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Lead Claims Representative

St. Joseph Health / Covenant Health

This is a Full-time position in Anaheim, CA posted April 8, 2021.

**We are looking for a Lead Claims Representative with HSS NSS Claims Department at Heritage Healthcare.****Location** : Anaheim, CA**Schedule** : Full-time 80 Biweekly Hour**Shift** : 8 Hour Day Shift**Job Summary:**Working under the direction of the Revenue Recovery Director, this position has sole responsibility for 48 hr.

claims adjudication and health plan capitation deduction reconciliation and disputes.

In addition, this position will assist with interviewing/hiring, orientation, and training of new employees.**Skills** :+ Ability to work under pressure by prioritizing work activities and re-negotiating deadlines.+ Strong analytical and problem solving skills+ Possess excellent verbal, written and interpersonal communications skills to communicate effectively with individuals at all levels of the organization.+ Excellent organizational and prioritization skills.+ Possess critical thinking and problem resolution.+ Knowledge of HIPAA and AB1455+ Ability to work independently, but also as a team player, supporting and promoting intra and inter-departmental teamwork.+ Possess a professional and mature demeanor, maintaining a positive attitude with changing conditions.+ Ability to make sole judgment calls with confidence.+ Ability to lead and delegate tasks appropriately**Position Requirements:****Education** : Requires a High School diploma or equivalent.**Experience** :+ Requires four (4) years prior experience in medical/institutional claims processing within a medical group/IPA setting.+ Previous experience with computerized claims processing/transactions system and medical coding (CPT, ICD10, and HCPCs) required.**Computer Skills** : Requires basic computer skills including MS Word, Excel, Access and emailing system.**Other** : 10 key by touch**Preferred Position Qualification:****Education** : AA degree**Experience** : Five (5) plus year’s experience in medical/institutional claims processing within a medical group/IPA setting highly desirable.**Computer Skills:** Previous IDX experience a plusSt.

Joseph Health
– Mission Heritage Medical Group is one of California’s most respected medical groups.

With over 3,000 employees and 75 locations throughout California, including, Northern California, Orange County, High Desert and Los Angeles County, Mission Heritage Medical Group has been continually recognized as a leader in quality, customer service and information technology.

This kind of success is the result of team work, a commitment to excellence and a strong adherence to the organization’s mission, vision and values.St.

Joseph Health
– Mission Heritage Medical Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics.

In addition to federal law requirements, Mission Heritage Medical Group complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.Company: Heritage HealthcareCategory: Administrative SupportReq ID: R318991

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