Claims Coordinator: Hoag Clinic Claims & Enrollment at Hoag Health System

Job Description

Primary Duties and Responsibilities

• The Claims Coordinator is responsible for pre-screening and batching correspondences received in the Hoag Clinic MSO mailroom.
• The Claims Coordinator coordinates the hand-offs and completions of retro-authorization requests, provider update requests, and eligibility verification requests between the Claims team and internal and external partners.
• Scan paper claims into electronic format.
• Ensures all documents are counted, date stamped, tracked, and reconciled.
• Assists with daily pick-ups and distribution of mail and correspondences from dedicated post office boxes, fax machines, e-fax, secure file transfers, as well as sending provider EOBs, member letters, misdirected claims, and other letters sent by the Claims team.
• Assists in making and answering phone calls to provider/billing offices when needed.
• Performs other duties as assigned.
  
  

Qualifications

Education and Experience

• High School Diploma or equivalent
• 1 year of experience in a healthcare environment
• Knowledge of HMO/managed care regulatory guidelines
• Microsoft Word, Excel, Typing/Data Entry
  
  

Preferred

• Experience with Epic Tapestry system
• 2 years claims mailroom experience, OCR processing
  
  

License Required

N/A

License Preferred

N/A

Certifications Required

N/A

Certifications Preferred

N/A

About Us

Hoag Memorial Hospital Presbyterian is a nonprofit regional health care delivery network in Orange County, California, consisting of three acute-care hospitals with sixteen urgent care centers, eleven health centers and a network of more than1,800 physicians, 100 allied health members, 8,000 employees, and 2,000 volunteers. More than 30,000 inpatients and 550,000 outpatients choose Hoag each year.

For over 70 years, Hoag has delivered a level of personalized care that is unsurpassed among Orange County’s health care providers. Since 1952, Hoag has served the local communities and continues its mission to provide the highest quality health care services through the core strategies of quality and service, people, physician partnerships, strategic growth, financial stewardship, community benefit and philanthropy.

Hoag offers a comprehensive blend of health care services including six institutes providing specialized care in the areas of cancer, heart and vascular, neurosciences, women's health, orthopedics, and digestive health through our institutes.

Hoag was the highest ranked hospital in Orange County in the 2024-2025 U.S. News &World Report, the only Orange County hospital ranked in the top 10 for California. The organization was ranked the #5 hospital in the Los Angeles Metro Area and the #10 hospital in California.

To learn more about Hoag’s awards and accreditations, visit: https://www.hoag.org/about-hoag/awards-accreditations/ .

Hoag is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind. Hoag is committed to the principle of equal employment opportunity for all employees and providing employees with a work environment free of discrimination and harassment. Hoag hires a diverse group of people in a manner that allows them to reach their full potential in the pursuit of organizational objectives.