Benefits Coordinator

Benefits Coordinator


Reports to AMM Vice President of Operations. Individual is responsible for supporting aspects of benefit configuration from execution to final claims adjudication. Will work closely with Claims to support the workflow of benefits within Ezcap. Will update benefits from all contracted healthplans while working with CPT, ICD9, ICD10, RBRVS, and HCPCS code sets.


Responsible for adding options in EzCap for Eligibility Verify benefits for referrals in Cerecons Verify benefits for Claims and Customer Service Review and update benefits in EzCap Responsible for auditing claims prior to each check run on copayments Responsible for member matching in AMM Patient Center for Pharmacy files by health plan Responsible for member matching AMM Patient Center for Laboratory files by health plan Download Benefits Online Level 2 Pend Claims Report Responsible for claims with different option report Responsible for Health plan Audits for claims manager for Claims copay


Experience with benefits configuration and interpretation. Individual should also demonstrate the ability to work with all levels of staff within AMM. Must be highly organized and able to perform multiple tasks efficiently, be computer literate and must be very knowledgeable of benefits. Must have knowledge CPT, ICD9, ICD10, RBRVS, and HCPCS code sets. Preferred experience with all lines of business such as Medicare, Medi-Cal, and Commercial benefits. Ability to work in a fast-paced environment. Knowledge of software applications such as Ezcap is a plus.