Healthcare Claims Support Specialist

Innovative Integrated Health, Inc.; California; Remote; USD 58,000 - 76,000; Full time

Benefits offered by this job

401(k)

Dental insurance

Employee assistance program

Employee discount

Flexible spending account

Health insurance

Health savings account

Life insurance

Paid sick time

Paid time off

Referral program

Retirement plan

Vision insurance

Job summary

Innovative Integrated Health, Inc. in California is seeking a Claims Customer Service Representative (CCSR) to serve as a critical liaison between our company and external healthcare providers.

You will handle incoming inquiries about medical and dental claims, research and resolve status, denials, and payment discrepancies with professionalism and accuracy. The role requires strong communication, ability to multitask in a fast-paced environment, and strict adherence to HIPAA and regulatory

Qualifications

• Minimum two years of work experience in a healthcare call center or claims processing.
• Experience responding to provider inquiries via phone and email.
• Knowledge of ICD-10, CPT, HCPCS codes and EOPs.
• Ability to maintain HIPAA confidentiality and accuracy.
• Strong written and verbal communication.

Responsibilities

• Respond to Provider inquiries regarding medical and dental claims via phone and email.
• Research and resolve issues related to claims status, denials, and payment discrepancies.
• Maintain up-to-date knowledge of benefit plans, claim adjudication guidelines, coding requirements, and HIPAA regulations.
• Accurately document all interactions and claim actions in the Company system by compliance standards.
• Maintain accurate records of interactions and claim resolutions.
• Communicate complex benefit details in a clear and concise manner to Providers.
• Collaborate with internal departments to facilitate resolution of claims-related issues.
• Recommend process improvements to enhance service delivery and improve Provider experience.

Skills

Microsoft Office

Claims processing

HIPAA regulations

Communication skills

Multi-tasking

Regulatory compliance

Education

High School Diploma or GED

Tools

Claims processing software

Job description

Innovative Integrated Health, Inc. in California is seeking a Claims Customer Service Representative (CCSR) to serve as a critical liaison between our company and external healthcare providers.

You will handle incoming inquiries about medical and dental claims, research and resolve status, denials, and payment discrepancies with professionalism and accuracy. The role requires strong communication, ability to multitask in a fast-paced environment, and strict adherence to HIPAA and regulatory