Claims Clerk reviews insurance claim forms and supporting documents for completeness and accuracy and obtains missing information as necessary. Inputs claim information into system for processing. Being a Claims Clerk verifies coverage eligibility. Calculates settlement amounts according to guidelines. Additionally, Claims Clerk processes routine claim payments. Requires a high school diploma or equivalent. Typically reports to a supervisor. The Claims Clerk works under the close direction of senior personnel in the functional area. Possesses a moderate understanding of general aspects of the job. May require 0-1 year of general work experience. (Copyright 2024 Salary.com)
Dignity Health Medical Foundation established in 1993 is a California nonprofit public benefit corporation with care centers throughout California. Dignity Health Medical Foundation is an affiliate of Dignity Health - one of the largest health systems in the nation - with hospitals and care centers in California Arizona and Nevada. Today Dignity Health Medical Foundation works hand-in-hand with physicians and providers throughout California to provide comprehensive health care services to the many communities we serve. As Dignity Health Medical Foundation continues to grow and establish new premier care centers we provide increasing support and investment in the latest technologies finest physicians and state-of-the-art medical facilities. We strive to create purposeful work settings where staff can provide great care while advancing in knowledge and experience through challenging work assignments and stimulating relationships. Our staff is well-trained and highly skilled qualities that are vital to maintaining excellence in care and service.
This position is responsible for opening date stamping counting and storing the daily mail received within the claims department.
This position is also responsible for archiving completed claims filing when needed sending out various communications to providers assisting with mailing out the weekly check run ordering supplies distributing faxes as appropriate and any other tasks as assigned by management.
This position has the freedom to work using the policy guidelines of the department and to process sensitive and confidential information.
This position requires significant contact with other staff within the department as well as Eligibility Member Services and occasionally our providers.
This position will have responsibility for working independently on assigned tasks and activities based on established policies and procedures.
Minimum Qualifications:
-High School Diploma or GED.
-Ability to utilize computer equipment and software are required as is experience with other types of standard office equipment
Preferred Qualifications:
-One year experience in a medical insurance environment preferred.
-Familiarity with an electronic practice management system is preferred.
-Working knowledge of standard coding is preferred.
-Medical terminology preferred.