On-site Valencia: Healthcare Claims Resolution Specialist

Shield HealthCare - Medical Supplies for Care at Home Since 1957; Santa Clarita (CA); Vor Ort; USD 22.000 - 32.000; Vollzeit

Benefits dieser Stelle

Medical, Dental, and Vision Insurance

401(k) with Company Match

Sick and Vacation Days

Flexible Spending Account

Life & Disability Insurance

Education Assistance

Zusammenfassung

Shield HealthCare, located in Valencia, CA, is hiring a Healthcare Claims Associate to research claim denials and underpayments, and to prepare corrected claims and appeals to meet billing guidelines. This is an on-site role with a focus on improving accounts receivable outcomes.

The ideal candidate has a high school diploma, 2 years in medical billing or collections, proficiency with Microsoft 365, and preferably a medical billing certification.

Qualifikationen

• High school diploma or equivalent.
• 2 years in a medical billing or collections role or similar experience.
• Proficiency in Microsoft 365 (Excel, Outlook, PowerPoint, Word, SharePoint, Teams) and other standard productivity tools.
• Medical billing and coding certification from accredited program preferred
• Familiarity with various medical insurance payer guidelines/billing requirements preferred
• Experience working in Excel
• Strong written and verbal communication abilities
• Proven ability to research and solve problems
• Strong organizational skills, detail oriented, thorough, accurate, with the ability to manage multiple priorities and respond to changing business needs

Aufgaben

• Reviews the claims billing processes, looking for ways to achieve positive financial outcomes
• Identify problems and find solutions to claim rejections, denials, and underpayments
• Inform management of trends in billing issues related to internal processes, clearinghouse claims processing, and third-party requirements
• Research denials and billing requirements of third-party carriers utilizing EOBs, provider manuals, web portals, and phone contact
• Adjudicate claims issues by preparing and submitting corrected claims and appeals
• Recommend claims for write-off when billing requirements are not met
• Effectively communicate by phone, email, and in-person with third-party payers and internal staff to resolve billing issues and establish positive relationships
• Accurately update and notate accounts receivable system, collections notepad, and customer accounts
• Remain updated on company policies and procedures and third-party payer guidelines, bulletins, and billing requirements
• Ensure appropriate follow-up and timely completion of assignments
• Completes special projects as assigned, supporting team and organizational objectives and continuous improvement initiatives

Kenntnisse

Microsoft 365

Research & problem solving

Communication skills

Organizational skills

Ausbildung

High school diploma

Medical billing certification

Tools

Excel

Jobbeschreibung

Shield HealthCare, located in Valencia, CA, is hiring a Healthcare Claims Associate to research claim denials and underpayments, and to prepare corrected claims and appeals to meet billing guidelines. This is an on-site role with a focus on improving accounts receivable outcomes.

The ideal candidate has a high school diploma, 2 years in medical billing or collections, proficiency with Microsoft 365, and preferably a medical billing certification.