CLAIMS SPECIALIST

performs complex clerical and accounting functions for insurance billing, including verification of invoice information, maintenance of third-party billing records, and resolution of denials. Follows up on submitted claims and patient billing, reprocesses claims, identifies inaccuracies, and collects payment information. Works with others in a team environment and handles all assigned tasks within a timely fashion.

PRINCIPAL DUTIES AND RESPONSIBILITIES

Monitors submitted claims; follows up on unpaid claims, and initiates dialogue with insurance companies Participates in the development of organization procedures and update of forms and manuals Reviews accounts for possible assignments to collections and makes recommendations to the Billing Team Leader also prepares information for the collection agency Review and process medical insurance claims for accuracy, completeness, and compliance with payer guidelines. Performs various collection actions including contacting patients by phone, correcting and resubmitting claims to third-party payers Works in conjunction with the other departments to ensure timely handling of necessary actions Follow up with insurance companies regarding claim status, payment discrepancies, and appeals. Ensure compliance with HIPAA regulations and all applicable healthcare billing standards. Participates in educational activities and attends scheduled staff meetings Investigate and resolve denied, rejected, or underpaid claims. Stay current on insurance policies, reimbursement guidelines, coding updates, and regulatory changes. Performs miscellaneous job-related duties as assigned Excellent analytical, problem-solving, and organizational skills. Strong attention to detail and accuracy. Ability to manage multiple priorities and meet deadlines in a fast-paced environment. Demonstrates strong professionalism, punctuality, dependability, and results oriented. We are committed to creating a diverse and inclusive workplace and welcome applicants from all backgrounds and experiences.

Job Type:

Full-time Pay:

$25.00 - $27.00 per hour

Benefits:

401(k) 401(k) matching Dental insurance Health insurance Paid time off Vision insurance

Experience:

Medical Billing/Claims:

2 years (Required)

Location:

Costa Mesa, CA 92626 (Required) Ability to

Commute:

Costa Mesa, CA 92626 (Required)

Work Location:

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