Claims Specialist

Healthcare Support Staffing; South San Francisco (CA); On-site; USD 25,003 - 35,610; Full time

Benefits offered by this job

Excellent benefits

Referral bonuses up to $100

Immediate opening

Job summary

A national healthcare recruiting firm is seeking an experienced Claims Specialist to manage provider dispute resolutions. The ideal candidate has over 2 years of experience in medical claims and is familiar with the reimbursement process. This position offers a pay rate of up to $22 per hour and benefits. The role is Monday to Friday from 8:00 am to 5:00 pm, with the potential for a Temp-to-Perm opportunity.

Qualifications

• 2+ years’ experience working with medical claims in a claims examiner or provider services role.
• Experience in a health services and/or managed care setting.
• Proficient in navigating medical claims and reimbursement processes.

Responsibilities

• Review and process provider dispute resolutions per defined timeframes.
• Adjust claims and compute interest as required.
• Maintain and track disputes through grievance and appeals database.

Skills

Medical claims knowledge

Reimbursement process understanding

Experience with Microsoft Office

Job description

Overview

HealthCare Support Staffing, Inc. (HSS) is a proven industry-leading national healthcare recruiting and staffing firm. HSS places talented healthcare professionals in clinical and non-clinical positions with healthcare facilities throughout the United States, including Fortune 100 Health Plans, mail order pharmacies, medical billing centers, hospitals, laboratories, surgery centers, private practices, and more. HSS maintains strong relationships with top providers in healthcare and offers fast access to career opportunities. Connect with a Professional Recruiting Consultant to explore opportunities.

Job Description

Are you an experienced Claims Specialist looking for a new opportunity with a prestigious healthcare company? Do you want to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions, this is the position for you!

Responsibilities

• Review and process provider dispute resolutions according to state and federally defined timeframes.
• Research issues; adjust claims, including computation of interest owed as appropriate.
• Send written responses to providers in a professional manner within required timelines.
• Forward cases to the IRE or the DMHC as needed.
• Answer provider inquiries regarding disputes that have been submitted.
• Maintain and track disputes through HPSM’s grievance and appeals database.
• Maintain knowledge of claims procedures and all appropriate reference materials; participate in ongoing training as needed.

Qualifications

• 2+ years’ experience working with medical claims (Example: Claims Examiner, Claims Provider Services Rep).
• Must have experience in a health services and/or managed care setting.
• Must be well-versed in medical claims and reimbursement process.
• Experience with Microsoft Office software.

Additional Information

Advantages of this Opportunity

• Hours for this Position: Monday- Friday 8:00am to 5:00pm
• Pay up to $22 per hour, negotiable
• Immediate opening, Temp-to-Perm position with excellent benefits offered.
• If you know of someone looking for a new opportunity, please pass along the information. We offer referral bonuses of up to $100.00 for each placement.