理赔客户服务代表

申请

地点： 默塞德、蒙特雷、圣克鲁斯、圣贝尼托、马里波萨

We have an opportunity to join the Alliance as Claims Customer Service Representative.

*This position is open to current Alliance employees and current Temporary employees on assignment at the Alliance.

您将承担的责任

Reporting to the Claims Manager, this position:

• Acts as a frontline customer service representative and researches, resolves, and responds to inquiries regarding claims issues from providers and Alliance staff
• Processes various claim types and conducts research and analysis related to claims resolution
• Maintains current knowledge of claims processes, procedures, and related documentation, assists in developing and maintaining internal operating procedures, and recommends coding and reimbursement changes in the Alliance’s claims processing system

关于团队

​​We handle billing-related inquiries and issues from providers concerning treatment, services and care of our members.:

你需要什么才能成功

阅读完整的职位描述和要求列表 点击这里.

• 的知识：
  • Methods and techniques of medical claims processing
  • General administrative procedures and standard business office practices and equipment
  • 客户服务原则与实践
  • Reading medical insurance Explanation of Benefits
• 有能力：
  • Effectively and clearly document, summarize and resolve concerns and inquiries related to claims issues and recognize those issues requiring escalation to a higher-level staff member
  • Gather and evaluate information, ask appropriate questions, and utilize problem solving skills · 
  • Utilize a variety of computer systems, including the Alliance information system and external websites and databases
  • 了解并传达联盟的复杂运营和流程，特别是利用管理、护理管理和会员服务部门
• 教育和经验：
  • High School Diploma or equivalent and a minimum of two years of experience performing claims processing in a Medi-Cal or managed care environment (an Associate’s degree may substitute for one year of the required experience); or an equivalent combination of education and experience may be qualifying

其他信息

• 我们处于混合工作环境中，我们预计面试过程将通过 Microsoft Teams 远程进行。
• 虽然有些员工可能需要完全远程办公，但他们仍需要参加每季度的全公司活动或部门会议。
• 某些职位可能需要在办公室或社区内工作，具体取决于业务需求。面试过程中可以查看相关详细信息。

该职位的全部薪酬范围按地点列出如下。 

该职位的实际薪酬将根据我们的薪酬理念、对选定候选人的资历（与职位、教育或培训相关的直接或可转移经验）的分析，以及其他因素（内部公平、市场因素和地理位置）来确定。

1区典型区域：湾区、萨克拉门托、洛杉矶地区、圣地亚哥地区

2 区典型地区：弗雷斯诺地区、贝克斯菲尔德、中央谷地（萨克拉门托除外）、加州东部、尤里卡地区

Apply for Claims Customer Service Representative