Healthcare Claims & Reimbursement Specialist

Healthcare Claims & Reimbursement Specialist

Position Overview

We are seeking a Healthcare Claims & Reimbursement Specialist to support claim review, denial management, appeals, reimbursement recovery, and billing accuracy initiatives. This role is responsible for investigating claim issues, resolving payment discrepancies, and helping maximize reimbursement outcomes.

Key Responsibilities

• Review healthcare claims for accuracy and completeness.
• Research denied, rejected, and underpaid claims.
• Prepare and submit supporting documentation and appeals.
• Investigate billing discrepancies and reimbursement issues.
• Work with insurance payers to resolve claim-related concerns.
• Track claim activity and maintain accurate records.
• Identify trends and opportunities to reduce denials and improve claim quality.
• Collaborate with internal teams to resolve complex claim issues.

Qualifications

• 2+ years of healthcare billing, claims, reimbursement, denial management, or revenue cycle experience.
• Knowledge of insurance claims and reimbursement processes.
• Strong attention to detail and problem-solving skills.
• Excellent communication and organizational abilities.
• Experience with appeals, claim research, or payer follow-up preferred.

All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the California Fair Chance Act, City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, Los Angeles County Fair Chance Ordinance, and San Francisco Fair Chance Ordinance.