Claim Assistant Jobs in Modesto, CA (NOW HIRING)

Position Summary

The Human Resources Assistant / Business Office Associate is a hybrid administrative position that provides support to both the Human Resources Department and the Business Office. This position is designed for an individual who is organized, dependable, detail-oriented, and interested in developing experience in both human resources and healthcare business operations.

The position assists the Human Resources Director with day-to-day administrative functions, employee data management, compliance training, leave tracking, and special projects throughout the year. The position also supports Business Office operations, including referrals, prior authorizations, denial processing, billing support, and other administrative tasks as assigned.

Because this position has access to confidential employee, patient, financial, and organizational information, a high level of professionalism, discretion, accuracy, and confidentiality is required.

Essential Duties

Human Resources Support

• Provide administrative support to the Human Resources Director and assist with routine HR functions and special projects.
• Assist with maintaining accurate employee information and updating HR records and databases.
• Assist with employee data entry, recordkeeping, filing, scanning, and document management.
• Maintain organized and confidential electronic and paper personnel records as assigned.
• Assist with tracking employee compliance requirements, including required training, certifications, licenses, and other employment-related documentation.
• Monitor compliance training completion and assist with communicating training deadlines and follow-up reminders to employees and supervisors.
• Assist with tracking employee leaves of absence, including maintaining leave calendars, documentation, dates, and other information as directed by the Human Resources Director.
• Assist with onboarding and offboarding administrative tasks, including preparation and collection of employment-related documents.
• Assist with periodic HR audits to ensure required employee documentation is complete and current.
• Prepare spreadsheets, reports, correspondence, forms, and other HR materials.
• Assist with annual and periodic HR projects, including employee training initiatives, policy acknowledgments, benefits-related projects, and other organizational activities.
• Respond to routine employee questions and appropriately refer questions involving policies, employee relations, benefits, leave determinations, compensation, or other HR decisions to the Human Resources Director.
• Maintain strict confidentiality regarding employee information and Human Resources matters.
• Perform other Human Resources duties and projects as assigned.

Business Office Support

• Provide administrative support to the Business Office based on departmental workload and operational needs.
• Assist with processing and tracking patient referrals.
• Assist with obtaining and tracking prior authorizations from insurance carriers and other payers.
• Follow up on outstanding referrals, authorizations, documentation, and related requests as assigned.
• Assist with reviewing and processing Waystar claim denials and other billing-related work queues.
• Research basic denial information and route issues requiring additional review to the appropriate billing team member.
• Assist the billing team with claim follow-up, documentation, data entry, account research, and other administrative functions.
• Assist with obtaining information needed to support accurate and timely billing and reimbursement.
• Communicate professionally with clinic staff, insurance carriers, outside healthcare organizations, and other parties as necessary to complete assigned tasks.
• Maintain accurate documentation of work performed and follow established Business Office procedures.
• Assist with special projects and other Business Office functions as assigned.

General Responsibilities

• Maintain confidentiality of employee, patient, financial, and organizational information in accordance with MMHC policies and applicable privacy requirements.
• Demonstrate accuracy and attention to detail when entering, reviewing, or maintaining information.
• Manage multiple assignments and priorities while meeting established deadlines.
• Communicate professionally and respectfully with employees, patients, providers, supervisors, insurance representatives, and outside organizations.
• Work collaboratively with Human Resources, Business Office staff, clinic departments, and leadership.
• Learn and appropriately use multiple software systems and electronic platforms.
• Follow established MMHC policies, procedures, confidentiality requirements, and standards of conduct.
• Maintain regular and reliable attendance.
• Perform other duties as assigned.

Education and Skills

• High school diploma or equivalent required.
• Previous experience in one or more of the following areas: healthcare referrals, prior authorizations, medical billing, electronic health records (EHR), medical office operations, or Human Resources.
• Basic understanding of healthcare administrative processes, medical office workflows, or Human Resources functions.
• Basic proficiency with Microsoft Office applications, including Word, Excel, and Outlook.
• Ability to learn and effectively use Human Resources, electronic health record, billing, payer, and other software systems.
• Strong organizational skills with attention to detail and accuracy.
• Ability to accurately enter, maintain, track, and manage confidential data and documentation.
• Ability to prioritize assignments, manage multiple tasks, and work effectively while supporting multiple departments.
• Ability to communicate professionally and effectively, both verbally and in writing.
• Ability to maintain confidentiality and exercise appropriate discretion when handling sensitive employee, patient, and organizational information.

Preferred Qualifications

• Experience with healthcare referrals and prior authorization processes.
• Experience with medical billing, claims processing, insurance denials, or revenue cycle functions.
• Experience using an electronic health record (EHR), practice management, HRIS, or medical billing system.
• Experience with Waystar or similar healthcare revenue cycle software.
• Familiarity with medical terminology, health insurance plans, payer requirements, and medical office workflows.

Physical Requirements

The position generally requires prolonged periods of sitting and working at a computer, frequent use of standard office equipment, and regular communication by telephone, email, and in person. May include walking or driving throughout the community to deliver and pick up documents. The employee must be able to perform the essential functions of the position with or without reasonable accommodation.

Reasonable accommodation may be provided to enable qualified individuals with disabilities to perform the essential functions of the position.

Tribal Preference

In accordance with MMHC's Tribal Preference policy, hiring preference may be given to qualified Native American applicants, as permitted by applicable law and Tribal policy.