... CSR III will be authorized to adjust their CIF'd claims. This authorization will be limited in ... Special Skills, Licenses and Certifications Knowledge of CPT, HCPC procedure coding, and ICD-9 ...
New

... CSR III will be authorized to adjust their CIF'd claims. This authorization will be limited in ... Special Skills, Licenses and Certifications Knowledge of CPT, HCPC procedure coding, and ICD-9 ...
New
... CSR III will be authorized to adjust their CIF'd claims. This authorization will be limited in ... Special Skills, Licenses and Certifications Knowledge of CPT, HCPC procedure coding, and ICD-9 ...
New
$17 - $22/hr
The Benefit & Claims Customer Service Representative provides information on health and welfare ... Education/Certification: * (Minimum) High School Diploma/GED Skills/Abilities: * Minimum 40 WPM and ...
$17 - $22/hr
The Benefit & Claims Customer Service Representative provides information on health and welfare ... Education/Certification: * (Minimum) High School Diploma/GED Skills/Abilities: * Minimum 40 WPM and ...
Minimum 5 years experience in medical claims environment. * Minimum 3 years customer service experience. * Demonstrated knowledge of ICD-9, CPT-4 and HCPCS coding * Fluent in both English and Spanish.
Minimum 5 years experience in medical claims environment. * Minimum 3 years customer service experience. * Demonstrated knowledge of ICD-9, CPT-4 and HCPCS coding * Fluent in both English and Spanish.
Chicago, IL · Hybrid
$72K - $141K/yr
At CNA, we strive to create a culture in which people know they matter and are part of something ... customer service. Regular communication with customers, insureds, and other stakeholders is ...
Chicago, IL · Hybrid
$72K - $141K/yr
At CNA, we strive to create a culture in which people know they matter and are part of something ... customer service. Regular communication with customers, insureds, and other stakeholders is ...
Lake Mary, FL · Hybrid
$72K - $141K/yr
At CNA, we strive to create a culture in which people know they matter and are part of something ... customer service. Regular communication with customers, insureds, and other stakeholders is ...
Lake Mary, FL · Hybrid
$72K - $141K/yr
At CNA, we strive to create a culture in which people know they matter and are part of something ... customer service. Regular communication with customers, insureds, and other stakeholders is ...
At CNA, we strive to create a culture in which people know they matter and are part of something ... meeting quality, timeliness, and customer service standards. The role requires regular ...
At CNA, we strive to create a culture in which people know they matter and are part of something ... meeting quality, timeliness, and customer service standards. The role requires regular ...
Plano, TX · Hybrid
$47K - $78K/yr
The position is responsible for investigating, evaluating, and resolving claims in accordance with ... or customer service is preferred. #LI-AR1 #LI-Hybrid In certain jurisdictions, CNA is legally ...
Plano, TX · Hybrid
$47K - $78K/yr
The position is responsible for investigating, evaluating, and resolving claims in accordance with ... or customer service is preferred. #LI-AR1 #LI-Hybrid In certain jurisdictions, CNA is legally ...
Wyomissing, PA · Hybrid
$47K - $78K/yr
Responsibilities include investigating and resolving claims according to company protocols, quality ... or customer service is preferred. #LI-AR1 #LI-Hybrid In certain jurisdictions, CNA is legally ...
Wyomissing, PA · Hybrid
$47K - $78K/yr
Responsibilities include investigating and resolving claims according to company protocols, quality ... or customer service is preferred. #LI-AR1 #LI-Hybrid In certain jurisdictions, CNA is legally ...
CNA is a market leader in insuring Allied Healthcare Providers, including nurses, nurse ... Ensures exceptional customer service by managing all aspects of the claim, interacting ...
CNA is a market leader in insuring Allied Healthcare Providers, including nurses, nurse ... Ensures exceptional customer service by managing all aspects of the claim, interacting ...
CNA is a market leader in insuring Allied Healthcare Providers, including nurses, nurse ... Ensures exceptional customer service by managing all aspects of the claim, interacting ...
CNA is a market leader in insuring Allied Healthcare Providers, including nurses, nurse ... Ensures exceptional customer service by managing all aspects of the claim, interacting ...
CNA is a market leader in insuring Allied Healthcare Providers, including nurses, nurse ... Ensures exceptional customer service by managing all aspects of the claim, interacting ...
CNA is a market leader in insuring Allied Healthcare Providers, including nurses, nurse ... Ensures exceptional customer service by managing all aspects of the claim, interacting ...
CNA is a market leader in insuring Allied Healthcare Providers, including nurses, nurse ... Ensures exceptional customer service by managing all aspects of the claim, interacting ...
CNA is a market leader in insuring Allied Healthcare Providers, including nurses, nurse ... Ensures exceptional customer service by managing all aspects of the claim, interacting ...
At CNA, we strive to create a culture in which people know they matter and are part of something ... Ensures exceptional customer service by managing all aspects of the claim, interacting ...
At CNA, we strive to create a culture in which people know they matter and are part of something ... Ensures exceptional customer service by managing all aspects of the claim, interacting ...
At CNA, we strive to create a culture in which people know they matter and are part of something ... Ensures exceptional customer service by managing all aspects of the claim, interacting ...
At CNA, we strive to create a culture in which people know they matter and are part of something ... Ensures exceptional customer service by managing all aspects of the claim, interacting ...
At CNA, we strive to create a culture in which people know they matter and are part of something ... Ensures exceptional customer service by managing all aspects of the claim, interacting ...
At CNA, we strive to create a culture in which people know they matter and are part of something ... Ensures exceptional customer service by managing all aspects of the claim, interacting ...
Los Angeles, CA · Hybrid
$54K - $103K/yr
At CNA, we strive to create a culture in which people know they matter and are part of something ... Partners with attorneys, account representatives, agents, underwriters, doctors, nurse case ...
Los Angeles, CA · Hybrid
$54K - $103K/yr
At CNA, we strive to create a culture in which people know they matter and are part of something ... Partners with attorneys, account representatives, agents, underwriters, doctors, nurse case ...
At CNA, we strive to create a culture in which people know they matter and are part of something ... Contributes to achievement of customer satisfaction targets by ensuring quality, service and cycle ...
New
At CNA, we strive to create a culture in which people know they matter and are part of something ... Contributes to achievement of customer satisfaction targets by ensuring quality, service and cycle ...
New
At CNA, we strive to create a culture in which people know they matter and are part of something ... Contributes to achievement of customer satisfaction targets by ensuring quality, service and cycle ...
New
At CNA, we strive to create a culture in which people know they matter and are part of something ... Contributes to achievement of customer satisfaction targets by ensuring quality, service and cycle ...
New
Tarrytown, NY · Hybrid
$97K - $189K/yr
At CNA, we strive to create a culture in which people know they matter and are part of something ... Accountable for the overall quality, customer service delivery and productivity of the team.
Tarrytown, NY · Hybrid
$97K - $189K/yr
At CNA, we strive to create a culture in which people know they matter and are part of something ... Accountable for the overall quality, customer service delivery and productivity of the team.
Irvine, CA · Hybrid
$97K - $189K/yr
At CNA, we strive to create a culture in which people know they matter and are part of something ... Accountable for the overall quality, customer service delivery and productivity of the team.
Irvine, CA · Hybrid
$97K - $189K/yr
At CNA, we strive to create a culture in which people know they matter and are part of something ... Accountable for the overall quality, customer service delivery and productivity of the team.

Full-time
Posted 3 days ago
New
Primary duty of the CSR III is to routinely process CIFs. They will be responsible to learn all CIF claim types within 18 months of accepting position.
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Research, resolve, and communicate outcome to providers on CIFs, claim tracers, and
general claim correspondence within established timeframes.
- Participate in provider meetings to resolve claim issues. Along with Provider Relations
staff, participate in quarterly provider focus group meetings and in-services.
- Follow established Partnership policies and procedures, Partnership claims operating instruction
memorandums, EDS provider manual guidelines, and Title 22 regulations when resolving
claims and claim issues. Complete claim processing accurately within established
production standards.
- Enter, process, and resolve claims from all Partnership CIF claim types and in any form (paper or
electronic) within established standards. This will include electronic and paper crossover
claims, pended claims, and claims which require manual pricing.
- Participate in special projects and assignments as required.
- Recognize and give feedback to management on procedure changes that would result in
more efficient operations.
- Record daily production statistics and related activities on appropriate reports; turn all logs
and reports in to Claims Customer Service Supervisor.
SECONDARY DUTIES AND RESPONSIBILITIES
- To provide support to CSR staff when call volume requires additional personnel.
- At the Supervisor’s discretion and Manager’s approval, a CSR III will be authorized to
adjust their CIF’d claims. This authorization will be limited in scope to only those claim
types they have demonstrated proficiency in and are consistently meeting both their
quality and production goals.
Education and Experience
High school diploma or equivalent. Minimum one (1) year of prior claims
processing experience in an automated claim environment; or equivalent
combination of education and experience.
Special Skills, Licenses and Certifications
Knowledge of CPT, HCPC procedure coding, and ICD-9 diagnostic
coding. Knowledge of medical terminology. Ability to access coding
reference guides for accurate information. Typing speed 30 wpm and
proficient use of 10-key calculator.
Performance Based Competencies
Effective written and oral communication skills. Ability to effectively
exercise good judgment within scope of authority and handle sensitive
issues with tact and diplomacy. Good organization skills. Ability to
accurately complete tasks within established times.
Work Environment And Physical Demands
Ability to use a computer keyboard. More than 80% of work time is spent
in front of a computer monitor. When required, ability to move, carry, or
lift objects of varying size, weighing up to 5 lbs.
All HealthPlan employees are expected to:
HIRING RANGE:
$33.65 - $40.38
IMPORTANT DISCLAIMER NOTICE
The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.
Sourced by ZipRecruiter
Insurance services
501 - 1,000 Employees
Fairfield, CA, US
1994