Healthcare Insurance Specialist

3 weeks ago


Richmond, California, United States Credit Solutions Full time

About the Role:

Credit Solutions is seeking a skilled Healthcare Insurance Specialist to join our dynamic team. As a Healthcare Insurance Specialist, you will be responsible for claims processing and insurance follow up, eligibility reviews, denial reviews, appeals processing, and trends analysis while providing excellent customer service to our clients and their consumers.

Key Responsibilities:

  • Process and follow up on medical claims to ensure timely and accurate payment
  • Conduct eligibility reviews to verify patient information and insurance coverage
  • Review and respond to denied claims, preparing and submitting appeals as necessary
  • Analyze trends in claims data to identify areas for improvement
  • Provide exceptional customer service to clients and their consumers

Requirements:

  • Previous experience in medical billing and insurance
  • Familiarity with claims software and clearinghouses
  • Understanding of UB-04 and 1500 forms
  • Experience with denial and appeal processes
  • Ability to review and interpret EOBs and reason codes
  • Ability to learn new software quickly
  • Understanding of HIPAA
  • Professional communication skills
  • A desire to help others and make a difference in their community
  • A strong work ethic and sense of loyalty to team members

What We Offer:

  • Medical Insurance
  • Dental Insurance
  • Vision Insurance
  • Employer Paid Life Insurance
  • Aflac Supplemental Insurance
  • Employer Sponsored Retirement Plan
  • Vacation Pay
  • Holiday Pay
  • Flex Time
  • AT&T Corporate Employee Cellular Discounts
  • Dell Corporate Employee Computer Discounts
  • Gym Membership Reimbursement
  • Numerous Employee Appreciation Activities
  • $500 Referral Bonus Program


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