Responsible for timely and accurate sorting, screening and batching of all Medicaid claim forms, as well as coding of third party payer, and Medicare Crossover, if required by state. Also accountable for preparing and mailing provider remittance advice and ‘Return to Provider’ letters in an efficient manner.
Duties and Responsibilities
• Opens and sorts all incoming mail.
• Screens medical claim forms for pertinent information.
• Batches medical claim forms by claim type.
• Completes Code Sheets for Third Party Liability and/or Medicare Crossover claims.
• Prepares, for mailing, Return to Provider (RTP) letters for returning claims with missing information required to enter into the claims payment system.
• Prepares Remittance Advices weekly for mailing to providers.
• Meets established production and quality standards.
• Supports all departmental initiatives in improving overall efficiency.
Knowledge, Skills and Abilities
• Ability to lift up to 50 lbs
• Basic knowledge of Microsoft Office Outlook
• Ability to abide by Molina’s policies
• Ability to maintain attendance to support required quality and quantity of work
• Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
• Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers
• High School Diploma or equivalent GED
• 2-3 years experience
• 3-4 years experience
To all current Molina employees if you are interested in applying for this position please fill out an Employee Transfer Request Form (ETR) and attach it to your profile when applying online. Be sure to let us know you are a current employee by selecting “Molina Employee (current) in the source section of the online application.
Molina Healthcare offers competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Navigating the murky waters of federal health care plans is no easy feat, but Molina Healthcare's mission is to help Medicaid and Medicare...