Job Description
Works under the direction of the Chief Executive Officer (CEO) and supports the Health Plan Board of Trustees. Under the direction of the CEO, performs clerical work which requires knowledge of Microsoft Office Suite, proficiency in MAS 90 and basic knowledge of the LA County Benefit system. Create correspondence, agendas, minutes of Trust meeting, response to members’ email inquiries. Prepare vendor payments for approval and subsequent checks for payments, accounts payable, journal entries, vendor file maintenance. Maintain and keep current office filing. Handle and maintain all necessary documentation for death benefit claims. Maintains membership files.
Essential Job Functions
-Populates Anthem Inventory report using the medical claims processing system for data for adjudication. Create Claims Activity Report and Trust Investment report for Trustees review.
-Perform Accounts Payable daily check run.
- Update Medicare information into the medical claims processing system. Maintain/update employee salaries report. Update LA County eligibility report for change of address and status.
-Prepare Union invoice for employees’ overhead expense. Log appeal information to the medical claims processing system system.
-Scan Trust Minutes. Schedule C spreadsheet for Auditors.
-Update Health Plan website content. Respond to claims and eligibility questions from members and providers.
-Respond to emails from members.
- Prepare banking transmission. Send temporary medical cards, as needed. Considine Files – upload cases. Prepare vendor 1099’s.
-Fulfill outside auditor data requests. Assist with Open Enrollment communication plan and New Recruit signups and enrollments. Process Life Insurance deceased benefits.
Required Knowledge/Skills/Abilities/ Experience
High School diploma/GED required. Working knowledge of medical terminology physician billing practices, CPT coding, ICD-9/ICD-10 coding, and HCPCS coding. Working knowledge of the Plan in terms of covered expenses and exclusions, coordination of benefits and third-party liability provisions.
Strong analytical ability and problem resolution skills. Excellent typing (55-60 wpm) and 10-key skills. Ability to work under pressure and adapt to changing environment. Must be familiar with computer and Windows PC applications; ability to learn new and complex computer system applications, navigate between various computer applications/systems to conduct research and to respond to members and providers.
Ability to communicate clearly and professionally, both verbally and written. Strong organizational skills and strong attention to detail and listening. Possess a strong work ethic and team player mentality.-
Job Type: Full-time
Pay: $33.80 per hour
Expected hours: 35 per week
Benefits:
- Health insurance
- Paid time off
Schedule:
- 8 hour shift
Work Location: In person
