Top 70 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
Billing Specialist On-site (Medi-Cal, SSI, ALW) - Multi Facility Organization
Alamo Health Management —San Ramon, CA
- $93,600 - $104,000 a year
- Full-time
- Spanish
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Dental insurance
Quick Apply
14d
Revenue Cycle Manager
Medic Ambulance Service —Fairfield, CA
- $140,000 - $180,000 a year
- Online Application
- Microsoft Excel
- HIPAA
- Office
- Health insurance
- Dental insurance
Quick Apply
Licensed Insurance Sales Representative
AJ Abdelkhalek - State Farm Agency —Pleasanton, CA
- $52,000 - $72,000 a year
- Urgently hiring
- Office
- In-person
- Communication skills
- Paid time off
- Opportunities for advancement
Quick Apply
Claims Examiner II
Partnership HealthPlan of California —Fairfield, CA
- $31.45 - $37.74 an hour
- Research
- Mid-level
- Office
Patient Account Representative, Billing (On-Site, Hybrid, Remote)
Northbay Healthcare —Fairfield, CA
- $32.51 an hour
- Full-time
- Hybrid work
- Word processing
- Computer literacy
- 11+ years
- 403(b) matching
- Health insurance
Claims Representative IAP - Workers Comp Training Program (On-Site Concord, CA)
Sedgwick —Concord, CA
- Full-time
- Customer service
- Office
- High school diploma or GED
- Health savings account
- Disability insurance
16h
Patient Account Representative III Hospital Billing, Remote, Hybrid,Onsite
Northbay Healthcare —Fairfield, CA
- $32.15 an hour
- Full-time
- Hybrid work
- Word processing
- Computer literacy
- Mid-level
- 403(b) matching
- Health insurance
Claims Specialist, Commercial Casualty - Remote
CSAA Insurance Services, Inc. —Walnut Creek, CA
- $62,460 - $83,400 a year
- Weekends as needed
- Remote
- Bachelor of Science
- Mid-level
- High school diploma or GED
- 401(k) matching
4d
Configuration Quality Assurance Analyst I
Partnership HealthPlan of California —Fairfield, CA
- $77,430.47 - $96,788.08 a year
- Computer literacy
- Mid-level
- Office
Senior Claims Examiner - County Account
Athens Administrators —Concord, CA
- $50.29 - $55.87 an hour
- Urgently hiring
- Management
- Bachelor of Science
- Basic math
- Health savings account
- AD&D insurance
Quick Apply
3d
Sr. Claims Specialist, Commercial Casualty - Remote
CSAA Insurance Services, Inc. —Walnut Creek, CA
- $74,295 - $99,050 a year
- Full-time
- Remote
- Spanish
- Bachelor of Science
- 3 years
- 401(k) matching
4d
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
Senior Collections Representative
University of California San Francisco —Emeryville, CA
- Full-time
- Medical office experience
- HIPAA
- Mid-level
Claims Analyst or (Senior) Claims & Patient Safety Specialist
MIEC —Oakland, CA
- $73,050 - $156,958 a year
- Full-time
- Remote
- Customer service
- 5 years
- Bachelor of Science
- Health insurance
- Dental insurance
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 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
Referral Coordinator II
University HealthCare Alliance —Dublin, CA
- $27.07 - $34.52 an hour
- Full-time
- Computer literacy
- Medical office experience
- Basic math
3d
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

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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

Billing Specialist On-site (Medi-Cal, SSI, ALW) - Multi Facility Organization

Revenue Cycle Manager

Licensed Insurance Sales Representative

Claims Examiner II

Patient Account Representative, Billing (On-Site, Hybrid, Remote)

Claims Representative IAP - Workers Comp Training Program (On-Site Concord, CA)

Patient Account Representative III Hospital Billing, Remote, Hybrid,Onsite

Claims Specialist, Commercial Casualty - Remote

Configuration Quality Assurance Analyst I

Senior Claims Examiner - County Account

Sr. Claims Specialist, Commercial Casualty - Remote

Property & Casualty Claims Advocate

Senior Collections Representative

Claims Analyst or (Senior) Claims & Patient Safety Specialist

Customer Service Representative - State Farm Agent Team Member

Patient Access Ambassador II (Per Diem, Evening)

Referral Coordinator II

Workers’ Compensation Specialist

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