Medical Claims Specialist
Company: Healthcare Support
Location: Long Beach
Posted on: January 13, 2022
Are you an experienced Medical Claims Specialist looking for a
new opportunity with a prestigious healthcare company? Do you want
the chance to advance your career by joining a rapidly growing
company? If you answered "yes" to any of these questions - this is
the Medical Claims Specialist position for you!
Daily Responsibilities of a Medical Claims Specialist:
Resolves and prepares written response to incoming member or
provider appeals, grievances, complaints and/or disputes.
--- Researches claims processing guidelines, provider contracts,
fee schedules and system configurations to determine root cause of
--- Identifies potential provider problems through a proactive
approach in which data is mined and trended to identify and prevent
provider problem areas.
--- Uses a variety of references to research and prepare healthcare
provider information for loading into the health plan
system/database; enters provider demographics, contract
affiliation, or other data as needed.
--- Requests and reviews medical records, notes, and/or detailed
bills as appropriate and collaborates with Medical Directors and
other team members to determine response; assures timeliness and
appropriateness of responses per state, federal and Molina
High School diploma or GED equivalent
2-3 years experience in a managed care setting; CPT and ICD-9
coding, data entry, and 10-Key experience.
2-3 years managed care experience; claims review and processing
background including coordination of benefits, subrogation, and
Hours for this Position:
Monday to Friday 8AM - 4:30 PM with 30-minute lunch or 7AM - 4PM
with 30-minute lunch (contractors will not be required to work on
Federal holidays) - allowed to work in their times zone
Advantages of this Medical Claims Specialist Opportunity:
Competitive salary, negotiable based on relevant experience
Benefits offered, Medical, Dental, and Vision
Fun and positive work environment
Interested in being Considered?
If you are interested in applying to this Medical Claims Specialist
position, please click Apply Now for immediate consideration.
Healthcare Support Staffing, Inc. is an equal employment
opportunity employer and will consider all qualified applicants
without regard to race, color, religion, disability, sex, sexual
orientation, gender identity, national origin, protected veteran
status, or any other characteristic protected by applicable local,
state, or federal law.
Keywords: Healthcare Support, Long Beach , Medical Claims Specialist, Healthcare , Long Beach, California
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