Claims Mailroom Clerk

California

‐ Onsite

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Keywords

Process mail by sorting according to type of claim for scanning vendor

Scan Claims and PM160s for submission to scanning vendor
Mail out Misdirected Claims to PPGs (Participating Provider Group) and PDR (Provider Dispute Resolution) letters.
Scans and email internal documents received from daily mail for examiner processing ( Internal documents: Medical Records, Authorizations, Tracers, Handwritten Claims, Claims for Manual Entry, High Dollar Claims, TPL, Refund Requests, Refund Check copies, Member Billing)
Provides claim images requested by managers, supervisors or examiners when unable to locate.
Updates Daily Certified Mail Log for tracking.
Identifies claims for rejected claims spreadsheet for submission to clerical unit.
Retrieve claim images and emails to Clerical Unit for processing.
Scan PDR (Provider Dispute Resolution) for the PDR Unit.
Light Data entry (MS Word & Excel).

SKILLS:

Required: High School Graduate

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