Call Center Representative - Mission Plaza OB

Administrative Support
Heritage Healthcare
R316235 Requisition #

We are looking for a Call Center Representative with the HSS NSS Claims at St. Joseph Heritage Healthcare.

Location: Mission Viejo, CA

Schedule: Full-Time

Shift: 8 HourDay

Job Summary: 

Working under the direction of the Manager, Claims, this position is responsible for answering and logging incoming calls into IDX from providers, members and healthplans regarding claims status, eligibility, and authorization issues and request adjustments when appropriate.

  • Strong analytical and problem solving skills.
  • Requires good written and verbal communications skills to communicate effectively with individuals at all levels of the organization.
  • Ability to work under general supervision.
  • Must be able to work as a team player and have a professional demeanor.
  • Organization and prioritization skills.
Minimum Position Qualifications:
Education: Requires High school diploma or equivalent.
  • One (1) year of experience in a medical claims customer service unit within a healthplan, medical group or IPA setting or Two (2) years medical billing verification within a medical group, IPA, or billing office.
  • Familiarity with computerized claims processing/transaction system and medical coding (CPT, ICD9 and HCPCS).
  • Knowledge of HIPAA and AB1455
Computer Skills: Familiar with Microsoft windows operating environment.  Strong knowledge of MS Excel.

Other: 10-key by touch

Preferred Position Qualifications:


Experience: Previous experience within the Health Care Industry

Computer Skills: Previous IDX experience.
St. Joseph Health - Mission Heritage Medical Group is one of California's most respected medical groups. With over 3,000 employees and 75 locations throughout California, including, Northern California, Orange County, High Desert and Los Angeles County, Mission Heritage Medical Group has been continually recognized as a leader in quality, customer service and information technology. This kind of success is the result of team work, a commitment to excellence and a strong adherence to the organization's mission, vision and values.

St. Joseph Health - Mission Heritage Medical Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Mission Heritage Medical Group complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

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