Mailroom Clerk

Imperial Health Plan of California, Inc.; Pasadena (CA); On-site; USD 22,000 - 31,000; Full time

Job summary

Imperial Health Plan of California, Inc. in Pasadena, CA seeks a mail room/clerical staff member for the Claims department. You will manage incoming mail, triage and batch items, and perform data entry in the EZ-CAP system to support daily claim processing.

Qualifications include a high school diploma and at least 1 year in a healthcare mail/clerical role, with strong English communication and confidentiality. This is an on-site position requiring accuracy and multi-tasking.

Qualifications

• High school graduate or equivalent.
• 1 year of mail room/clerical experience in a healthcare setting.
• Willingness to read, write, speak English and communicate accurately.

Responsibilities

• Open, triage, and batch incoming mail and faxes.
• Open claim mail (manual and automated) and organize by claim.
• Research provider and member status in EZ-CAP.
• Enter manual claims into EZ-CAP claims system.
• Log daily mail and batch claims for daily vendor pickup.
• Process daily pend, denial and forwarding correspondence.
• Provide requested documentation to internal departments and provider network.

Tools

EZ-CAP

Excel

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Claims - Exchange Pasadena, CA, US

Salary Range: $19.00 To $19.00 Hourly

JOB DESCRIPTION

DEPARTMENT:

Claims

JOB SUMMARY:

Responsible for managing incoming mail from providers while ensuring a high level of accuracy. Requires the ability to multi-task while providing accurate and timely mail triaging and processing.

ESSENTIAL JOB FUNCTIONS:

• Responsible for opening, triaging, and batching incoming mail, faxes.
• Open claim related mail (manually and through use of automated letter opener) and organize by claim

type (CMS-1500, UB-04, and variants)

• Sort all daily incoming mail for distribution to designated individuals or department.
• Utilize EZ CAP claim processing system to research provider and member status.
• Data entry of manual claims into EZ CAP claims system.
• Daily logging and counting of mail.
• Batch claims according to policy and ready claims for daily pick-up by scanning vendor
• Responsible for processing daily pend, denial and claim forwarding correspondence.
• Accountable for providing requested documentation to internal departments and provider network (EOB, faxes, scanning, requests for letter copies).

• Support of research projects through claims look-up and simple documentation via Excel
• As requested, sort, log and distribute certified mail.
• As requested, scan and log registered mail and next day mail (USPS, UPS, FedEX) for reference and tracking purposes.

• Provide support to eClaims for daily reject letter processing when available.
• Adheres to payroll policies and properly uses timekeeping system with minimal manual changes.
• Maintains regular and consistent attendance.
• Adheres to Compliance Plan and HIPAA regulations.

MARGINAL JOB FUNCTIONS:

• Takes on special projects as needed.
• Performs other duties as assigned.

BEHAVIORAL EXPECTATIONS:

a. Attends staff meetings as required.

b. Attends appropriate training, seminars and workshops as required

2. Customer Focus:

a. Maintains client/customer confidentiality and privacy in accordance with HIPPA regulations

and IMAS’s Standards of Conduct.

b. Fosters appropriate communication and relations with Supervisor, co-workers and other staff.

3. Quality /Process Improvement/Safety

a. Reports issues of security, health and/or safety to appropriate supervisor as soon as practicable.

b. Supports and demonstrates safety throughout all duties performed.

c. Follows established policies and procedures and understands and complies with all regulators

standards set forth by governing entities.

POSITION REQUIREMENTS:

EDUCATION/EXPERIENCE:

• High school graduate or equivalent.
• 1 year of mail room/clerical experience in a healthcare setting.

SKILLS/KNOWLEDGE/ABILITY:

• Faxing and scanning knowledge preferred
• EZ-CAP knowledge
• Willingness and ability to read, write, speak, understand English and have the communications skills necessary to provide accurate information to residents and staff.
• Willingness and ability to follow written and verbal direction in English.
• Willingness and ability to maintain appropriate level of confidentiality and privacy.
• Willingness and ability to interact professionally with all customers, members, and co-workers, individually and as part of a team.
• Willingness and ability to effectively handle multiple items/tasks as required and adapt favorably to changing priorities.
• Willingness and ability to make appropriate judgments, decisions and problem solving in a timely manner and within the context of the situation at hand.
• Ability to effectively prioritize items/tasks as required. Willingness and ability to take initiative and be a self-starter.
• Willingness and ability to understand and comply with Federal, State, and local regulations.