Transaction Entry Clerk

 
Position: Transaction Entry Clerk

Job ID: 163206

Location: US-TX-Houston

Department: Claims - Administration

Talent Area: Administrative Support

Full/Part Time: Full-Time

Regular/Temporary: Regular

Shift: 8a - 5p

About Texas Children's Hospital

Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.     To join our community of 14,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org. At Texas Children’s Hospital, diversity, equity, and inclusion are at the core of our values and mission for the women and children that we serve. We are committed to providing a diverse and inclusive work environment for all faculty, staff and learners throughout our organization. We believe that each member of our one amazing team provides enrichment that allows us to create a lasting legacy for future employees of this great organization.      Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved. 

Summary:

We are searching for a Transaction Entry Clerk — someone who works well in a fast-paced setting. In this position, you will enter all claims received for adjudication. You’ll open, sort and scan daily mail, data enter claims into the system, file, verify and update Coordination of Benefits (COB) information in the Claims system, create form letters and other duties as assigned. 

  

Think you’ve got what it takes? 



Responsibilities :

  • Open, sort and scan daily mail received.
  • Data enters claims in the system
  • Verify Coordination of Benefits (COB) information in an external vendor's system and update verified information in a web based application
  • Pull claims from filed batches, refile, work assigned work queues daily, print faxes and other duties and tasks as assigned
  • Create form letters for rejected claims
  • Complete special projects as requested
  • Open, sort into various categories, scan and data enter claims and miscellaneous documents into data entry system for uploading into claims processing system. Claims that are rejected for missing required information must be returned to the provider within 3 days from the date rejected
  • Sort, scan and key claims


Qualifications:

  • Being fully vaccinated against COVID-19, including any booster dose(s) of the COVID-19 vaccine recommended by the Centers for Disease Control when eligible, is required for all employees at Texas Children’s, unless approved for a medical or religious exemption. 
  • S. Diploma or GED Required 
  • 1 Year of Data Entry Experience Required 
  • Claim Entry Experience Preferred 


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