Claims Customer Service Representative

NAMM California a leader in the Managed Care Industry has an immediate opening for a Claims Customer Service Representative in our Rancho Cucamonga Office.Responsible for representing organization and functioning as the key communication vehicle for organization?s HMO and fee-for-service members.  Educates and informs customers of organization?s programs, services and functions in a manner that promotes company?s commitment to superior customer service.  Position proactively and reactively seeks appropriate solutions to potential and existing membership issues and works to effectively resolve current member questions and complaints.  Educational requirements: Some College Business Courses preferred.Educational requirements: High School Graduate or G.E.D. College level business/secretarial classes.Experience needed: Minimum of 1 - 2 years experience in Medicare and HMO claims processing. Working knowledge of CPT, ICD-9 coding, medical terminology, and UB92 and HCFA 1500 claim formatsWorking knowedge CMS(HCFA) and DMHC guidelinesAbility to interpret provider and health plan contractsPC proficient in a windows environmentAbility to retain composure in stressful situationsKnowledge of standard billing practices.