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Claims Appeals Clerk

Company: Mindlance
Location: West Sacramento
Posted on: January 18, 2023

Job Description:

Title - Claims Appeals Clerk - 2.1
Day Shift - 6:00 a.m. 2:30 p.m.
Bill rate - Max
Location - West Sacramento,Onsite Required


- Process appeals & DCC Error Corrections at CA-MMIS via Edit Resolution Tool/ACSNET
- Prepare multiple preparation forms (CMS-1500, UB-04, LTC 25-1, Pharmacy 30-1, Claims Inquiry Forms [CIFS])
- Batch and file appeals claims in a timely manner to ensure Service Level Agreements (SLAs) are met
- Attend to appeals correspondence to determine whether mail is to be sent back or scanned in for appeals
- Assist with Specialty Suspense to adjudicate claims per the edit criteria in assigned Data Control Centers
- Work on special projects

Knowledge and Skills:

- Basic knowledge of the administrative methods, and an acumen to develop the required administrative skills of the job
- Specific level of software skills as required by the work unit
- Must have excellent problem-solving skills
- Good verbal and written communication skills
- Detailed oriented

Education and Experience Required:

- High school education or equivalent
- 1 years clerical experience preferred
- Must be a proficient typist and have a minimum of 50 WPM while maintaining a 99.9% accuracy

Keywords: Mindlance, West Sacramento , Claims Appeals Clerk, Other , West Sacramento, California

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