Billing Denials & Reimbursement Specialist

United WestLabs, Inc.; Santa Ana (CA); On-site; USD 55,000 - 75,000; Full time

Job summary

United WestLabs, Inc. in Santa Ana, CA is seeking a Billing Problem Resolution Specialist to investigate and resolve complex billing discrepancies across patient, client, and insurer accounts. You will act as a liaison among patients, health plans, laboratories, and internal teams to ensure accurate billing and timely reimbursement.

The role emphasizes analyzing denials, researching payer policies, and improving billing processes, with a 50% on-site requirement in a full-time hybrid setting.

Qualifications

• High school diploma or equivalent.
• Minimum of two (2) years of experience in healthcare billing, medical claims processing, revenue cycle management, or insurance collections.
• Knowledge of medical terminology, insurance billing processes, and healthcare reimbursement methodologies.
• Experience researching and resolving claim denials and billing discrepancies.
• Strong analytical and problem-solving skills.
• Excellent verbal and written communication skills.
• Proficiency with Microsoft Office applications, particularly Excel.
• Ability to prioritize workload, manage multiple cases, and meet deadlines.

Responsibilities

• Investigate and resolve billing discrepancies and denials.
• Research payer policies and reimbursement issues.
• Review patient accounts for errors.
• Communicate with carriers, providers, clients, and patients.
• Analyze Explanation of Benefits (EOBs) and denial codes.
• Submit corrected claims and appeals.
• Monitor aging accounts and follow up.
• Collaborate with departments to resolve issues.
• Document all activity in billing systems.
• Identify recurring issues and suggest process improvements.
• Assist in developing billing procedures and training.
• Ensure compliance with HIPAA and regulations.
• Participate in revenue cycle optimization projects.

Skills

Analytical skills

Communication skills

Attention to detail

Time management

Education

High school diploma or equivalent

Associate's or Bachelor's degree in Healthcare Administration, Business, Finance, or related field

Tools

Microsoft Excel

Billing software

EHR/LIS systems

Job description

United WestLabs, Inc. in Santa Ana, CA is seeking a Billing Problem Resolution Specialist to investigate and resolve complex billing discrepancies across patient, client, and insurer accounts. You will act as a liaison among patients, health plans, laboratories, and internal teams to ensure accurate billing and timely reimbursement.

The role emphasizes analyzing denials, researching payer policies, and improving billing processes, with a 50% on-site requirement in a full-time hybrid setting.