Mecial Claims Specialist at Roth Staffing Companies in South El Monte, California
Posted in Other 15 days ago.
Job Description:
We are seeking a detail-oriented and experienced Medical Claims Specialist to join our team in South El Monte, CA. The ideal candidate thrives in a fast-paced environment and is skilled in processing a high volume of claims efficiently and accurately. This role involves working with a minimum of 100 claims daily while ensuring compliance with applicable regulations and policies.
Key Responsibilities:
- Review, process, and resolve medical insurance claims accurately and within established timeframes.
- Verify patient information, insurance coverage, and billing codes to ensure proper claim submission.
- Communicate with insurance companies, healthcare providers, and patients to resolve claim discrepancies or denials.
- Monitor and follow up on unpaid claims to ensure timely reimbursement.
- Maintain compliance with HIPAA regulations and other applicable healthcare laws.
- Document claim activity and updates in the system for accurate tracking and reporting.
- Collaborate with the billing and customer service teams to address and resolve issues related to claims.
- Identify trends or recurring issues and recommend process improvements.
Qualifications:
- High school diploma or equivalent; additional education in medical billing or coding is preferred.
- Minimum of 2 years of experience in medical claims processing or a related field.
- Proven ability to handle a high-volume workload (minimum of 100 claims per day) in a fast-paced environment.
- Strong knowledge of medical terminology, CPT, ICD-10 codes, and healthcare insurance procedures.
- Proficiency in using medical billing software and electronic health records (EHR) systems.
- Excellent attention to detail, organizational, and time-management skills.
- Strong written and verbal communication skills.
- Ability to analyze and resolve complex claims issues independently.
All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the California Fair Chance Act, City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, and Los Angeles County Fair Chance Ordinance. For unincorporated Los Angeles county, to the extent our customers require a background check for certain positions, the Company faces a significant risk to its business operations and business reputation unless a review of criminal history is conducted for those specific job positions.
