*ON-SITE*
Job Summary
The Data Entry Tech (Claims) ensures consistent and efficient mailroom operations and assists with the day-to-day mailroom
Position Responsibilities
- Incoming mail must be sorted, counted by claim type, and prepped to be sent to the imaging vendor daily.
- Prep, date stamp all Certified and FedEx mail and log in a timely manner. Copying all Certified and FedEx mail envelopes daily and attached to the original document.
- Delivers mail to the general mailroom to be mailed out twice per day.
- Maintains a daily log of all misdirected Provider Dispute Resolution forms and places in the Grievance and Appeals Resolution Services (GARS) bin for pick up.
- Performs regularly scheduled morning and afternoon mail deliveries in a timely and consistent manner.
- Keeps mailroom area neat and free from clutter, maximizing safety and efficiency.
- Alerts supervisor of any issues that impact production and quality.
- Reviews rejected claim files received from vendor to determine appropriate course of action.
- Is responsible for sending misrouted claims to the appropriate group within 10 (ten) business days.
- Ensures all Protected Healthcare Information (PHI) is locked at the end of the day.
- Other duties as assigned by management.
- Accurately sort and deliver mail to multiple departments in a timely and consistent fashion.
- Data entry using common techniques.
- Analyze incoming mail and determine appropriate course of action.
- Effectively utilize computer and appropriate software (i.e., MS Office: Outlook, Excel, and Word) and interact as needed with Claims Processing Systems.
Requirements
Experience & Education
- High School diploma or equivalent required.
- 1 year of data entry experience required.
Preferred Qualifications
- Medical claims experience preferred.
Knowledge of:
- Different types of Medi-Cal claim forms; CMS1500, UB04, 25-1.
- Standard medical terminology, CPT-4, HCPC, revenue codes, and ICD-10 preferred.
Benefits
At Sunshine Enterprise USA LLC, we firmly believe that our employees are the heartbeat of our organization and we are happy to offer the following benefits:
Competitive pay & weekly paychecks
Health, dental, vision, and life insurance
401(k) savings plan
Awards and recognition programs
Benefit eligibility is dependent on employment status.
Sunshine Enterprise USA is an Equal Opportunity Employer Minorities, Females, Veterans and Disabled Persons
Experience & Education High School diploma or equivalent required. 1 year of data entry experience required. Preferred Qualifications Medical claims experience preferred. Knowledge of: Different types of Medi-Cal claim forms; CMS1500, UB04, 25-1. Standard medical terminology, CPT-4, HCPC, revenue codes, and ICD-10 preferred.