Healthcare - Claims Resolution Specialist
Bartz-Altadonna Community Health Center•Lancaster, CA
59d•$27 - $30•Onsite
About The Position
The Claims Resolution Specialist ensures timely resolution of denied or underpaid claims to maximize revenue for BACHC. This role focuses on analyzing denials, correcting claims, submitting appeals, and identifying recurring issues that impact reimbursement.
Requirements
- High school diploma required; associate or bachelor's degree preferred.
- Minimum 3 years of experience in claims resolution, denial management, or A/R follow-up.
- Familiarity with FQHC, Medi-Cal, and Medicare billing environments.
- Strong analytical and problem-solving skills with excellent attention to detail.
- Proficiency in Excel and EHR billing systems.
Nice To Haves
- Certification in Medical Billing or Coding (CMB, CBCS, CPC, or equivalent) preferred.
Responsibilities
- Review denied and underpaid claims across all payer types.
- Correct, appeal, and resubmit claims promptly and accurately.
- Track all claim actions and maintain comprehensive documentation.
- Collaborate with billing, coding, and front-office teams to correct root causes of denials.
- Identify denial trends and propose process improvements.
- Maintain current knowledge of payer rules, compliance standards, and deadlines.
- Provide feedback and training to staff to reduce repeat errors.
Benefits
- Dental insurance
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Industry
Ambulatory Health Care Services
Education Level
High school or GED
Number of Employees
101-250 employees
