Top 66 Claims representative Jobs in Concord, 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
12d
Claims Examiner II
Partnership HealthPlan of California —Fairfield, CA
- $31.45 - $37.74 an hour
- Full-time
- Research
- Mid-level
- Office
Patient Account Representative III Pro Fee (Onsite, Hybrid, Remote)
Northbay Healthcare —Fairfield, CA
- $32.15 - $39.02 an hour
- 8 hour shift
- Hybrid work
- Word processing
- Writing skills
- 11+ years
- 403(b) matching
- Health insurance
Senior Collections Representative
University of California San Francisco —Emeryville, CA
- Full-time
- Medical office experience
- HIPAA
- Mid-level
Property Claims Specialist Field I
Mercury Insurance Services, LLC —Concord, CA
- $63,410 - $117,348 a year
- Overtime
- Bilingual
- Military
- Writing skills
- Paid holidays
- Health insurance
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
7d
Claims Team Supervisor
Athens Administrators —Concord, CA
- $119,000 - $132,000 a year
- Urgently hiring
- Bachelor of Science
- Employment & labor law
- Mid-level
- Health savings account
- AD&D insurance
Quick Apply
Cost Avoidance Specialist I
Partnership HealthPlan of California —Fairfield, CA
- $80,140.53 - $100,175.67 a year
- Computer literacy
- Writing skills
- Research
14d
Account Representative - State Farm Agent Team Member
Brian Haghighi - State Farm Agency Intern —Concord, CA
- $20 - $50 an hour
- Part-time
- Office
- Communication skills
- Entry level
- Opportunities for advancement
- Flexible schedule
Quick Apply
7d
Member Service Representative Level 1 (Pleasanton, CA)
BeneSys, Inc. —Pleasanton, CA
- $34.12 an hour
- Full-time
- Microsoft Word
- Basic math
- High school diploma or GED
- Paid jury duty
- AD&D insurance
Quick Apply
Customer Service Representative - State Farm Agent Team Member
Jeff Chaput - State Farm Agent —Pittsburg, CA
- $40,000 - $47,000 a year
- Full-time
- Office
- Communication skills
- Entry level
- 401(k)
- Paid time off
Quick Apply
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
Patient Services Rep, Outpatient Cardiology Clinic (Part Time, Day)
Northbay Healthcare —Fairfield, CA
- $26 an hour
- Full-time
- Hybrid work
- BLS Certification
- HIPAA
- Mid-level
- 403(b) matching
- Health insurance
7d
Bilingual Licensed Insurance Sales - Spanish
Sonny Randhawa - State Farm Agency —El Sobrante, CA
- $21 - $40 an hour
- Urgently hiring
- Spanish
- English
- Office
- Paid time off
- Opportunities for advancement
Quick Apply
13d
Property & Casualty Claims Advocate
HUB International —San Ramon, CA
- $68,000 - $100,000 a year
- Online Application
- Microsoft Outlook
- Writing skills
- Mid-level
- Health savings account
- Disability insurance
Workers’ Compensation Specialist
TransPak, Inc. —Hayward, CA
- $40,000 - $70,000 a year
- Full-time
- Remote
- Microsoft Excel
- Mid-level
- Bachelor's degree
Quick Apply
10d
Lead Reimbursement Specialist - Remote, must be based in PST
Telecare Corporation —Alameda, CA
- $66,588.63 - $82,280.72 a year
- Full-time
- Remote
- 18 years or older
- 6 years
- Current TB test
Quick Apply
4d
Senior Systems Specialist, Chargemaster (Onsite, Hybrid, Remote)
Northbay Healthcare —Fairfield, CA
- $46.63 - $56.68 an hour
- 8 hour shift
- Hybrid work
- Nursing
- Microsoft Excel
- Computer literacy
- 403(b) matching
- Health insurance
Customer Service Representative - State Farm Agent Team Member
Samantha Harris - State Farm Agent —Castro Valley, CA
- $52,000 - $100,000 a year
- Full-time
- Office
- Communication skills
- Entry level
- 401(k)
- Paid time off
Quick Apply
13d

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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 representative jobs in concord, ca

Claims Customer Service Representative I

Claims Resolution Coordinator

Claims Examiner II

Patient Account Representative III Pro Fee (Onsite, Hybrid, Remote)

Senior Collections Representative

Property Claims Specialist Field I

Patient Access Ambassador II (Per Diem, Evening)

Claims Team Supervisor

Cost Avoidance Specialist I

Account Representative - State Farm Agent Team Member

Member Service Representative Level 1 (Pleasanton, CA)

Customer Service Representative - State Farm Agent Team Member

Customer Service Representative - State Farm Agent Team Member

Patient Services Rep, Outpatient Cardiology Clinic (Part Time, Day)

Bilingual Licensed Insurance Sales - Spanish

Property & Casualty Claims Advocate

Workers’ Compensation Specialist

Lead Reimbursement Specialist - Remote, must be based in PST

Senior Systems Specialist, Chargemaster (Onsite, Hybrid, Remote)

Customer Service Representative - State Farm Agent Team Member

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