Dignity Health Claims Processor in SCOTTS VALLEY, California
The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric, full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health’s Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first.
Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art, flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options, including medical, dental and vision plans, for the employee and their dependents, Health Spending Account (HSA), Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.
This position is responsible for all aspects of the scanning process for the Claims Department.
Principal Duties and Responsibilities:
Timely, accurate preparation of all paper claims batches.
Timely, accurate scanning and validation of incoming paper claims using the Datacap system.
Timely, accurate data entry of UB-1450 paper claims and CMS-1500 forms to maintain acknowledgement compliance.
Review of various check run prep audit reports under the direction of a Claims Examiner.
Attend general staff meetings and other meetings as required.
Adhere to PMG/DHMSO established policies and procedures.
Perform miscellaneous job-related duties as assigned.
Knowledge and Skills:
Must possess a minimum of two (2) years’ experience in data entry having achieved speed and accuracy with the ability to type at least 40 WPM.
General understanding and knowledge of healthcare, medical terminology and health insurance claim types on CMS-1500 and CMS-1450 forms. Working knowledge of CPT codes, ICD-10 codes, HCPCS Level II codes, Hospital Revenue Codes and Red Book.
Must possess working knowledge of Microsoft Office applications, familiarity with medical management and other software packages, and ability to learn new computer software as necessary.
Must demonstrate ability to operate copier, fax and telephone equipment.
Strong research, judgment, decision-making and problem-solving skills.
Ability to focus on repetitive claims detail information.
Must demonstrate excellent interpersonal skills necessary to communicate effectively with a variety of individuals while conducting oneself in a courteous and professional manner in person, by telephone and e-mail communications.
Excellent written and verbal communication skills.
- High School Diploma or equivalent.
- Reports to the Claims Manager
Physical Demands and Work Environment:
Physical demands: While performing the duties of the job, the employee is required to walk; sit; use hands and fingers to operate job related equipment; occasionally reach with hands and arms; occasionally climb stairs; talk and hear. The employee must occasionally lift and/or move up to 15 pounds. Vision abilities required by the job include close vision, distance vision, peripheral vision, depth perception, and the ability to adjust focus.
Work environment: While performing the duties of this job, the employee is exposed to an indoor building climate. The noise level in the work environment is usually minimal.
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Dignity Health is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected Veteran status or any other characteristic protected by law. For more information about your EEO rights as an applicant, please
If you need a reasonable accommodation for any part of the employment process, please contact us by telephone at (415) 438-5575 and let us know the nature of your request and your contact information. Requests for accommodation will be considered on a case-by-case basis. Please note that only inquiries concerning a request for reasonable accommodation will be responded to from this telephone number.
Job ID 2018-55577
Employment Type Full Time
Department Claims Processing
Hours / Pay Period 80
Facility Dignity Health Management Services Organization
Location SCOTTS VALLEY
Standard Hours Mon-Fri (8-5 PM)