Hybrid Health Claims & Customer Service Specialist

Career Strategies; Santa Monica (CA); Hybrid; USD 56,000 - 65,000; Full time

Benefits offered by this job

Salary range

Health insurance

401K match

Pension after 5 years

PTO 2–5 weeks

Holiday pay

Sick pay

Career advancement

Job summary

Career Strategies is seeking a Claims Specialist/Analyst to be a customer-facing role in a Health Organization. You will process health insurance claims, answer calls, and ensure eligibility, claims, and policy adherence while resolving inquiries with clear communication.

The position is hybrid; most work is remote, but you must reside in the Los Angeles County area to be considered. Requires bachelor’s degree in healthcare-related field and 4+ years in claims and heavy call center work.

Qualifications

• Bachelor’s degree in a healthcare, math, engineering or related field or equivalent work experience.
• Minimum of four years of claims processing experience preferred.
• Minimum of four years in heavy call center environment.
• Proficient with Microsoft Office (Word, Excel, Outlook).
• Strong customer service and verbal/written communication skills.

Responsibilities

• Elevate and protect the Health Organization’s reputation by delivering world-class customer service in a high-call-volume environment.
• Answer incoming calls to determine the type of assistance needed (benefits, eligibility, billing, authorizations, EOBs).
• Communicate clearly with customers and collaborate to resolve issues.
• Review and research healthcare claims across systems to verify data required for processing.
• Ensure proper health benefits are applied by following processing policies and guidelines.

Skills

Customer service

Call center experience

Communication skills

Medical terminology

Education

Bachelor’s Degree in Healthcare, Math, Engineering or related field

Tools

Microsoft Word

Microsoft Excel

Microsoft Outlook

Job description

Career Strategies is seeking a Claims Specialist/Analyst to be a customer-facing role in a Health Organization. You will process health insurance claims, answer calls, and ensure eligibility, claims, and policy adherence while resolving inquiries with clear communication.

The position is hybrid; most work is remote, but you must reside in the Los Angeles County area to be considered. Requires bachelor’s degree in healthcare-related field and 4+ years in claims and heavy call center work.