Claims Processing Clerk jobs in San Francisco, CA

Claims Processing Clerk receives and inputs new healthcare claims, processes payments, researches billing issues, and responds to email and telephone inquiries. Evaluates claims and administers payment, denies, or returns claims according to policy provisions and organizational guidelines. Being a Claims Processing Clerk produces routine and ad hoc reports. Requires a high school diploma. Additionally, Claims Processing Clerk typically reports to a supervisor. The Claims Processing 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)

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Claims Examiner
  • SF Health Plan
  • San Francisco, CA FULL_TIME
  • You can make a difference in the San Francisco community. San Francisco Health Plan is seeking a full-time Claims Examiner.

    The Claims Examiner is responsible for claims processing, adjudication, and research. In addition, this position keeps current on claim processing procedures, produces a quality and timely work product, and assists Claims Management with special projects as needed. You will have claims processing experience with the ability to maintain high qualitative and quantitative standards established for this position.

    Please note that while SFHP supports a hybrid work environment, this role will be required to be onsite and in-office a minimum of 4 days per month.

    Salary: $29.06 - $32.26/hour

    WHAT YOU WILL DO

    The accurate and timely processing, adjudication and claims research to include:

    • Keep the department’s claim inventory current and clear edit queues by process claims according to verification of eligibility, interpretation of program benefits and provider contracts to include manual pricing.
    • Utilize the QNXT claims processing module in an effective and efficient manner to process claims.
    • Meet production and quality standards when processing claims and performing tasks.
    • Reprocess claims when necessary.
    • Handle call tracking tickets promptly regarding claims status, billing and payment issues, disputes, etc.
    • Stay abreast of the changes in Medi-Cal regulations, program policies and current processing procedures.
    • Foster an environment that solicits and enlists diverse and inclusive perspectives and approaches to better serve our staff, our members and our providers.

    WHAT YOU WILL BRING

    • Minimum of one year prior work experience in medical claims processing preferably with focus on Medi-Cal claims.
    • Hands-on working knowledge and background using claims processing systems.
    • Knowledge of CPT/HCPCS, ICD-9 coding, medical terminology and managed care principles.
    • A high school diploma or equivalent; college degree preferred.
    • Detail oriented with problem-solving abilities.
    • Effective interpersonal and professional communication skills.
    • Strong organizational, time management and project management skills and multi-tasking abilities.
    • Demonstrated working knowledge of any editing claims system, QNXT is preferred.
    • Must be PC literate; MS Office skills (Word, Excel, PowerPoint).

    WHAT WE OFFER

    A competitive and robust compensation package, including:

    • Health benefits
      • Medical: You’ll have a choice of medical plans, including options from Kaiser and Blue Shield of California. Employee-only coverage in the HMO plans is currently available at no cost and dependent coverage is heavily subsidized by SFHP.
      • Dental: You’ll have a choice of a basic dental plan or an enhanced dental plan which includes orthodontic coverage.
      • Vision: Employee vision care coverage is available through Vision Service Plan (VSP).
    • Retirement – Employer-matched CalPERS Pension and 401(a) plans, 457 Plan
    • Time off – 23 days of Paid Time Off (PTO) and 13 paid holidays
    • Professional development: Opportunities for tuition reimbursement, professional license/membership.
    • An opportunity to work in a vibrant atmosphere with the most amazingly talented people who are shaping the future of healthcare!
    • The chance to make a difference in the lives of many San Francisco residents!

    ABOUT US:

    Established in 1994, San Francisco Health Plan (SFHP) is an award winning, managed care health plan whose mission is to provide affordable health care coverage to the underserved low and moderate-income residents in San Francisco county. SFHP is chosen by eight out of every ten San Francisco Medi-Cal managed care enrollees and its 170,000 members have access to a full spectrum of medical services including preventive care, specialty care, hospitalization, prescription drugs, and family planning services. SFHP was designed by and for the residents it serves, and takes great pride in its ability to accommodate a diverse population that includes young adults, seniors, and people with disabilities.

    San Francisco Health Plan is proud to be an equal opportunity employer. We are committed to a work environment that supports, inspires, and respects all individuals and in which our people processes are applied without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, marital status, age, disability, national or ethnic origin, military service status, citizenship, or other protected characteristics.

    Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

    San Francisco Health Plan is an E-Verify participating employer.

  • 19 Days Ago

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Clerk
  • CVR Associates
  • San Francisco, CA FULL_TIME
  • Log, sort, scan, and manage incoming and outgoing postal mail. Scan and index participant documents to ensure a complete electronic administrative record. Respond or assign customer service inquiries/...
  • 13 Days Ago

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Travel (Sterile Processing Tech) - Sterile Processing Unit
  • Trusted Allied Staffing, LLC
  • San Francisco, CA OTHER
  • Night 5 shifts x 8 hours 03/25/2024 8 wks $1,455/wk Contract Details Job Type Travel Shift Type Night Contract Date 03/25/2024 - 05/20/2024 Expected Length 8 Hours Per Week 8 Shifts Per Week 5 Facilit...
  • 1 Month Ago

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Paralegal/Claims Analyst
  • Clyde&Co
  • San Francisco, CA FULL_TIME
  • Refer a friend Printer Friendly Apply Job Title Paralegal/Claims Analyst Job Location San Francisco Job Type Paralegals Country/Territory United States Region The Americas Description Clyde & Co seeks...
  • 20 Days Ago

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SkillBridge Claims Assistant
  • DOD SkillBridge
  • San Francisco, CA FULL_TIME
  • Position Summary A claims assistant at EPIC Brokers is a service focused contributor who thrives on providing knowledge, and seeking information to successfully aid our clients as they are working wit...
  • 11 Days Ago

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Claims Examiner I (TEMP)
  • Health Plan of San Mateo
  • South San Francisco, CA FULL_TIME
  • General Description Under close supervision, the Claims Examiner will perform the accurate review, entry and processing of all claims received for payment by HPSM. Essential Functions: Research reject...
  • 12 Days Ago

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0 Claims Processing Clerk jobs found in San Francisco, CA area

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Claims clerk
  • West Valley Staffing Group
  • Hayward, CA
  • Job Description Job Description About the role: 2-3 months contract – Monday to Friday (8-5) We are looking for a detail...
  • 4/25/2024 12:00:00 AM

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School Business Manager Bilingual (Sp/Eng)
  • Voices College-Bound Language Academies
  • Pinole, CA
  • Job Description Job Description Salary: $68,000 - $82,000 Overview Though 9 in 10 Latino young adults say a college degr...
  • 4/25/2024 12:00:00 AM

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Plaintiff Litigation Associate, Product Liability (High Base Salary)
  • Incendia Partners
  • Oakland, CA
  • Job Description Job Description -Law Clerks and Junior level Associates are encouraged to apply. Must have passed CA bar...
  • 4/23/2024 12:00:00 AM

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IT Procurement
  • Bayside Solutions
  • Richmond, CA
  • IT Procurement W2 Contract to Hire Salary Range: $83,200 - $93,600 per year Location: Martinez, CA - Onsite Role Duties ...
  • 4/23/2024 12:00:00 AM

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IT Procurement
  • Bayside Solutions
  • Martinez, CA
  • IT Procurement W2 Contract to Hire Salary Range: $83,200 - $93,600 per year Location: Martinez, CA - Onsite Role Duties ...
  • 4/22/2024 12:00:00 AM

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IT Procurement
  • Bayside Solutions
  • Concord, CA
  • IT Procurement W2 Contract to Hire Salary Range: $83,200 - $93,600 per year Location: Martinez, CA - Onsite Role Duties ...
  • 4/22/2024 12:00:00 AM

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IT Procurement
  • Bayside Solutions
  • Richmond, CA
  • IT Procurement W2 Contract to Hire Salary Range: $83,200 - $93,600 per year Location: Martinez, CA - Onsite Role Duties ...
  • 4/21/2024 12:00:00 AM

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Accounts Payable Clerk
  • Anatomage, Inc.
  • Santa Clara, CA
  • Who is Anatomage? Founded in 2004, Anatomage is a world-leading health care technology company. Anatomage offers 3D medi...
  • 4/21/2024 12:00:00 AM

San Francisco is located on the West Coast of the United States at the north end of the San Francisco Peninsula and includes significant stretches of the Pacific Ocean and San Francisco Bay within its boundaries. Several picturesque islands—Alcatraz, Treasure Island and the adjacent Yerba Buena Island, and small portions of Alameda Island, Red Rock Island, and Angel Island—are part of the city. Also included are the uninhabited Farallon Islands, 27 miles (43 km) offshore in the Pacific Ocean. The mainland within the city limits roughly forms a "seven-by-seven-mile square", a common local collo...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Processing Clerk jobs
$47,184 to $57,056
San Francisco, California area prices
were up 4.5% from a year ago