Description

As a Claims Customer Service Coordinator, you will play a crucial role in connecting members, billers, providers, physicians, and Health Plans. Your primary responsibilities will include:

• Answering calls promptly and courteously, providing professional assistance to customers with claims-related issues.

• Ensuring timely resolution of customer inquiries.

• Handling typical inquiries such as:

• Claim Status

• Requests for Explanation of Benefits (EOB)

• Requests for Denial Letters

• Health Plan demands

• Check tracers

• Managing incoming faxes

• Documenting all interactions in our CRM system.

Salary Range: $25.60 - $36.33/hourly

Qualifications

We are seeking a detail-oriented, independent individual with:

• High school diploma, GED, or equivalent.

• Minimum of 2 years of medical claims customer service experience in an HMO environment (e.g., MSO, IPA, or health plan).

• Proficient with CPT/HCPC codes, UB04, 1500 forms, ICD-10, ASA, Medicare Guidelines, and COB.

• Extensive knowledge of professional and facility reimbursement methodologies and benefit determination.

• Demonstrated competence in medical terminology and claims adjudication systems.

• Able to handle a high volume of calls and work under pressure.

• Proficient computer skills, including Microsoft Word and Excel.

• Independent worker with the ability to meet deadlines and production standards.

• Flexible, adaptable, and goal-oriented, capable of multitasking and working with frequent interruptions.

UCLA Health welcomes all individuals, without regard to race, sex, sexual orientation, gender identity, religion, national origin or disabilities, and we proudly look to each person’s unique achievements and experiences to further set us apart.