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Claims Clerk - March Vision Care - Los Angeles, CA

UnitedHealth Group

Los Angeles, CA
Job Code:
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Job Details

Claims Clerk - March Vision Care - Los Angeles, CA(Job Number:731880)

Position Description:

Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.

The Claims Clerk is responsible for performing clerical activities related to claims processing, inventory tracking, inbound claims reconciliation, refund request / processing, claim intake and other clerical activities to support the Claims Department.

Positions in this function are responsible for providing expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing and adjusting claims. Authorizes the appropriate payment or refers claims to investigators for further review. Conducts data entry and re-work; analyzes and identifies trends and provides reports as necessary.

Primary Responsibilities:
  • Sends and tracks first and second refund request letters to providers
  • Processes and tracks provider refunds received
  • Reviews Customer Service retracts payment requests and process the reversal
  • Forwards claims to the health plan for processing
  • Performs address verification on return mail
  • Interfaces with Provider Relations to research and update mailing address in Eye Manager
  • Processes pending lab invoice claims
  • Reviews lab invoice claims with errors and clears for processing
  • Data enters paper claims
  • Back up to Facilities to pick up and distribute mail
  • Performs Mail Room tasks of opening, sorting, batching, counting, and scanning incoming paper claims
  • Performs Mail Room claim inventory control and prepares imaged claims for shredding in accordance with company policy
  • Runs daily inventory reports and creates ticket to Software Development for discrepancies
  • Reports end of the month claims count
  • Other duties as assigned by management
  • Limited work experience
  • Works on simple tasks using established procedures
  • Depends on others for guidance
  • Work is typically reviewed by others

Job Claim Operations
Primary Location US-CA-Los Angeles
Other Location 
Organization E&I Spec Ben - Operations
Schedule Full-time
Number of Openings 1
Apply on the Company Site

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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