Medical Claims Representative, Robert Half

Medical Claims Representative

Robert Half

Location:

United States, Los Angeles

Category:

Health and Beauty

Contract Type:

Not provided

Salary:

Not provided

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Job Description:

The Medical Claims Representative will be primarily responsible for monitoring, investigating and analyzing relevant agreements, as well as handling claims payments and maintaining effective communication with various stakeholders.

Job Responsibility:

Handle the filing and pursuit of claims payments meticulously and efficiently
Answering inquiries regarding EOBs as well as any other issues pertaining to medical claims
Monitor and analyze healthcare industry trends and developments, and understand their implications on claims
Investigate potential violations of collective bargaining agreements and take necessary action
Maintain timely and effective communication with members, agents, attorneys, and company representatives
Manage workload independently, ensuring all tasks are completed accurately and on time
Work closely with the legal department to provide information/analysis of associated claims
Research and analyze various agreements, including member contracts, assumption agreements and distribution agreements
Handle appeals, benefit functions, billing functions, claim administration, and collection processes effectively
Maintain a strong focus on customer service, ensuring all queries and issues are resolved promptly and professionally

Requirements:

Medical Claims
Familiarity with Medical Insurance or Medical Billing
Experience in managing Appeals processes
Understanding of Benefit Functions within a healthcare setting
Proficiency in Billing Functions specific to medical claims
Experience in Claim Administration procedures and processes
Familiarity with Collection Processes in a healthcare environment

What we offer:

Medical insurance
Vision insurance
Dental insurance
Life insurance
Disability insurance
401(k) plan

Additional Information:

Job Posted:

March 23, 2025

Employment Type:

Fulltime

Work Type:

On-site work

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