Senior Healthcare Claims Specialist

CareMore Health Management Services, LLC; Cerritos (CA); On-site; USD 36,000 - 55,000; Full time

Job summary

CareMore Health Management Services, LLC is seeking a Claims Support Specialist III to perform advanced claims administration, review documentation, and resolve non-routine issues across billing, coding, clinical, and payer teams.

You will identify claim trends, reduce denials, support audits, and participate in system enhancements and process improvements to strengthen revenue cycle efficiency.

Responsibilities

• Review and validate complex healthcare claims for payer requirements and documentation standards.
• Investigate non-routine edits, denials, and discrepancies in coordination with internal teams.
• Analyze recurring issues and recommend workflow improvements to reduce denials.
• Monitor claim work queues and prioritize time-sensitive submissions.
• Support audits and quality assurance by identifying processing errors and ensuring compliance.

Job description

CareMore Health Management Services, LLC is seeking a Claims Support Specialist III to perform advanced claims administration, review documentation, and resolve non-routine issues across billing, coding, clinical, and payer teams.

You will identify claim trends, reduce denials, support audits, and participate in system enhancements and process improvements to strengthen revenue cycle efficiency.