Overview
Senior Claims Coordinator Jobs in Austin, Texas, USA at Central Health
Overview
As the Senior Claims Coordinator for a Health Maintenance Organization (HMO) and other Health Plans based in Texas, you will be responsible for securely processing and distributing incoming and outgoing mail daily, ensuring all timelines are met. This position is not remote and does require the ability to travel between the office and post office daily.
Responsibilities
Essential Functions:
Processing Incoming Mail:
Retrieve mail daily from the Post Office. Open, triage, and batch incoming mail to appropriate Health Plan Departments.
Processing Outgoing Mail:
Prepare and deliver all outgoing mail to the post office or coordinate with other delivery services. Oversee postage system and coordinate with Finance to maintain a sufficient level of available postage to meet demand.
Manage Claims Payment and Statement Mailings:
Prepare claim checks and explanations of payments, explanations of benefits, and other claims-related documents for mailing or other delivery systems.
Managing Claims Scanning Process:
Scan all physical claims received into the software system and perform a detailed review to verify the accuracy of scanned documents within the designated timeline required.
Health Plan Department Coordination:
Coordinate with Health Plan Departments, such as Clinical, Operations, Financial, and Claims for the processing of required documents via mail or other delivery systems.
Consent:
Ensure the privacy and security standards of PHI (Protected Health Information) as outlined in department policies and procedures related to HIPAA compliance.
Support all Health Plan Claims Mailroom staff and ensure appropriate turnaround times are met for the team.
Knowledge, Skills, and Abilities:
Strong understanding of mailroom process procedures and security requirements.
Proficiency in utilizing scanning software and detailed review of information.
Knowledge of healthcare regulatory compliance requirements, including HIPAA.
Ability to travel between the post office and office daily.
Qualifications
Minimum Education: High School Diploma or equivalent (higher degree accepted).
Minimum Experience: Minimum of 5 years of experience in a mailroom, preferably within an HMO or managed care environment.
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Title: Senior Claims Coordinator
Company: Central Health
Location: Austin, Texas, USA
Category: Administrative/Clerical (Healthcare Administration), Healthcare (Healthcare Administration)
