Claims Specialist

1 month ago

Riverside, California, United States Illumination Foundation Full time

Job Title: Claims Specialist

About the Role:

The Claims Specialist is a key member of our team at Illumination Foundation, responsible for ensuring the accuracy of claims submission, benefits, and eligibility verification. This role requires attention to detail, strong organizational skills, and the ability to work independently.

Key Responsibilities:

  • Reviewing data and creating claims for services rendered
  • Verifying client eligibility prior to creating and submitting claims
  • Reviewing rejected or denied claims and conducting proper follow-up procedures
  • Ensuring claims meet the standards of our contracts and programs
  • Posting payment accurately to claims and continuing with the claim close-out process

Requirements:

  • High School Diploma or equivalent
  • 1-2 years' relevant experience
  • Basic computer skills, including the ability to send and receive emails and summarize data in spreadsheets
  • Valid CA Driver's License and eligibility for company vehicle insurance

Preferred Qualifications:

  • Proficiency in Microsoft (Outlook, Word, Excel, Teams)
  • Associate's Degree
  • Bachelor's degree
  • Experience in Medical Billing and Primary Care Billing
  • Medical Billing Certification

Benefits:

  • Hybrid schedule with 2 days in office and 3 days working from home (after successful completion of 90-day probation period)
  • Medical Insurance funded up to 91% by Illumination Foundation (Kaiser and Blue Shield), depending on the plan
  • Dental and Vision Insurance
  • Life, AD&D, and LTD Insurance funded 100% by Illumination Foundation
  • Employee Assistance Program
  • Professional Development Reimbursement
  • 401K with Company Matching
  • 10 days vacation PTO/year
  • 6 days sick PTO/year
  • 10 days holiday PTO/year
  • Potential eligibility for the Public Service Loan Forgiveness Program (PSFL) for federally qualified loans

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