HealthCare Claims Clerk (On-site)

Shield California Health • Santa Clarita, CA

9d • $0 - $20 • Onsite

About The Position

Shield HealthCare is looking for a Healthcare Claims Clerk to research medical supply claims rejections, denials, and underpayments, making the necessary corrections to meet billing guidelines or recommending claims for write-off. The position has a set schedule, Monday through Friday, no nights or weekends. This is an on-site position in Valencia, CA.

Requirements

• High school diploma or equivalent
• 2 years in a medical billing or collections role or similar experience
• Proficiency in Microsoft 365 (Excel, PowerPoint, Word, SharePoint, Teams)
• Experience working in Excel
• Strong written and verbal communication abilities
• Proven ability to research and solve problems
• Strong organizational skills, detail oriented, thorough, accurate, with the ability to manage multiple priorities and respond to changing business needs

Nice To Haves

• Medical billing and coding certification from accredited program preferred
• Familiarity with various medical insurance payer guidelines/billing requirements preferred

Responsibilities

• Reviews the claims billing processes, looking for ways to achieve positive financial outcomes
• Identify problems and find solutions to claim rejections, denials, and underpayments
• Inform management of trends in billing issues related to internal processes, clearinghouse claims processing, and third-party requirements
• Research denials and billing requirements of third-party carriers utilizing EOBs, provider manuals, web portals, and phone contact
• Adjudicate claims issues by preparing and submitting corrected claims and appeals
• Recommend claims for write-off when billing requirements are not met
• Effectively communicate by phone, email, and in-person with third-party payers and internal staff to resolve billing issues and establish positive relationships
• Accurately update and notate accounts receivable system, collections notepad, and customer accounts
• Remain updated on company policies and procedures and third-party payer guidelines, bulletins, and billing requirements
• Ensure appropriate follow-up and timely completion of assignments
• Completes special projects as assigned, supporting team and organizational objectives and continuous improvement initiatives

Benefits

• Medical, Dental, and Vision (Available first day of employment)
• 401(k) with Company Match
• Sick and Vacation Days
• Flexible Spending Account
• Life & Disability Insurance
• Education Assistance
• continuous training and development programs

What This Job Offers

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