RenoRecruiter Since 2001
the smart solution for Reno jobs


Company: Prominence Health Plan
Location: Reno
Posted on: January 16, 2022

Job Description:

ResponsibilitiesJob Summary:Performs daily clerical and technical support for Mail room. Duties include filing, incoming and outgoing mail handling, data entry, claims re-pricing, preparing, and presenting Excel spreadsheets, composing letters and client documents for distribution and project support.QualificationsDuties & Responsibilities:

  • Greet visitors in a friendly and professional manner and direct to appropriate personnel. Answer multiple phone lines, screen calls and transfer to appropriate department. Excellent customer service skills to welcome all callers and visitors.
  • Gather information from visitors, adheres to all HIPAA guidelines for allowing visitor entry into the work area. Issues visitors' badges, sign in/out sheet and adheres to all HIPAA Privacy guidelines to protect and Personal Health Information (PHI).
  • Process incoming mail. Sort mail for distribution and for claims scanning. Handle returned mail. Verify addresses and re-direct mail when necessary.
  • Claims Scanning. Scan all incoming claim forms using the electronic scanning equipment. Name and save scanned files. Transfer electronic files to clearinghouse on a daily basis. Confirm successful transfer of daily files. Report any unusual claims submissions to Claims Manager.
  • Complete client mailing projects. Fold, stuff and seal client mailers. Coordinate timelines and meet all deadlines to ensure project completion.
  • Eligibility Support. Work with eligibility analysts to complete weekly COBRA letters and COBRA file reconciliation. Perform data entry to post COBRA payments, help complete COBRA charts and any other COBRA correspondence to meet all internal and Federal guidelines and timelines.
  • File paper claim forms in proper numbered filing system. File enrollment forms and COBRA documents for easy retrieval by staff.
  • Outgoing mail. Run all outgoing mail daily through mail machine to ensure proper sealage and postage. Ensure mail goes out in a timely manner daily to outside mail handler. Update mail machine postage data, and refill with postage funds when needed.
  • Receive and log incoming overnight deliveries (Fed Ex, UPS) and responsible for outgoing overnight deliveries.
  • Match incoming claims to eligibility information within the CDS claims system. Delete appropriate claims, add providers and inform Claims Manager of any unusual claims' submission patterns. Ensure that eligibility queue is cleared daily.
  • Log and track number of visitors, call transfers and reason for transfer in Excel spreadsheet to track activity levels. Calculate weekly and monthly totals to present to Manager of Customer Service
  • Perform Claim Re-pricing. Submit claims information to external PPO networks via their on-line pricing tool. Receive and print pricing sheet and return to claims examiner for adjudication.
  • Word documents- prepare letters, memos, for internal and external communication. Use Mail Merge to create member mailing lists and facilitate client mailings utilizing internal and external resources
  • Enter daily phone activity into member services spreadsheet. Calculate talk time, average length of call, unavailable time, and totals for Member Services Department.
  • Perform outside errands including delivery of checks, ID cards, plan documents, client lunch pickup or other supplies as needed by clients.
  • Purge files when needed for relocation to back warehouse. Clearly mark files and work with leadership staff to determine when files need shredding. Contact shredding vendor and arrange for shredding when needed.Qualifications & Requirements:
    • High school diploma.
    • 2-4 years' experience in a medical insurance officeLanguage Skills:
      • Ability to effectively communicate in English, both verbally and in writing.Skills:
        • Excellent computer skills.
        • Proficient in Microsoft Office products including Word and Excel.
        • Customer service experience both direct and phone.
        • Ability to be innovative and take initiative.
        • Excellent communication and customer service skills.Physical Demands:
          • For physical demands of position, including vision, hearing, repetitive motion and environment see following description. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position without compromising patient care.

Keywords: Prominence Health Plan, Reno , OFFICE SUPPORT TECH, Administration, Clerical , Reno, Nevada

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category

Log In or Create An Account

Get the latest Nevada jobs by following @recnetNV on Twitter!

Reno RSS job feeds