Provider Claims Specialist (Remote)

Innovative Integrated Health Inc; Fresno (CA); Remote; USD 36,000 - 54,000; Full time

Job summary

Innovative Integrated Health Inc is seeking a Claims Customer Service Representative to handle provider inquiries about claims, denials, and payment discrepancies. You will document interactions in the system, stay updated on benefit plans and guidelines, and work with internal teams to resolve issues with accuracy and HIPAA compliance.

The role requires strong communication, multitasking, and the ability to manage competing priorities in a fast-paced healthcare environment.

Qualifications

• Strong written and verbal communication skills and discretion.
• Experience handling healthcare claims and inquiries.
• Familiarity with HIPAA and privacy regulations.

Responsibilities

• Respond to provider inquiries about medical and dental claims via phone and email.
• Research and resolve issues related to claims status, denials, and payments.
• Document all interactions accurately in the company system per compliance standards.
• Maintain knowledge of benefit plans and claim adjudication guidelines.
• Collaborate with internal teams to resolve claims-related issues.

Skills

Excellent communication

Multi-tasking

HIPAA knowledge

MS Office

Detail-oriented

Education

High School Diploma or GED

Tools

Claims processing software

EHR system

Job description

Innovative Integrated Health Inc is seeking a Claims Customer Service Representative to handle provider inquiries about claims, denials, and payment discrepancies. You will document interactions in the system, stay updated on benefit plans and guidelines, and work with internal teams to resolve issues with accuracy and HIPAA compliance.

The role requires strong communication, multitasking, and the ability to manage competing priorities in a fast-paced healthcare environment.