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Claims Assistant, South San Francisco, CA


Health Plan of San Mateo

Professional

South San Francisco, CA

September 27, 2017


CLAIMS ASSISTANT

The Health Plan of San Mateo (HPSM), a managed care health plan, seeks a full time Claims Assistant. Provide support to assigned area(s) in the Claims Department including, but not limited to, Operations, Recovery, Provider Service Representatives and/or Quality Control.

  • The essential duties and responsibilities will include the following:
  • Respond to voicemails, emails, and faxes; log, distribute and track those requiring higher-level review.
  • Prepare and mail appropriate letters as required.
  • Maintain accuracy and integrity of data base and spreadsheets.
  • Enter non-claim mail into the designated database
  • Facilitate the assignment and review of provider disputes
  • Complete claim, TAR, PDR and check status requests from Providers as requested or required.
  • Research basic claim information and handle appropriately.
  • Prepare and update electronic files and records.
  • Collect information and generate/distribute required reports as needed.
  • As requested, gather information for audits.
  • Conduct internal audits as directed.
  • Maintain files including scanning and filing.
  • Administrative support as requested by staff
  • Maintain office supplies and prepare office supply purchase orders.
  • Attend and actively participate in meetings as required.
  • Perform other duties as assigned.

Requirements

Education and Experience: Equivalent to a high school diploma or GED required. One (1) or more years’ clerical experience.

Knowledge of: General clerical processes and procedure. Personal computers and proficiency in Microsoft Office Suite applications, including Outlook, Word, Excel, Access and PowerPoint.

Ability to: Work in a fast-paced, highly pressured and changing environment. Follow oral and written instructions. Operate standard office equipment and personal computers. Produce basic logs and reports.

Interact well with others and be a team player. Use effective oral and written communications. Organize and prioritize workload.

Starting Compensation Range: Between $17.35/hour - $23.85/hour – depending on experience.

Benefits Information: Excellent benefits package offered, including HPSM paid premiums for employee’s Medical, Dental and Vision coverage. Employee pays a small portion of the dependent premiums (5%) for medical and dental benefits. Additional HPSM benefits include fully paid life, AD&D, STD, and LTD insurance; retirement plan (10% of salary for compensation/HPSM paid); holiday and vacation pay; tuition reimbursement plan; onsite fitness center and more. Check out our full benefits package at: https://www.hpsm.org/abouthpsm/employment-opportunities.aspx (Under Employee Benefits Tab)

Application Process: To apply, submit a resume and cover letter with salary expectations to: Health Plan of San Mateo, Human Resources Department, 801 Gateway Blvd., Suite 100, South San Francisco, CA 94080 or via email: careers@hpsm.org or via fax: (650) 616-8039. File by: Continuous until filled. EOE


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