Healthcare Claims Associate- Onsite

Shield HealthCare - Medical Supplies for Care at Home Since 1957 • Santa Clarita, CA

7d • Onsite

About The Position

Shield HealthCare is seeking a Healthcare Claims Associate to research claim denials and underpayments, make necessary corrections to meet billing requirements, and recommend claims for write-off when appropriate. This is an on-site, office-based position in Valencia, California, with a Monday–Friday schedule from 8:00 a.m. to 4:30 p.m. The role involves communicating with third-party payers and internal staff, maintaining accurate account records, and completing follow-up and assigned projects. The position supports continuous improvement and offers ongoing training and development.

Requirements

• High school diploma or equivalent.
• Two years of experience in medical billing, collections, or similar work.
• Proficiency with Microsoft 365, including Excel, Outlook, PowerPoint, Word, SharePoint, and Teams, and other standard productivity tools.
• Experience working in Excel.
• Strong written and verbal communication abilities.
• Proven ability to research and solve problems.
• Strong organizational skills; attention to detail; thoroughness and accuracy; and ability to manage multiple priorities and respond to changing business needs.

Nice To Haves

• Medical billing and coding certification from an accredited program.
• Familiarity with medical insurance payer guidelines and billing requirements.

Responsibilities

• Review claims billing processes and identify opportunities for positive financial outcomes.
• Identify problems and develop solutions for claim rejections, denials, and underpayments.
• Inform management of billing issue trends related to internal processes, clearinghouse claims processing, and third-party requirements.
• Research denials and payer billing requirements using EOBs, provider manuals, web portals, and phone contact.
• Prepare and submit corrected claims and appeals to resolve claims issues.
• Recommend claims for write-off when billing requirements are not met.
• Communicate by phone, email, and in person with third-party payers and internal staff to resolve billing issues and build positive relationships.
• Accurately update and document the accounts receivable system, collections notepad, and customer accounts.
• Stay current on company policies and procedures and third-party payer guidelines, bulletins, and billing requirements.
• Follow up appropriately and complete assignments on time.
• Complete special projects supporting team and organizational objectives and continuous improvement initiatives.

Benefits

• Medical, dental, and vision coverage available from the first day of employment.
• 401(k) with company match.
• Sick and vacation days.
• Flexible Spending Account.
• Life and disability insurance.
• Education assistance.
• Continuous training and development programs.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED