Top 2302 Business services representative Jobs in Martinez, 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
Admissions Representative
Unitek Learning —Concord, CA
- $30 - $40 an hour
- Full-time
- Microsoft Excel
- Microsoft Outlook
- University
- Paid holidays
- Dental insurance
Quick Apply
Customer Service Rep
Vishay Precision Group —Concord, CA
- $31.73 - $36.00 an hour
- Full-time
- Microsoft Outlook
- Mid-level
- Office
- AD&D insurance
- Paid holidays
Quick Apply
10d
Customer Service Representative, CC
Partnership HealthPlan of California —Fairfield, CA
- $29.95 - $35.19 an hour
- Full-time
- Spanish
- Mid-level
- Administrative experience
Administrative Assistant (Part time with the potential for full time)
Municipal Pooling Authority —Concord, CA
- $35.74 - $43.44 an hour
- Part-time
- Hybrid work
- Microsoft Excel
- English
- Research
- Paid holidays
- Health insurance
Quick Apply
6d
Architectural Services Representative - Regional Program Representative
Woodwork Institute —San Francisco Bay Area, CA
- $60,000 - $90,000 a year
- Full-time
- Background check
- 5 years
- Mid-level
- Mileage reimbursement
- Health insurance
Quick Apply
7d
Territory Sales Manager
Infusion For Health —San Francisco, CA
- $85,000 - $120,000 a year
- Full-time
- Mid-level
- Analysis skills
- Bachelor's degree
- Health insurance
- Dental insurance
Quick Apply
10d
Massage Therapist at Luxury Hotel
LAFAYETTE PARK HOTEL & SPA —Lafayette, CA
- $16.90 - $35.00 an hour
- Full-time
- CPR Certification
- Anatomy knowledge
- BLS Certification
- Health insurance
- Dental insurance
Quick Apply
Compliance Investigator II
Partnership HealthPlan of California —Fairfield, CA
- $96,970.04 - $121,212.56 a year
- Full-time
- Microsoft Excel
- HIPAA
- Office
Customer Service Representative Bilingüal (english spanish)
Apoyo Financiero Inc. —San Rafael, CA
- $19.00 - $20.50 an hour
- Full-time
- Spanish
- Computer literacy
- No experience needed
- Paid holidays
- Health insurance
Quick Apply
Restaurant Host at Luxury Hotel
LAFAYETTE PARK HOTEL & SPA —Lafayette, CA
- $18 an hour
- Part-time
- Customer service
- Basic math
- English
- Health insurance
- Dental insurance
Quick Apply
Automotive Sales Representative
Toyota of Vallejo —Vallejo, CA
- $35,152 - $150,000 a year
- Weekends as needed
- Clean driving record
- Sales
- Dealership
- Health insurance
- Dental insurance
Quick Apply
8d
Vietnamese-English Bilingual Healthcare Customer Service Representative - Remote in California
TTEC —California
- $21.65 an hour
- Full-time
- Remote
- English
- Research
- Windows
- Wellness program
- Tuition reimbursement
Community Liaison
Centre For Neuro Skills —Emeryville, CA
- $80,000 - $95,000 a year
- Overtime
- Mid-level
- Clinic
- Bachelor's degree
- Paid holidays
- Health insurance
Russian-English Bilingual Healthcare Customer Service Representative - Remote in California
TTEC —California
- $21.65 an hour
- Full-time
- Remote
- English
- Research
- Windows
- Wellness program
- Tuition reimbursement
Machinist IV
Benchmark Electronics, Inc —Concord, CA
- $41 - $52 an hour
- Email
- Writing skills
- Pass drug screening
- 8 years
- Dental insurance
- 401(k)
Machinist IV
Benchmark Electronics, Inc —Concord, CA
- $41.35 - $62.03 an hour
- 8 hour shift
- Writing skills
- 8 years
- High school diploma or GED
- Dental insurance
- 401(k)
Safety Representative
AC Transit —California
- $105,932 - $126,493 a year
- Online Application
- Mid-level
- Office
- Bachelor's degree
- Wellness program
- Commuter assistance
Project Manager
Singular Builders —San Francisco, CA
- $140,000 - $180,000 a year
- Weekends as needed
- Background check
- Schematics
- Construction site
- Health savings account
- Health 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

business services representative jobs in martinez, ca

Claims Customer Service Representative I

Claims Resolution Coordinator

Admissions Representative

Customer Service Rep

Customer Service Representative, CC

Administrative Assistant (Part time with the potential for full time)

Architectural Services Representative - Regional Program Representative

Territory Sales Manager

Massage Therapist at Luxury Hotel

Compliance Investigator II

Customer Service Representative Bilingüal (english spanish)

Restaurant Host at Luxury Hotel

Automotive Sales Representative

Vietnamese-English Bilingual Healthcare Customer Service Representative - Remote in California

Community Liaison

Russian-English Bilingual Healthcare Customer Service Representative - Remote in California

Machinist IV

Machinist IV

Safety Representative

Project Manager

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