Claims Processor III Job at Southern California Pipe Trades Administrative Corporation, Los Angeles, CA

YndLeDJUeVA4S1dFZTNoV0FCU2lHWmMxZEE9PQ==
  • Southern California Pipe Trades Administrative Corporation
  • Los Angeles, CA

Job Description

The Southern California Pipe Trades Administrative Corporation is seeking a Claims Processor in the Health & Welfare Benefit Funds Department. This is a Grade 3 union position that offers competitive pay as well as health and pension benefits.

EXPERIENCE & GENERAL JOB REQUIREMENTS:

  • High school diploma or GED.
  • Experience with Microsoft Office including Word, Excel, and Outlook.
  • Must be detail oriented and have strong organizational skills.
  • Must have the ability to expedite work to meet deadlines with minimum supervision.
  • Must maintain confidentiality of documents processed.
  • Knowledge of medical terminology and coding preferred.

JOB RESPONSIBILITIES:

The most significant responsibilities of this job classification are:

  • Review and resolve submitted claims by initiating payment or denial in line with eligibility and benefits as described in the applicable Summary Plan Description.
  • Communicate with the appropriate party to obtain additional documentation where necessary.
  • Provide proper and timely response to Member and provider inquires on all non-complex claims.
  • Review and resolve submitted claims through our HRA and WEX systems, ensuring that claims meet our guidelines before releasing payments.
  • Familiarity with Innovative Software Solutions Inc. (ISSI) and WEX platforms.

Other responsibilities will be assigned by Management based on the individual's abilities.

NOTES:

  • Background screening and educational verification will be conducted on individuals offered employment.

The Southern California Pipe Trades Administrative Corporation is subject to the Los Angeles Fair Chance Initiative for Hiring Ordinance (FCIHO) (LAMC 189.00) and will consider for employment any qualified Applicants with criminal histories in a manner consistent with the requirements of FCIHO.

Job Tags

Work at office

Similar Jobs

Christus Health

Medical Laboratory Technician I - Lab AdminGeneral Job at Christus Health

 ...the following sections: Hematology, Urinalysis, Coagulation, Chemistry, Special Chemistry, ER Stat Lab, and Microbiology; performs blood...  ..., and the use of hazardous materials. Utilizes LIS and HIS computer systems appropriately to perform, charge, and report... 

University Health - San Antonio

Instrument Technician Job at University Health - San Antonio

 ...Room staff has correct, fully functional, sterile surgical instrumentation delivered in a timely manner consistent with the highest standards...  ...Management as a Certified Registered Central Service Technician (CRCST) is required within one (1) year from the date of hire... 

AstraZeneca

Director, Advanced Cell Model External Engagement, Safety Sciences Job at AstraZeneca

 ...strive to innovate to enhance our scientific capabilities and accelerate the speed at which we bring medicines forward. Advanced Cell Models (ACM), such as organoids and Microphysiological Systems (MPS), are New Approach Methods (NAMs) used for safety assessment and to... 

Teamwork Online

Event Day Premium Runner/Busser (Dicks Sporting Goods Park) Job at Teamwork Online

Runner/Busser Hourly Wage: $19.37 Responsibilities: Deliver food and beverages from kitchen to guests in a timely and organized manner utilizing key information on kitchen tickets including table and seat numbers Read kitchen tickets to ensure quality and accuracy...

Milestones Academy of Texas

Assistant Preschool Education Teacher Job at Milestones Academy of Texas

 ...Job Description Job Description Were looking for a passionate Assistant PreSchool Teacher! Requirements: Child Development Associate (CDA)2+ year experience as a Assistant Teacher Available to start immediately All trainings provided Responsibilities...