Document Control Clerk

Network Support Services is part of the St. Joseph Health System providing support services to St. Joseph and St. Jude Hospitals in Orange County and other hospitals in California.  We are inspired by and dedicated to the Mission and Values of the Sisters of St. Joseph of Orange:  Service, Dignity, Excellence and Justice.

 

At Network Support Services you will enjoy a stable and successful work environment.  We currently have anoutstanding opportunity for you as a Document Control Clerk

 

This position is responsible for:

 

Working under the direction of the Manager, Document Control, this position is responsible for sorting, opening, date stamping, batching and distributing all incoming business, professional and institutional HMO claims from providers within established guidelines set forth in the Claims Industry including but not limited to HIPPA, AB1455, PHI, HCFA and ERISA are meet

 

Essential Functions:

 

? Accurately sorts business mail and claims as established by policy and procedure

? Accurately date stamps all incoming business mail and claims

? Accurately and timely batches claims according to network, product, and oldest date on hand with 24 hours of receipt

? Accurately counts and records all claims count

? Properly completes batch cover sheets for tracking and assignment, production, and compliance according to batching criteria

? Researches claims product-fund and network for proper batching

? Routes claims to Eligibility Department for membership verification

? Sorts and batches incoming fax information

? Demonstrate dependability

? Work with Department Manager to expedite batches that are greater than 30 days from date received

? Maintain a positive attitude with changing conditions

? Possess strong problem solving skills

? Inventory Control Clerk backup to include logging, assigning and reconciling batches

? Assist on retrieval and coping of claims for health plan audits provided by the Compliance Department

? Maintain 95% or better on Monthly Audit Results

 

Education:

High School Diploma or equivalent.

 

Experience:  At least 6 months of General Clerical within an office environment.  Previous experience in the Health Care Industry a plus.  Familiar with Microsoft windows and an email system.