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Medical Claims Representative

TotalMed Staffing Inc.

Medical Claims Representative

Woodland Hills, CA
Full Time
Paid
  • Responsibilities

    Job Description

    TITLE: GRIEVANCE AND APPEALS COORDINATOR  ADDRESS: WOODLAND HILLS, CA COIVD: WFH UNTIL OFFICE REOPENS IN SEPT. PAY: $22.00 HOURS : M-F ANYWHERE BETWEEN 8AM-6PM (STAGGERED SHIFTS) CONTRACT TO HIRE 

    MUST HAVE

    •       HIGH SCHOOL DIPLOMA -       MEDICAL CLAIMS AND CSR EXPERIENCE
    •        JOB TASKS: SPEAKING WITH MEMBERS, DOCUMENTING, RESEARCH, FORMULATING RESPONSES IN WRITING TO MEMBERS, WILL NEED TO MEET DEADLINES. PLEASE HIGHLIGHT TEMP WORKER’S ABILITY TO HANDLE MULTIPLE TASKS. THIS POSITION HAS A TON OF MOVING PARTS. NEED STRONG CANDIDATES WHO HAVE CRITICAL THINKING SKILLS AND WRITING SKILLS, THIS IS NOT AN ENTRY LEVEL POSITION.

    ROLES THAT HAVE DONE WELL: •    CALL CENTER EXPERIENCE (BEING ABLE TO MULTITASK AND WORK THROUGH VARIOUS ISSUES) •    G&A EXPERIENCE •    PEOPLE WHO HAVE WORKED IN DR.S OFFICES (I.E. BILLING, TALKING TO MEMBERS, PULLING RECORDS), EXPERIENCE DEALING WITH MEMBERS (PROBLEM SOLVING) •    MEDICAL MANAGEMENT/UM •    COORDINATING (COORDINATION OF CARE FOR PATIENT OR MEMBER)

    OTHER NOTES: •    THIS IS NOT AN ENTRY LEVEL POSITION- THIS IS A PRODUCTION BASED DEPARTMENT •    NEED STRONG CANDIDATES WHO HAVE CRITICAL THINKING SKILLS AND WRITING SKILL •    THIS TEAM DEALS WITH MEMBERS, DOCTORS, INTERNAL MDS, ETC. SO THE COMMUNICATION AND WRITING SKILLS MUST BE ON POINT •    THEY WILL BE WRITING FORMAL LETTER RECAPS- THOSE LETTERS MUST BE  ACCURATE AND WELL WRITTEN AS THEY END UP IN AUDITS AND WITH CENTENE’S REGULATORS •    ISSUES ARE COMING AND OUT EVERY DAY- MUST BE ABLE TO BALANCE A BOOK OF BUSINESS AND MANAGE THEIR WORK

    Company Description

    In the rapidly-changing, highly regulated industry that is healthcare, you need a medical staffing partner who works for you. Enter TotalMed. We’re an award-winning medical staffing agency delivering flexible healthcare staffing solutions no matter how complex your needs. But even more than that, we’re a team who really cares. Our end goal is to achieve quality patient care while enhancing your employee morale. If you’re a healthcare professional in either clinical or non-clinical healthcare, our recruiters can help you navigate the sea of healthcare jobs, uncovering your ideal career path. Or, if you’re faced with open positions and short-staffed projects in either business care or patient care, TotalMed can provide customized medical staffing solutions to fulfill your hiring requirements.