Top 44 Revenue cycle specialist Jobs in Berkeley, Ca

Claims Resolution Specialist
Integrated Pain Management Medical Group, Inc. —Walnut Creek, CA
- $28 - $35 an hour
- Full-time
- HIPAA
- Research
- Mid-level
- Paid holidays
- Health insurance
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Billing Operations Specialist (PST)
Octave —San Francisco, CA
- $23.51 - $27.00 an hour
- Weekends as needed
- Remote
- Mid-level
- US work authorization
- Computer skills
- Paid parental leave
- Health savings account
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4d
Revenue Cycle Specialist (Contract)
Midi Health —San Francisco, CA
- $25 an hour
- Contract
- Remote
- Research
- Mid-level
- Analysis skills
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3d
Insurance Reimbursement Specialist
CareDx, Inc. —San Francisco, CA
- $28 - $36 an hour
- Overtime
- Remote
- HIPAA
- Mid-level
- Office
- Commuter assistance
- Employee stock purchase plan
13d
MEDICAL BILLING AND COLLECTIONS SPECIALIST
American CareQuest, Inc. —Burlingame, CA
- $28 - $35 an hour
- Part-time
- Background check
- Mid-level
- Home Health
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Hospice Medical Billing Specialist
ALAMEDA CARE HOSPICE —Walnut Creek, CA
- $26 - $32 an hour
- Full-time
- HIPAA
- Mid-level
- High school diploma or GED
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Accounts Payable Specialist
Everflow Technologies Inc. —Oakland, CA
- $65,000 - $70,000 a year
- Full-time
- Hybrid work
- Bachelor of Science
- English
- Mid-level
- Paid parental leave
- Health insurance
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Healthcare Billing Specialist
East Bay Rheumatology Medical Group Inc —San Leandro, CA
- $25 - $30 an hour
- Full-time
- Private practice
- Internal Medicine
- HIPAA
- Paid holidays
- Health insurance
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Healthcare AR/ Collections Specialist - Bilingual Spanish
MedRevenu Inc. —California
- $20 - $25 an hour
- Urgently hiring
- Spanish
- Mid-level
- Conflict management
- Health insurance
- Dental insurance
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DME Documentation Criteria Reviewer
Hike Medical —San Francisco, CA
- $90,000 - $145,000 a year
- Full-time
- Hybrid work
- Mid-level
- Office
- Commercial
Eligibility Specialist (Contract)
Midi Health —San Francisco, CA
- $20 an hour
- Contract
- Remote
- Mid-level
- US work authorization
- 2 years
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Emergency Trauma Charger
Sutter Health —Castro Valley, CA
- $31.33 - $39.66 an hour
- 8 hour shift
- Nursing
- Anatomy knowledge
- Microsoft Excel
5d
Revenue Cycle Healthcare Associate Director
University of California San Francisco —Emeryville, CA
- 7 years
- Bachelor's degree
- Organizational skills
Compliance & Outcomes Specialist
Hike Medical —San Francisco, CA
- $140,000 - $200,000 a year
- Full-time
- Hybrid work
- Mid-level
- Office
- Commercial
Hospital Billing and Follow Up Specialist - Limited Term
County of San Mateo —San Mateo, CA
- $75,940.80 - $94,972.80 a year
- Full-time
- Microsoft Word
- Hospital
- Basic math
- Retirement plan
Radiation Oncology Coder Outpatient Specialty
Sutter Health —Berkeley, CA
- $47.58 - $66.60 an hour
- 8 hour shift
- Anatomy knowledge
- Surgery
- Writing skills
Billing Specialist
Estavillo Law Group —Oakland, CA
- $70,720 - $79,040 a year
- Full-time
- Mid-level
- 3 years
- Finance
- Paid holidays
- Dental insurance
Quick Apply
Lead Medical Billing Specialist
North Bay Aesthetics —San Francisco, CA
- $40 - $50 an hour
- Full-time
- Mid-level
- Supervising experience
- Mentoring
- Health insurance
- Dental insurance
Quick Apply
Outpatient Coding Assistant Director
University of California San Francisco —Emeryville, CA
- Full-time
- Management
- 5 years
- IT
Patient Records Abstractor 2
University of California San Francisco —Emeryville, CA
- Full-time
- Remote
- 5 years
- Data analysis skills
- Analysis skills

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Claims Resolution Specialist

Integrated Pain Management Medical Group, Inc. -
Walnut Creek, CA

Quick Apply

Job Details

Full-time
$28 - $35 an hour

Benefits

Paid holidays
Health insurance
Dental insurance
Paid time off
Vision insurance
401(k) matching
Employee discount

Qualifications

High school diploma or GED

Full Job Description

The Claims Resolution Specialist is responsible for the day-to-day investigation and resolution of claim rejections, denials, edits, and reimbursement issues across a multi-site, multi-specialty healthcare organization specializing in pain management, physical medicine, and functional rehabilitation services.

Working closely with the Pre-Billing, Accounts Receivable (A/R), Denials Management, Coding, and Revenue Integrity teams, this position performs detailed claim reviews, researches payer requirements, corrects claim errors, and facilitates timely claim resubmission and payment. The Claims Resolution Specialist serves as a key resource in resolving billing issues and ensuring claims are processed accurately and efficiently.

This is a remote role. We are only hiring in the following states: AZ, CA, NM, NV, OR, TX and WA.

What you will do:

Claims Resolution & Follow-Up

Investigate and resolve claim rejections, denials, and payer edits identified before or after claim submission.
Review claim history, payer correspondence, medical records, authorizations, and supporting documentation to determine the cause of claim issues.
Correct billing, coding, demographic, authorization, and insurance-related claim errors as appropriate.
Process claim corrections, adjustments, resubmissions, and reconsideration requests in accordance with payer guidelines.
Perform payer research and communicate directly with insurance carriers to resolve claim processing issues.
Monitor assigned work queues and ensure timely resolution of outstanding claims.
Escalate complex reimbursement, coding, or compliance issues to senior team members.

Denial Management Support

Partner with A/R and Denials Management teams to resolve denied and underpaid claims.
Assist in preparing appeal documentation and supporting materials for denied claims.
Identify recurring denial patterns and communicate findings to the Senior Claims Resolution Coordinator.
Maintain accurate documentation of denial resolution activities and payer communications.
Support efforts to reduce preventable denials and improve reimbursement outcomes.

Pre-Billing & Revenue Cycle Collaboration

Work closely with the pre-billing team to identify and correct claim issues prior to submission.
Review claims for completeness and compliance with payer billing requirements.
Verify insurance information, authorizations, referrals, diagnosis coding, procedure coding, and modifier usage.
Collaborate with coding and clinical teams to obtain information needed for claim resolution.
Assist with reducing claim holds and billing delays.

Audit & Compliance Support

Participate in routine claim quality reviews and internal audit activities.
Ensure claim corrections comply with payer regulations, organizational policies, and billing guidelines.
Support Revenue Integrity initiatives through accurate claim review and documentation.
Maintain knowledge of Medicare, Medicaid, Workers' Compensation, and Commercial payer requirements.
Adhere to HIPAA, CMS, and organizational compliance standards.

Documentation & Reporting

Maintain detailed documentation of claim investigations, resolutions, payer communications, and follow-up activities.
Track assigned workloads and resolution outcomes.
Assist with compiling information for denial trend reporting and operational reviews.
Provide feedback regarding workflow issues contributing to claim errors or payment delays.
Assumes other responsibilities as appropriate to the position and organizational needs

Qualifications:

High School Diploma or equivalent required.
Associate degree in Healthcare Administration, Medical Billing and Coding, or related field preferred.
Minimum 2-4 years of experience in medical billing, claims resolution, denial management, accounts receivable, or healthcare revenue cycle operations.
Working knowledge of Medicare, Medicaid, Workers' Compensation, and Commercial insurance billing requirements.
Knowledge of CPT, ICD-10-CM, HCPCS, modifiers, and medical terminology.
Experience researching and resolving denied or rejected claims.
Strong analytical and critical thinking skills.
Ability to manage multiple priorities and meet productivity expectations.

Compensation Range:

$28.00 to $35.00 Hourly

All compensation ranges are posted based on internal equity, job requirements, experience, and geographical locations.

Why You'll Love Working Here:

Amazing work/life balance
Generous Medical, Dental, Vision, and Prescription benefits (PPO & HMO)
401(K) Plan with Employer Matching
License & Tuition Reimbursements
Paid Time Off
Holiday Pay & Floating Holiday
Employee Perks and Discount Programs
Supportive environment to help you grow and succeed

Boomerang Healthcare (BHC) is a multidisciplinary and comprehensive team of experienced, committed healthcare providers that treat pain. Our team of doctors approaches each patient with one goal in mind: to help patients return to normal daily activities. We work with our patients to identify the cause of their pain and create a personalized treatment plan, recognizing that no two patients are alike, and neither is their pain. Our providers create a comprehensive care plan, then monitor, manage and coordinate patient access to health services at BHC.

Boomerang Healthcare strives to be a diverse workforce that reflects, at all job levels, the patients we serve. We are an equal opportunity employer. Boomerang Healthcare is committed to compliance with the American Disabilities Act. If you require reasonable accommodation during the application process or have a question regarding an essential job function, please contact us.

Monday-Friday, 8am-5pm
40

Quick Apply

Refine Your Search

revenue cycle specialist jobs in berkeley, ca

Claims Resolution Specialist

Billing Operations Specialist (PST)

Revenue Cycle Specialist (Contract)

Insurance Reimbursement Specialist

MEDICAL BILLING AND COLLECTIONS SPECIALIST

Hospice Medical Billing Specialist

Accounts Payable Specialist

Healthcare Billing Specialist

Healthcare AR/ Collections Specialist - Bilingual Spanish

DME Documentation Criteria Reviewer

Eligibility Specialist (Contract)

Emergency Trauma Charger

Revenue Cycle Healthcare Associate Director

Compliance & Outcomes Specialist

Hospital Billing and Follow Up Specialist - Limited Term

Radiation Oncology Coder Outpatient Specialty

Billing Specialist

Lead Medical Billing Specialist

Outpatient Coding Assistant Director

Patient Records Abstractor 2

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