Medical Insurance Specialist

7 days ago


Los Angeles, California, United States Tucker Parker Smith Group (TPS Group) Full time
Job Title: Insurance Billing Specialist

Location: Los Angeles, CA

Compensation:

  • Salary Range: $19.23 - $22.50 per hour
  • Duration: 6 months, with the strong possibility of extension
  • Work Hours: 8:00 AM – 5:00 PM

Interview Process:

  • 2-step video/Teams interview
Job Overview:

The Insurance Billing Specialist will play a key role in ensuring accurate and timely billing for both government and non-government payers. This role requires a thorough understanding of medical insurance billing, proficiency with Soarian Financials, and the ability to handle claim edits within a 48-72 hour window.

The Specialist will coordinate with various internal teams such as Compliance, Collections, Audit, Customer Service, and HIM to resolve claim issues efficiently, ensuring that claims are processed in a professional and timely manner.

Key Responsibilities:
  • Review and resolve claim edits using Soarian Financials for all government and non-government payers.
  • Submit claims within 48-72 hours of creation date to maintain compliance with billing guidelines.
  • Coordinate rebill requests from internal departments such as Compliance, Collections, Audit, Customer Service, and HIM.
  • Act as a liaison between Revenue Cycle areas and the billing agency to address claim issues and ensure problematic claim edits are resolved.
  • Maintain a comprehensive understanding of current billing and coding guidelines to ensure accurate claim submissions.
  • Work collaboratively with multiple internal departments and external vendors to resolve claim issues efficiently.
  • Ensure all billing processes adhere to professional standards and are completed in a timely manner.
Must-Have Qualifications:
  • Two (2) years of medical insurance billing experience required.
  • Experience with Soarian Financials required.
  • Strong understanding of billing and coding guidelines for both government and non-government payers.

This role is essential to maintaining the efficiency and compliance of the billing processes within the medical enterprise, ensuring timely claim submissions and resolution. Candidates who meet the qualifications and have experience with Soarian Financials will be prioritized.


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