Top 46 Claims customer service representative i Jobs in Napa, Ca

Claims Customer Service Representative I
Partnership HealthPlan of California —Fairfield, CA
- $29.95 - $35.19 an hour
- Full-time
- Computer literacy
- Research
- High school diploma or GED
Claims Resolution Coordinator
Partnership HealthPlan of California —Fairfield, CA
- $37.22 - $46.53 an hour
- Full-time
- Computer literacy
- Mid-level
- Office
Patient Access Representative (Per Diem)
Sonoma Valley Hospital —Sonoma, CA
- $26.95 - $35.03 an hour
- Per diem
- Bilingual
- Hospital
- High school diploma or GED
Customer Service Representative
CrossCheck, Inc. —Petaluma, CA
- $20 an hour
- Full-time
- Microsoft Outlook
- Windows
- Typing
- AD&D insurance
- Health insurance
Quick Apply
6d
Patient Access Representative
Sonoma Valley Hospital —Sonoma, CA
- $23.43 - $30.47 an hour
- Full-time
- Bilingual
- Hospital
- High school diploma or GED
Customer Service Representative - State Farm Agent Team Member
Rena Macdonald - State Farm Agent —Fairfield, CA
- $25 - $35 an hour
- Full-time
- Sales
- Office
- Communication skills
- Health insurance
- Dental insurance
Quick Apply
Financial Assistance Representative I
Redwood Credit Union —Napa, CA
- $27 - $35 an hour
- Full-time
- Word processing
- Computer literacy
- Writing skills
- Paid holidays
- Health insurance
Quick Apply
1d
Customer Service Representative
Team Allied Distribution —Benicia, CA
- $21 - $24 an hour
- 8 hour shift
- Spanish
- English
- Mid-level
- AD&D insurance
- Health insurance
Quick Apply
2d
Customer Service Representative - State Farm Agent Team Member
Marissa Johnson - State Farm Agent —Napa, CA
- $25 - $35 an hour
- Full-time
- Windows
- Computer skills
- Communication skills
- Health insurance
- Dental insurance
Quick Apply
Customer Service Representative - State Farm Agent Team Member
Lyndsie Debonis - State Farm Agent —Petaluma, CA
- $40,000 - $60,000 a year
- Full-time
- Office
- Communication skills
- Entry level
- 401(k)
- Paid time off
Quick Apply
Patient Services Rep (Full Time, Days) Neurosurgey Clinic
Northbay Healthcare —Fairfield, CA
- $26 an hour
- Full-time
- Hybrid work
- BLS Certification
- HIPAA
- Mid-level
- 403(b) matching
- Health insurance
7h
Insurance Representative
Redwood Credit Union —Napa, CA
- $30 - $40 an hour
- Full-time
- Computer literacy
- Writing skills
- Research
- Paid holidays
- Health insurance
Quick Apply
Patient Account Representative - Dental
Marin Community Clinics —Novato, CA
- $25.00 - $29.25 an hour
- Part-time
- Microsoft Excel
- Mid-level
- Windows
Customer Service Representative - State Farm Agent Team Member
Bal Claire - State Farm Agent —San Rafael, CA
- $52,000 a year
- Full-time
- Office
- Communication skills
- Entry level
- Health insurance
- Paid time off
Quick Apply
Patient Access Ambassador II (Per Diem, Evening)
Northbay Healthcare —Fairfield, CA
- $33.23 an hour
- 8 hour shift
- Hybrid work
- Customer service
- Writing skills
- Mid-level
- 403(b) matching
- Health insurance
Claims Trainer
Partnership HealthPlan of California —Fairfield, CA
- $33.65 - $40.38 an hour
- Full-time
- Mid-level
- Office
- Driver's License
Valet Supervisor - Napa CA
Parking Management Company —Napa, CA
- Overtime
- Background check
- Mid-level
- High school diploma or GED
- Paid training
- Health insurance
Quick Apply
Customer Service Representative - State Farm Agent Team Member
Nancy Shotts - State Farm Agent —Petaluma, CA
- $25 an hour
- Full-time
- Windows
- Organizational skills
- Computer skills
- Paid holidays
- Paid time off
Quick Apply
Patient Services Rep -NBGW Specialty (Per Diem, Days)
Northbay Healthcare —Fairfield, CA
- $28.60 an hour
- Full-time
- Hybrid work
- BLS Certification
- HIPAA
- Research
- 403(b) matching
- Health insurance
7h
Account Representative - State Farm Agent Team Member
Marissa Johnson - State Farm Agent —Napa, CA
- $45,000 - $60,000 a year
- Full-time
- Organizational skills
- Communication skills
- Marketing
- Health insurance
- Dental insurance
Quick Apply

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Claims Customer Service Representative I

Partnership HealthPlan of California -
Fairfield, CA

Apply Now

Job Details

Full-time
$29.95 - $35.19 an hour

Qualifications

Customer communication
Computer literacy

Full Job Description

Overview:

To research and resolve provider telephone and written inquiries within established time frames, accurately screen claims, and participate in provider meetings and projects. To accurately research and process paper and electronic medical, outpatient, ancillary, long term care, CHDP, encounter data and paper crossover/other coverage claims within established time frames, applying appropriate program policies related to claims processing and analysis.

Responsibilities:

Responds to provider telephone inquiries, researches policy issues, and analyzes EOP's and claim history, recommends resolution to the issues, implements resolution once approved.
Researches and communicates outcome to providers of CIF's, claim tracers, and general claim correspondence within established time frames
Follows established Partnership policies and procedures, Partnership claims operating instruction memorandums, EDS provider manual guidelines, and Title 22 regulations when resolving claims and claim issues.
Participates in provider meetings to resolve claim issues.
Recognizes and gives feedback to management on procedure changes that would result in more efficient operations.
Records daily production statistics and related activities on appropriate reports; turns all logs and reports in to Claims Customer Service Supervisor.
Meets established production and call performance metrics as determined.
Participates in special projects and assignments as required.
Participates in resolution of CIFs as required.
Other duties as assigned.

Qualifications:

Education and Experience

High school diploma or equivalent; one (1) year of prior claims processing experience in an automated claim environment preferred; or equivalent combination of education and experience.

Special Skills, Licenses and Certifications

Knowledge of CPT, HCPC procedure coding, and ICD-10 diagnostic coding. Knowledge of medical terminology preferred. Ability to access coding reference guides for accurate information. Typing speed 30 wpm and proficient use of 10-key calculator.

Performance Based Competencies

Excellent written and oral communication skills. Ability to effectively exercise good judgment within scope of authority and handle sensitive issues with tact and diplomacy. Good organizational skills. Ability to accurately complete tasks within established time frames.

Work Environment And Physical Demands

Ability to use a computer keyboard. More than 80% of work time is spent in front of a computer monitor; when required, ability to move, carry, or lift objects of varying size weighing up to 25 lbs.

All HealthPlan employees are expected to:

Provide the highest possible level of service to clients;
Promote teamwork and cooperative effort among employees;
Maintain safe practices; and
Abide by the HealthPlan’s policies and procedures, as they may from time to time be updated.

HIRING RANGE:

$ 29.95 - $ 35.19

IMPORTANT DISCLAIMER NOTICE

The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

Apply Now

Refine Your Search

claims customer service representative i jobs in napa, ca

Claims Customer Service Representative I

Claims Resolution Coordinator

Patient Access Representative (Per Diem)

Customer Service Representative

Patient Access Representative

Customer Service Representative - State Farm Agent Team Member

Financial Assistance Representative I

Customer Service Representative

Customer Service Representative - State Farm Agent Team Member

Customer Service Representative - State Farm Agent Team Member

Patient Services Rep (Full Time, Days) Neurosurgey Clinic

Insurance Representative

Patient Account Representative - Dental

Customer Service Representative - State Farm Agent Team Member

Patient Access Ambassador II (Per Diem, Evening)

Claims Trainer

Valet Supervisor - Napa CA

Customer Service Representative - State Farm Agent Team Member

Patient Services Rep -NBGW Specialty (Per Diem, Days)

Account Representative - State Farm Agent Team Member

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