Mail Intake Coordinator
NAMM North America Medical Management - Ontario, CA

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To assure claims are sorted by markets, priority, scannable, non-scannable, and health plan responsibility. So that all claims are put through the appointed areas for scanning and manual processing .

Responsibilities:
  • Open, sort, batch and distribute mail according to markets, scan able, manual, ER claims, appeals and Health Plan Risk
  • Prioritize, log and track all received claims within excel spread sheets
  • Look up provider status daily to identify if providers are contracted or non-contracted
  • Look up member eligibility in the diamond system as needed
  • Verify validity of CPT & ICD-9 codes within diamond
  • Inspect all incoming claims to determine quality and suitability for processing
  • Responsible for forwarding all un-cleaned claims to provider and all shared risk claims to the health plan
  • Responsible for researching claim tracers

Qualifications:
  • High School diploma or GED
  • 6 months to 1 year experience in medical office or claims environment
  • CPT and ICD-9 codes, ability to identify HCFA 1500 and UB-04 forms, light medical office skills, some claims environment, some computer knowledge and familiarity with spreadsheet applications such as excel

*CB

NAMM North America Medical Management - 11 months ago - save job - block
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