Claims Review Specialist - Los Angeles, United States - Global Healthcare IT

Global Healthcare IT
Global Healthcare IT
Verified Company
Los Angeles, United States

2 weeks ago

Mark Lane

Posted by:

Mark Lane

beBee recruiter
Description

99% remote, only the orientation will be onsite and a few meetings when necessary.

CPC-H, CPC, or CCS coding certification required.

Job Summary:

Responsibilities:


  • Review and process medical claims for accuracy and completeness
  • Verify insurance coverage and eligibility for claim submission
  • Ensure compliance with Medicare, HCPCS, ICD10, and other coding standards
  • Analyze medical documentation to determine claim validity
  • Communicate with healthcare providers and insurance companies to resolve claim issues
  • Maintain accurate records of claims processed and payments received
  • Stay updated on changes in workers' compensation laws and regulations

Qualifications:

  • Proficiency in medical coding and terminology
  • Experience with Medicare billing procedures
  • Knowledge of HCPCS, ICD10, and medical records management
  • Strong clerical and organizational skills
  • Familiarity with workers' compensation law is a plus

Job Types:
Full-time, Contract


Pay:
$ $30.00 per hour


Benefits:


  • 401(k)
  • 401(k)
matching

  • Dental insurance
  • Health insurance
  • Life insurance
  • Paid time off
  • Vision insurance

Schedule:

  • 8 hour shift
  • Day shift
  • Monday to Friday

Work setting:

  • Hybrid work

Education:


  • Bachelor's (required)

Experience:

Hospital Billing Systems: 5 years (required)

  • Thirdparty billing requirements: 5 years (required)
  • Epic: 1 year (required)
  • CPT coding: 5 years (preferred)
  • ICD10: 5 years (preferred)
  • Medicare, Medi-Cal and Commercial Payers processing: 1 year (preferred)
  • Denials management: 1 year (preferred)

License/Certification:

  • Certified Coding Professional (preferred)
  • Certified Coding Specialist (preferred)
  • CPCH (preferred)
  • AHIMA (preferred)

Ability to Relocate:

  • Los Angeles, CA 90024: Relocate before starting work (required)

Work Location:
Hybrid remote in Los Angeles, CA 90024
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