Crystal Stairs
  • 27-Mar-2018 to 27-May-2018 (PST)
  • Provider Services
  • Los Angeles, CA, USA
  • Full Time

Provider Services - Claims Administrator

What We're Looking For:

We are seeking a Claims Administrator who will be responsible for handling all payment-related matters to providers of child care services, both licensed and exempt, covered under the CalWORKs and Alternative Payment Child Care Subsidy Programs. The ideal candidate will have the following responsibilities:

  1. Evaluate and review documentation for provider claims in accordance with contractual requirements, regulations and agency policies and procedures.
  2. Identify, track and report processing discrepancies to appropriate staff and amend all discrepancies by processing payment adjustments/authorizations within specified timeframes.
  3. Assist with the completion of all monthly reports that are necessary to ensure agency compliance with provider payments.
  4. Research and resolve provider payment inquiries and provide all necessary follow-up and responses.
  5. Review claims for accuracy and insure all required documentation is appropriate, complete and data entered before each scheduled provider payment export.
  6. Maintain a running log of all claim returns, adjustments and stop payments, the action taken and current status.
  7. Work with the management team to identify, implement and train staff on processes that will increase work efficiency and productivity
  8. Participate in work groups, committees and ad hoc groups
  9. Perform other duties as assigned.

EXPERIENCE, KNOWLEDGE, SKILLS AND ABILITIES YOU SHOULD POSSESS:

  • Bachelor of Science/Arts degree from an accredited university with a focus on Accounting, Business, or Human/Social Services preferred; related work experience in claims/human services may be substituted for college level education.
  • Minimum of one to two years experience in a claim or billing environment; preferably worked with child care providers and parents receiving subsidized child or social support services.
  • Must have knowledge of County, State and Federal provider contract requirements for Alternative Payment and Child Care Subsidy Programs.
  • Must have excellent communication and customer relations skills.
  • Requires analytical and problem solving abilities.
  • Requires considerable accuracy, attention to details and ability to produce in a timely manner.
  • Must be flexible and able to multi-task while working in a collaborative, team environment.
  • Must have ability to work with diverse groups.
  • Requires the exercise of some independent judgment and discretion in analyzing facts and circumstances and in the determination of actions to be taken within the limits of standard practice.

Crystal Stairs is committed to building and sustaining a diverse workforce and culture. As part of this commitment, Crystal Stairs provides equal opportunity in all of our employment practices, including selection, hiring, promotion, transfer, and compensation, to all qualified applicants and employees without regard to race, color, medical condition as defined by state law, ancestry, religion, sex, national origin, age, marital status, sexual orientation, gender, ethnic group identification, mental or physical disability, pregnancy, childbirth and related medical conditions, or any other legally protected status.

   For more information about Crystal Stairs, please visit our website at: www.crystalstairs.org

Crystal Stairs
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