Claims Mailroom Support Clerk (Temp to Hire Benefits Included) (Finance)
Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.
The Claims Clerical-Mailroom Support Clerk is responsible for managing incoming mail from providers while ensuring a high level of accuracy. Requires the ability to multi-task while providing accurate and timely mail triaging and processing.
Job Duties/Responsibilities:
Opens, triages, and batches incoming mail & faxes. Utilizes the EZ CAP claim processing system to research provider and member status. Enters manual claims into EZ CAP claims system. Keeps a daily log & count of all mail. Processes daily pend, denial and claim forwarding correspondence. Provides the requested documentation to internal departments and provider network (EOB, faxes, scanning, requests for letter copies). Supports research projects through claims look-up and simple documentation via Excel spreadsheets. Supports the needs of providers and claims team through professional communication that demonstrates the company culture. Participates in the Claims Department team meetings and other activities (as needed). Ensures the privacy and security of PHI (Protected Health Information) as outlined in the department policies and procedures relating to HIPAA Compliance. Performs other duties and projects as assigned.
Job Requirements:
Experience:
• Required: Minimum 1 year of mail room/clerical experience in a healthcare setting.
• Preferred: Medicare claim knowledge.
Education:
- Required: High School Diploma or GED.
- Preferred: None
Training:
- Required: None
- Preferred: None
Specialized Skills (Required):
- Possess a strong team attitude.
- Ability to multi-task.
- Ability to remain focused and productive while performing tasks daily.
- Ability to perform data entry.
- Ability to travel between locations.
- Ability to operate a telephone, computer, scanner, copier, fax machine, and other office equipment.
- Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others.
- Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors.
- Mathematical Skills: Ability to perform mathematical calculations and calculate simple statistics correctly.
- Reasoning Skills: Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolution.
- Computer Skills: Knowledge of computer programs and applications required.
Licensure:
- Required: None
- Preferred: None
Essential Physical Functions:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- 1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
- 2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.
*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/ . If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health's talent acquisition team, please email careers@ahcusa.com .
