIPAA disclosures in designated database.
* Troubleshoot any problems that arise in completing disclosure accounting.
* Open mail, sort and prioritize requests.
* Troubleshoot issues (i.e. track records, previous correspondence, etc.).
* Research information missing in charts when necessary.
* Answer telephone inquiries and interact with members, third party entities, physicians and other staff.
* Make copies and file as necessary.
* May assist with on the job training of other employees, as required.
* Maintain excellence in service to members, physicians, other departments and fellow employees.
* Function as team member in completing work of the department.
* Perform other related duties as necessary.
Basic Qualifications:
* High School diploma or GED.
* Testing: Typing 30 WPM
* Testing: PC Skills Test (able to pass PC skills assessment)
* Testing: Medical Terminology (able to pass standardized test)
* Minimum of 1 year of release of information (ROI) experience preferred.
* Excellent attendance record required.
* Must be service oriented with strong customer service skills and ability to communicate effectively.
* Knowledge of medical terminology required and ICD-9 coding preferred.
* Must have basic PC and keyboard skills, ability to enter data into database.
* Ability to work independently, organize and complete work with minimal supervision.
* Must be able to work in Labor Management Partnership.
Skills Testing*: Typing 30 WPM or keystroke equivalent, Basic PC Skills Test (able to pass PC skills assessment), and Medical Terminology (able to pass standardized test).
* If it is determined that you need to complete testing to qualify for this position, you will receive an email inviting you to take the assessment(s) listed above. Passing test scores remain on file for one year.
This position supports Kaiser Permanente's code of conduct and compliance by adhering to all laws and regulations, accreditation and licensure requirements, and internal policies and procedures. Kaiser Permanente is proud to be an equal opportunity/affirmative action employer.
INTERNAL POSTING PERIOD: Starts 12:00AM 07/28/2017 - Ends 12:00AM 08/04/2017
Primary Location: California,Santa Clara,Santa Clara Medical Offices 710 Lawrence Express W Scheduled Weekly Hours: 0 Shift: Day Workdays: On-Call *includes coverage at satellites and scheduled days and hours are dependent on departmental needs and may include holidays and weekends Working Hours Start: On-Call Working Hours End: On-Call Job Schedule: Call-in/On-Call Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: United Healthcare Workers - West Job Level: Entry Level Job Category: Insurance / Claims Department: Medical Secretary Travel: No
Click here for additional requirements >