Medical Claims Specialist

3 days ago


Irvine, California, United States Agendia Full time
Job Summary

We are seeking a highly organized and detail-oriented Medical Claims Specialist to join our team at Agendia. As a Medical Claims Specialist, you will play a critical role in ensuring the timely and accurate processing of medical claims and appeals.

Key Responsibilities
  • Collect and process medical claims and appeals in compliance with relevant laws and regulations.
  • Communicate with insurance companies, hospitals, and patients to resolve claim issues and obtain necessary documentation.
  • Prepare and submit medical appeals and payer reviews in a timely and accurate manner.
  • Process and follow up on patient copays and deductible amounts due.
  • Interface with insurance company representatives, doctor's offices, and hospitals to resolve billing inquiries and schedule of services.
  • Assist in the development of new procedures and systems to enhance productivity and efficiency.
Requirements
  • High school diploma or general education degree.
  • 3+ years of related experience in medical billing, insurance claims, or a related field.
  • Advanced technical knowledge of Microsoft products (Excel, Word, Outlook).
  • Strong organizational skills, attention to detail, and ability to manage multiple tasks independently.
  • Excellent problem resolution, customer service, and communication skills.
Working Environment

Our Medical Claims Specialist will work in a general office environment with a clean, neat, and orderly workspace. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.



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