Verifier I - August 2008

As a ministry of the Sisters of St. Joseph of Orange, here at St. Joseph Heritage Healthcare, we strive to create environments that promote wholeness for the communities and people we serve.  We currently have an outstanding opportunity for you in Network Support Services as a Claims Verifier I.Working under the direction of the Support Services Manager, this position is responsible for performing alpha and numerical data entry and data verification functions according to established procedures using Teleform, member research in IDX, and mailing of correspondence.  This position will perform duties in accordance with guidelines set forth in the Claims Industry to ensure compliance with AB1455 and departmental policy and procedures.Some of the Essential Job Functions are: Verify and manage daily work by selecting the oldest date received from Teleform.  Route claims to appropriate department for research and produce work with a minimum of 450-alpha/numerical characters, against a UB04 Health Plan generated claim images to ensure 95% accuracy during verification within 2 business days of being scanned as established  by departmental procedures. Verify claims in the Research Folder daily.  Identify and drop claims images to paper, which are rejected by Teleform, and route to the appropriate department for further research. Audits verified claims and correspondence bi-weekly to ensure 95% accuracy during verification.   Experience & Education required: Must have High School Diploma or equivalent Require 1 years of general clerical and data entry experience within a Medical Group, IPA or Health Plan. ICD-9, HCPC, Medical Terminology and Medical Coding experience. Our benefits for full time personnel include Medical, Dental, Vision, Life Insurances, PTO, Paid Holidays, 401(a) and 401(k) plans, Credit Union and much more! Company: ST JOSEPH HERITAGE HEALTHCARE Location: 92805 Salary/Wage: 11.44 - 13.73 USD /hour Job Status/Type: Full Time, Employee Job Category: Administrative/Clerical Occupation: Claims Processing Industry: Healthcare Services Work Experience: 1+ to 2 Years Career Level: Experienced (Non-Manager) Education Level: High School or equivalent Fax: 714/937-6204 Email: Apply by Email Reference Code: Verifier