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Recovery Services Third Party Liability Coordinator II

Job Category:  Claims
Department:  Claims Integrity
Location: 

Los Angeles, CA, US, 90017

Position Type:  Full Time
Requisition ID:  8032

 

Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure our members get the right care at the right place at the right time.

Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.

As a condition of employment, L.A. Care requires a COVID-19 vaccine. This requirement includes our remote workforce. If you would like to request an exemption, L.A. Care has implemented a process to consider exemptions, for documented medical conditions and sincerely held religious beliefs. L.A. Care will review all exemption requests prior to proceeding with the recruitment process.

Job Summary

The Recovery Services Third Party Liability (TPL) Coordinator II is responsible for completing claims information and coordination with the Department of Health Services, External Insurance Carriers and La Care Health Plan for Third Party Liability. Maintain and support the requirements for TPL in order to meet the need of State Department of Health Services (SDHS's) process of appropriate reimbursement.

 

Maintain the turn around time of all related reporting and notification requirements with regard to TPL guidelines. Assist in other duties assigned within the Claims Department including process improvement.

Duties

Coordinate request and submission of Third Party Liability documents to Department of Health Services. Assist SDHS in the retrieval of TPL information form the Plan Partners and its PPG's. (15%)

 

Support active communication between the Plan Partners and SDHS to ensure a cohesive working relationship. This includes responding to questions from SDHS and requested claims information from Plan Partners. (25%)

 

Photocopying; answering phone calls from DHCS, Plan partners and other departments. Support Claims Department activities as assigned including process improvement efforts. (40%)

 

Working with other departments for the purpose of L.A. Care maintaining compliance with regulatory agencies. (10%)

 

Perform other duties as assigned. (10%)

Education Required

High School Diploma/or High School Equivalency Certificate

Education Preferred

Experience


Required:
At least 0-1 years experience in TPL experience in coordination of information exchange with third party liability cases.

 

At least 0-1 years data entry experience, at least 0-1 years experience in process documentation and process development, healthcare background.

Skills

Required:
Excellent interpersonal and written communication skills.

 

Computer literate, excellent MS office skills and professional working knowledge of MS Excel.

Licenses/Certifications Required

Licenses/Certifications Preferred

Required Training

Additional Information

 

L.A. Care offers a wide range of benefits including

  • Paid Time Off (PTO)
  • Tuition Reimbursement
  • Retirement Plans
  • Medical, Dental and Vision
  • Wellness Program
  • Volunteer Time Off (VTO)

 

At L.A. Care, we value our team members’ safety. In order to keep our work locations safe, each employee is required to self-screen for symptoms prior to entering any L.A. Care location each day. L.A. Care and all of its staff are required to comply with all state and local masking orders. Therefore, when on-site at any L.A. Care location, employees are expected to wear a mask in areas where physical distancing cannot be managed.


Nearest Major Market: Los Angeles

Job Segment: Liability, Data Entry, Claims, Insurance, Administrative

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