SMB Examiner I

Evolving Solution Services; Santa Ana (CA); On-site; USD 22,000 - 26,000; Full time

Benefits offered by this job

Competitive pay

Great culture

Impactful work

Job summary

WeShare is seeking a Shared Medical Bills Examiner in Santa Ana, CA to review, process, and resolve medical bills submitted through our shared services model. This role is ideal for someone looking to build a career in healthcare operations, billing, or claims processing.

You’ll work with providers, members, and internal teams to ensure bills are handled accurately and efficiently in line with WeShare guidelines.

Qualifications

• High school diploma or equivalent.
• 6+ months of experience in customer service, administrative, or healthcare support.
• Strong attention to detail and accuracy in data entry.
• Ability to manage a high volume of tasks in a fast-paced environment.
• Clear and professional communication skills, both written and verbal.
• Comfort working with computer systems, databases, and Microsoft Office.

Responsibilities

• Review incoming shared medical bills for accuracy, completeness, and eligibility under WeShare guidelines.
• Verify member information, provider details, coding accuracy, and supporting documentation.
• Process bills in a timely manner while adhering to internal policies and regulatory requirements.
• Identify discrepancies, missing information, or billing errors and follow up with providers or internal teams to resolve them.
• Investigate and resolve issues related to denied, incomplete, or disputed bills.
• Communicate with providers to clarify billing questions, coding issues, or documentation needs.
• Coordinate with internal teams to ensure proper adjudication and sharing decisions.
• Track outstanding items and ensure timely resolution.
• Accurately enter billing details, notes and updates into systems.
• Maintain organized, detailed records of bill status, provider communications, and resolution steps.
• Ensure all documentation meets internal quality standards.
• Assist providers and members with questions related to bill status, eligibility, sharing guidelines, and required documentation.
• Deliver clear, courteous, and professional communication across phone, email, and chat.
• Help educate providers on WeShare processes to reduce future billing issues.
• Follow established workflows to ensure consistency and accuracy in bill processing.
• Escalate complex or unusual cases to senior team members as needed.
• Support continuous improvement by identifying recurring issues or process gaps.

Skills

Attention to detail

Data entry

Communication skills

Written and verbal communication

Time management

Education

High school diploma or equivalent

Tools

Microsoft Office

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Santa Ana, CA, US

5 days ago Requisition ID: 1095

Salary Range: $24.00 To $24.00 Annually

Shared Medical Bills Examiner

Healthcare is increasingly unaffordable for many Americans. For those who can afford it, they are in a health insurance system that has become more confusing, restrictive, and lower value with each passing year. Here at WeShare our mission is to bring better healthcare to America at a better price. We offer consumers a member-to-member health sharing program that is much more cost effective than standard health insurance while providing access to over 1.2 million physicians across the country. Come join us on this important journey to create the next generation of healthcare!

WeShare is a rapidly growing faith-based nonprofit that strives to do good while delivering great and affordable healthcare. The company is led by senior executives with an extensive background in both for-profit and not-for-profit enterprises. If you have a bias for action, enjoy challenges, and love creating impact in a massive industry, WeShare might be the place for you!

About this role

The Shared Medical Bills Examiner plays a key role in reviewing, processing, and resolving medical bills submitted through WeShare’s shared services model. This role is ideal for someone looking to build a career in healthcare operations, medical billing, or claims processing. You’ll work closely with providers, members, and internal teams to ensure bills are handled accurately, efficiently, and in alignment with WeShare’s guidelines.

Key Responsibilities

Medical Bill Review & Processing

• Review incoming shared medical bills for accuracy, completeness, and eligibility under WeShare guidelines
• Verify member information, provider details, coding accuracy, and supporting documentation
• Process bills in a timely manner while adhering to internal policies and regulatory requirements
• Identify discrepancies, missing information, or billing errors and follow up with providers or internal teams to resolve them

Billing Resolution & Follow-Up

• Investigate and resolve issues related to denied, incomplete, or disputed bills
• Communicate with providers to clarify billing questions, coding issues, or documentation needs
• Coordinate with internal teams to ensure proper adjudication and sharing decisions
• Track outstanding items and ensure timely resolution

Data Entry & Documentation

• Accurately enter billing details, notes and updates into systems
• Maintain organized, detailed records of bill status, provider communications, and resolution steps
• Ensure all documentation meets internal quality standards

Provider & Member Support

• Assist providers and members with questions related to bill status, eligibility, sharing guidelines, and required documentation
• Deliver clear, courteous, and professional communication across phone, email, and chat
• Help educate providers on WeShare processes to reduce future billing issues

Quality & Compliance

• Follow established workflows to ensure consistency and accuracy in bill processing
• Escalate complex or unusual cases to senior team members as needed
• Support continuous improvement by identifying recurring issues or process gaps

Required Qualifications

• High school diploma or equivalent
• 6+ months of experience in customer service, administrative, or healthcare support role
• Strong attention to detail and accuracy in data entry
• Ability to manage a high volume of tasks in a fast-paced environment
• Clear and professional communication skills, both written and verbal
• Comfort working with computer systems, databases, and Microsoft Office

Preferred Qualifications

• Experience in medical billing, claims processing, or healthcare administration
• Familiarity with CPT, ICD-10, or HCPCS codes
• Understanding of healthcare billing workflows or insurance processes
• Strong organizational skills and ability to prioritize effectively
• Customer service mindset with a focus on problem-solving

What we offer

• Competitive Hourly
• Ability to make important enhancements to the Healthcare industry.
• Great culture where you work with the founders and key stakeholders in a relaxed, but innovative atmosphere.

UHSM is an Equal Opportunity Employer. Our business is fast-paced and will continue to evolve. As such, the duties and responsibilities of this role may be changed as directed by the Company at any time to promote and support our business needs. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, gender expression, national origin, protected veteran status, or any other basis protected by applicable law and will not be discriminated against on the basis of disability.