Job description

POSITION SUMMARY

IT - Responsible for assisting the Data Management Specialist with inbound and outbound (EDI) electronic data exchange. Provides telephone training, registration and support for Web site users. Perform administrative and clerical duties for the IT department. Provide entry level hardware/software troubleshooting along with onboarding and offboarding of employees.

Claims - Assists the Claims Department staff by sorting & distributing daily forms and letters, pulling manual claims, and distributing incoming faxes. Handles mail room functions, including sorting and posting mail, scanning and folding letters, and forwarding misdirected claims. Assists with pulling claims for audits.

JOB DUTIES

IT Responsibilities:

Retrieves and distributes EDI data files from health plan websites and FTP.

Submits outbound electronic medical claims to health plans and clearinghouses.

Performs other duties as assigned, including regular and temporary teams as assigned by the Director of Information Technology.

Basic PC hardware / software troubleshooting.

Creates user accounts for new employees on requested health plan web sites. Accurately updates spreadsheet for Data management specialist who creates the Secure login function and trains the users.

Onboarding/ offboarding of new employees.

Manage printer supplies and repair requests.

Provides Web site user support including; password reset, new user profile setup, and new user telephone-based training.

Performs administrative and clerical duties for the IT department.

Reports all security, privacy and procedure breaches to the Director of Information Technology immediately.

Claims:

Prepares requested documents for health plan audits.

Sorts and Operates folding machine for all outgoing letters and checks.

Compiles misdirected claims. Prints misdirected claims and mails them to appropriate health plan.

Applies postage to all outgoing mail.

Sorts and distributes incoming mail.

Distributes incoming fax emails.

Keeps mailroom clean and stocked. Refills the copier and fax machine with paper as required.

Other duties as assigned.

POSITION QUALIFICATIONS AND REQUIREMENTS

Experience/Specialized Skills:

Proven experience supporting multiple electronic environments for data exchange with trading partners in both batch and interactive environments including the Web and FTP.

Should be familiar with and have experience with EDI formats, multiple protocols, preferably in a medical transaction environment. Working knowledge of MS Office, Excel and Word, Access a plus.

Proven ability to work with multiple projects with internal personnel and trading partners in a professional manner.

Excellent interpersonal skills are essential.

Proven organizational skills with attention to detail and the ability to prioritize work.

Strong written and verbal communication skills.

Must have an excellent disposition/attitude and ability to multi-task.

Experience in supporting IT is a plus.

Must be able to speak/read/write English.

Ability to compose letters with emphasis on correct grammar, punctuation, etc.

Must be authorized to work in the USA.

Minimum two years clerical experience.

Education/Course(s)/Training:

Associate degree in Information Systems or Business Administration or equivalent experience required, Bachelor’s preferred.

Work Schedule:

• Monday - Thursday
• 10 Hour shift
• Non-clinical, office setting and onsite.

View our company website to learn more about the company and career opportunities. You may apply through company website or through Indeed.

www.scpmcs.org

SCPMCS is an Equal Opportunity Employer

Job Type: Full-time

Pay: $19.69 - $24.21 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Referral program
• Tuition reimbursement
• Vision insurance

Ability to commute/relocate:

• San Diego, CA 92121: Reliably commute or planning to relocate before starting work (Required)

Application Question(s):

• Do you have any experience with EDI Formats?
• Do you have any experience working in a medical transaction environment?
• Are you comfortable working a 4/10 schedule?
• What is your salary expectation for this position?
• What is your interview availability?

Experience:

• IT: 1 year (Required)
• Clerical: 1 year (Preferred)
• Help desk: 1 year (Preferred)
• Mailroom: 1 year (Preferred)
• Microsoft Office: 1 year (Preferred)

Work Location: In person

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