L.A. Care Health Plan Job - 41216866 | CareerArc
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Company: L.A. Care Health Plan
Location: United States of America
Career Level: Entry Level
Industries: Banking, Insurance, Financial Services

Description

 

Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure our members get the right care at the right place at the right time.

Mission: L.A. Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.

Job Summary


The Claims Data Entry Clerk II is responsible for the accurate and timely data entry of claims and other documents, which includes: Keying claims for all lines of business, including complex claims. Data Entry of Claims in Core adjudication system. Checking the eligibility of members of services in order to sort claims by product. Scanning and sorting medical records. Reviewing claims for required information, returning claims to the provider when necessary. Preparing reports and ensuring that reports are accurate and generated within specified timeframes.

Duties

Create and sending of Rejection letters to the providers for the rejected Claims 98.5% accuracy. Follow LAC policies and procedures. Keep current with incoming daily receipts. Meet production standards. (50%)

 

Accurately sort based on department procedures. Keep current with incoming daily receipts. (25%)

 

Perform special projects and ad-hoc reporting as necessary. Projects will be complete and reports will be generated within the specific time frame agreed upon at the time of assignment. (15%)

 

Perform other duties as assigned. (10%)

Education Required High School Diploma/or High School Equivalency Certificate Education Preferred Experience

Required:
At least 0-6 months of accurate, high-volume claims data entry or claims processing experience.

 

Preferred:  
Managed care or Medi-Cal claims experience.

Skills


Proficient in Microsoft Office

 

Strong verbal and written communication skills

Licenses/Certifications Required Licenses/Certifications Preferred Required Training

Preferred:
Claims Examiner Training

Additional Information

 

L.A. Care offers a wide range of benefits including

  • Paid Time Off (PTO)
  • Tuition Reimbursement
  • Retirement Plans
  • Medical, Dental and Vision
  • Wellness Program
  • Volunteer Time Off (VTO)

 

At L.A. Care, we value our team members' safety. In order to keep our work locations safe, each employee is required to self-screen for symptoms prior to entering any L.A. Care location each day. L.A. Care and all of its staff are required to comply with all state and local masking orders. Therefore, when on-site at any L.A. Care location, employees are expected to wear a mask in areas where physical distancing cannot be managed.


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