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Claims Assistant, South San Francisco, CA

Organization: Health Plan of San Mateo
Category: Professional
Location: South San Francisco, CA
Date Job Posted: March 5, 2020
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The Health Plan of San Mateo (HPSM), a managed care health plan, seeks a full time Claims Assistant. Provide support to assigned area(s) in the Claims Department including, but not limited to, Operations, Recovery, Provider Service Representatives and/or Quality Control.

The essential duties and responsibilities will include the following:

  • Respond to voicemails, emails, and faxes; log, distribute and track those requiring higher-level review.
  • Prepare and mail appropriate letters as required.
  • Maintain accuracy and integrity of data base and spreadsheets.
  • Enter non-claim mail into the designated database
  • Facilitate the assignment and review of provider disputes
  • Complete claim, TAR, PDR and check status requests from Providers as requested or required.
  • Research basic claim information and handle appropriately.
  • Prepare and update electronic files and records.
  • Collect information and generate/distribute required reports as needed.
  • As requested, gather information for audits.
  • Conduct internal audits as directed.
  • Maintain files including scanning and filing.
  • Administrative support as requested by staff
  • Maintain office supplies and prepare office supply purchase orders.
  • Attend and actively participate in meetings as required.
  • Perform other duties as assigned.


Education and Experience: Equivalent to a high school diploma or GED required. One (1) or more years’ clerical experience.

Knowledge of: General clerical processes and procedure. Personal computers and proficiency in Microsoft Office Suite applications, including Outlook, Word, Excel, Access and PowerPoint.

Ability to: Work in a fast-paced, highly pressured and changing environment. Follow oral and written instructions. Operate standard office equipment and personal computers. Produce basic logs and reports. Interact well with others and be a team player. Use effective oral and written communications. Organize and prioritize workload.

Compensation and Benefits

Starting Compensation Range: Depending on experience.

Benefits Information: Excellent benefits package offered, including HPSM paid premiums for employee’s Medical, Dental and Vision coverage. Employee pays a small portion of the dependent premiums (5%) for medical and dental benefits. Additional HPSM benefits include fully paid life, AD&D, and LTD insurance; retirement plan (HPSM contributes equivalent of 10% of annual compensation); holiday and vacation pay; tuition reimbursement plan; onsite fitness center and more.

How to Apply

Application Process: To apply, submit a resume and cover letter with salary expectations to: Health Plan of San Mateo, Human Resources Department, 801 Gateway Blvd., Suite 100, South San Francisco, CA 94080 or via email: or via fax: (650) 616-8039. File by: Continuous until filled. The Health Plan of San Mateo is proud to be an Equal Opportunity Employer and encourages minority candidates of all backgrounds to apply.

Submissions without a Cover Letter and Salary Expectations may not be considered.

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