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Claims Customer Service Representative

1 month ago

Redding, California, United States Yoh Full time
Job Summary

We are seeking a skilled Claims Customer Service Representative to join our team at Yoh. As a Claims Customer Service Representative, you will be responsible for researching and resolving provider telephone and written inquiries, accurately screening claims, and participating in provider meetings and projects.

Key Responsibilities
  • Research and resolve provider telephone and written inquiries within established time frames
  • Accurately screen claims and participate in provider meetings and projects
  • Respond to provider telephone inquiries, research policy issues, and analyze EOPs and claim history
  • Communicate outcome to providers of CIFs, claim tracers, and general claim correspondence
  • Follow established policies and procedures, claims operating instruction memorandums, EDS provider manual guidelines, and Title 22 regulations
Requirements
  • High school diploma or equivalent
  • One (1) year of prior claims processing experience in an automated or call center claims environment preferred
  • Knowledge of CPT, HCPC procedure coding, and ICD-10 diagnostic coding
  • Excellent written and oral communication skills
  • Ability to effectively exercise good judgment within scope of authority and handle sensitive issues with tact and diplomacy
What We Offer
  • Medical, Dental & Vision Benefits
  • 401K Retirement Saving Plan
  • Life & Disability Insurance
  • Direct Deposit & weekly EPayroll
  • Employee Discount Programs
  • Referral Bonus Programs