Data Entry Technician (Claims)

Company Overview:Sunshine Enterprise is an industry-leading Staffing and Recruitment Firm. Our clients are fortune 500 companies, high growth start-up companies, government, and private equity firms, and lead professional services firms. As a leading force in the business landscape, we take pride in bringing together great people and great organizations by fostering a work environment that values creativity, diversity, and growth.If you're ready to embark on a rewarding career journey with a company that prioritizes its employees, explore our current job opportunities below.

Position Summary:

The Data Entry Tech (Claims) will ensureconsistent and efficient operations and assist with the day-to-dayresponsibilities for Claims Administration. The Data Entry Techs should beattentive to detail and capable of assisting with day-to-day data entry tasksincluding processing, organizing, and other services. This individual isresponsible and communicative with staff. They will be performing routine andcomplex data entry and maintenance functions.

Position Responsibilities

• Performs data entry of various documents, data sources and files.
• Conducts outreach calls for data entry purposes as needed.
• Assists with mailing information to members.
• Provides resource and mailing support for teleworking staff as applicable.
• Alerts supervisor of any issues that impact production and quality.
• Ensures all Protected Healthcare Information (PHI) is locked at the end of the day.
• Completes other projects and duties as assigned.

Possesses the Ability to:

• Use data entry common techniques.
• Maintain organized files and be detail oriented.
• Analyze incoming mail and determine an appropriate course of action.
• Work independently and as part of a team.
• Communicate clearly and concisely, both orally and in writing.
• Utilize computer and appropriate software (e.g., Microsoft Office: Excel, Outlook, PowerPoint, Word) and job-specific applications/systems to produce correspondence, charts, spreadsheets and/or other information applicable to the position assignment.

Experience & Education

• High School diploma or equivalent required.
• 1 year of data entry experience required.
• Bilingual in English and in one of the defined threshold languages preferred.
•  Experience in an HMO, Managed Care or Medi-Cal setting preferred.
• An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above is also qualifying.

Preferred Qualifications

• Experience in claims operation within a managed care or health care industry.

Knowledge of:

• Medi-Cal claim forms: CMS1500, UB04 and 25-1.
• Standard medical terminology, Current Procedure Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), revenue codes and International Classification of Diseases (ICD-10)