Claims Processing Specialist

Claims Processing Specialist - Rancho Cordova (Onsite) Are you a meticulous professional looking to advance your career in healthcare administration? Join our supportive, growth-oriented team as a Claims Processing Specialist. In this vital role, you get to contribute to patient care by ensuring the accuracy of vital health records and billing processes. We offer a collaborative environment where your analytical skills are valued, and your continuous learning is prioritized.

Key Opportunities to Make an Impact

• Analyze & Resolve: Evaluate complex authorizations against submitted claims to ensure accuracy and compliance.

• Manage Financial Workflows: Process special claim payments, specifically for VA CCN clients, and handle returned checks, refunds, and stop-payment requests.

• Collaborate & Improve: Coordinate with finance teams to resolve outstanding overpayments and collaborate with the Special Correspondence Unit on quality complaints.

• Ensure Data Integrity: Adjudicate claims and perform manual reviews comparing authorized versus actual treatments to uphold the highest standards of patient information integrity.

What You Bring to the Team

• Essential: 2+ years of recent, proven experience in Dental/Medical claims processing.

• Essential: High attention to detail with proficiency in MS Excel and basic accounting principles.

• Essential: Proven analytical, organizational, and critical thinking skills to independently prioritize work.

• Essential: Ability to collaborate effectively within cross-functional teams to achieve shared objectives.

• Preferred: Experience with dental claims processing and a solid understanding of claims re-adjudication.

• Preferred: Excellent customer service skills with the ability to address concerns with empathy and professionalism.

Ready to Advance Your Career? Apply today for this Claims Processing Specialist role! Experience a streamlined and efficient application process, expertly managed by your dedicated team. We are committed to supporting your long-term career aspirations with expert advice and market knowledge.

salary: $25 - $27 per hour
shift: First
work hours: 6 AM - 2:30 PM
education: Bachelors

Responsibilities

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Skills

• Claims Processing Specialist
• Claims Processing
• Customer Service
• Dental Claims Processing
• MS Excel
• GAAP
• Claims
• Verbal Communication
• Responsiveness
• Analytical Thinking
• Dental Claims Specialist
• Healthcare Claims Analyst
• Prior Authorizations
• Manual Review
• Rancho Cordova Jobs

Qualifications

• Years of experience: 3 years
• Experience level: Experienced

Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact View email address on us.fitly.work.

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).

This posting is open for thirty (30) days.

Qualified applicants in San Francisco with criminal histories will be considered for employment in accordance with the San Francisco Fair Chance Ordinance.




Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.




We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance.