Top 217 Claims specialist Jobs in Orange, Ca

Collection Account Specialist I
HealthQuest Esoterics —Irvine, CA
- $22 - $25 an hour
- Full-time
- Medical office experience
- HIPAA
- High school diploma or GED
- Health insurance
- Dental insurance
Quick Apply
Customer Experience, Social Media & AI Operations Specialist
Ace Link Industrial INC —Santa Ana, CA
- $23 - $30 an hour
- Full-time
- Organizational skills
- In-person
- Communication skills
- Paid training
- Health insurance
Quick Apply
5d
Grievance & Appeals Resolution Specialist
Clever Care Health Plan —Huntington Beach, CA
- $26 - $32 an hour
- Full-time
- Hybrid work
- Background check
- Microsoft Excel
- Writing skills
Credit Specialist
Action Gypsum Supply West —Chino, CA
- $25 - $26 an hour
- Full-time
- Microsoft Word
- Microsoft Outlook
- Writing skills
- Disability insurance
- Health insurance
Quick Apply
Property Claims Specialist Field I
Mercury Insurance Services, LLC —Brea, CA
- $63,410 - $117,348 a year
- Overtime
- Bilingual
- Military
- Writing skills
- Paid holidays
- Health insurance
12d
Property Claims Specialist Field II
Mercury Insurance Services, LLC —Brea, CA
- $76,829 - $142,213 a year
- Overtime
- Bilingual
- Military
- Writing skills
- Paid holidays
- Health insurance
12d
Member Liaison Specialist (Customer Service)
CalOptima —Orange, CA
- Weekends as needed
- Background check
- Spanish
- Microsoft Outlook
- Tuition reimbursement
- Paid time off
11d
Senior Claims Specialist
Crum & Forster —Orange, CA
- $55,800 - $104,900 a year
- Remote
- Mid-level
- 3 years
- Organizational skills
- Employee stock purchase plan
- Health insurance
Claims Receivables and Recovery Specialist
WESTERN GROWERS GROUP —Irvine, CA
- $46,669.19 - $60,668.60 a year
- Full-time
- Remote
- Writing skills
- HIPAA
- Research
- Dental insurance
Quick Apply
11d
Patient Account Specialist III - Santa Ana, CA
KPC GLOBAL MEDICAL CENTERS INC. —Santa Ana, CA
- $31.75 - $38.19 an hour
- Per diem
- Mid-level
- Team management
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Compliance Specialist
Össur —Irvine, CA
- $61,123 - $95,394 a year
- Full-time
- Mid-level
- Bachelor's degree
- Continuous improvement
- Health insurance
- Dental insurance
10d
Healthcare Revenue Cycle Billing Specialist II (SNF)
Wipfli —Irvine, CA
- $23 - $30 an hour
- Remote
- Microsoft Excel
- Microsoft Outlook
- HIPAA
- Health savings account
- AD&D insurance
Reimbursement Specialist
BMR Partners —Orange, CA
- $26 - $30 an hour
- Overtime
- Mid-level
- Office
- High school diploma or GED
Quick Apply
Mission Support Specialist
US Immigration and Customs Enforcement —Santa Ana, CA
- $61,722 - $114,413 a year
- Online Application
- Background check
- Psychiatry
- Pass drug screening
- Paid holidays
- Loan repayment program
5d
EHS Senior Specialist
Solventum —Irvine, CA
- $106,000 - $145,750 a year
- Full-time
- 6 years
- High school diploma or GED
- Bachelor's degree
- Health savings account
- Disability insurance
13d
Claims Specialist (Behavioral Health Billing)
Indigo Billing —Costa Mesa, CA
- $25 - $27 an hour
- Full-time
- Hybrid work
- HIPAA
- Mid-level
- Office
- Health insurance
- Dental insurance
Quick Apply
3d
Claim Specialist - Property Field Inspection
State Farm —Yorba Linda, CA
- $64,965.62 - $104,056.00 a year
- Overtime
- Mid-level
- Residential
- Analysis skills
- Paid holidays
- Health insurance
Government Specialist II
KPC GLOBAL MEDICAL CENTERS INC. —Santa Ana, CA
- $28.84 - $35.19 an hour
- Full-time
- Microsoft Outlook
- Basic math
- Mid-level
- AD&D insurance
- Health insurance
Quick Apply
Claim Operations Specialist
The Travelers Companies, Inc. —Diamond Bar, CA
- $45,400 - $74,900 a year
- Hybrid work
- Computer literacy
- Office
- High school diploma or GED
- Wellness program
- Paid holidays
5d
Safety & Health Specialist III
Granite Construction Company —Anaheim, CA
- $88,170 - $132,255 a year
- Bilingual
- Microsoft Excel
- Construction site
- Health savings account
- Paid holidays
Quick Apply

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Collection Account Specialist I

HealthQuest Esoterics
Irvine, CA

Quick Apply

Job Details

Full-time
$22 - $25 an hour

Benefits

Health insurance
Dental insurance
401(k)
Flexible spending account
Paid time off
Vision insurance
401(k) matching

Qualifications

Customer communication
Medical software
Medical insurance coverage verification
Spreadsheets
Medical office experience
HIPAA
High school diploma or GED
Attention to detail
Productivity software
Root cause analysis
Customer service problem-solving
Technical Proficiency
Time management

Full Job Description

Position Summary

The Collection Account Specialist I is responsible for coordinating all aspects of patient billing, collections, and account resolution for a medical laboratory environment. This position requires a thorough understanding of patient accounting, medical billing, insurance processing, reimbursement methodologies, and customer service principles.

The Patient Account Representative serves as a primary point of contact for patients regarding billing inquiries, account balances, payment arrangements, insurance information, and account resolution. This role is responsible for reviewing the status of the entire patient account and exercising sound judgment to determine the appropriate course of action to ensure timely and accurate reimbursement while maintaining exceptional customer service.

Essential Duties and Responsibilities

Patient Account Management

· Work assigned patient accounts receivable inventories efficiently and timely while maintaining departmental productivity and quality standards.

· Contact patients regarding prepayments, outstanding balances, payment arrangements, and account resolution.

· Review, monitor, research, and update patient accounts to resolve balances and maximize reimbursement opportunities.

· Analyze account activity and determine appropriate next steps based on account status and payer requirements.

· Reconcile patient account balances to ensure accuracy and proper account resolution.

Billing and Insurance Support

· Demonstrate knowledge of patient accounting, medical billing procedures, insurance claims processing, and reimbursement practices.

· Verify and update patient demographics, financial information, insurance coverage, and payer information within applicable systems.

· Communicate effectively with insurance carriers regarding claim status, payment inquiries, eligibility, and reimbursement issues.

· Utilize payer portals and online resources to research claims, verify information, and resolve account discrepancies.

· Assist in obtaining and verifying billing information required for accurate claim submission and reimbursement.

Patient Communication and Customer Service

· Maintain and manage a high volume of inbound and outbound patient calls.

· Respond to patient inquiries, correspondence, and account concerns within established service standards.

· Explain billing statements, insurance payments, adjustments, and patient financial responsibility in a clear and professional manner.

· Address patient concerns, answer questions, and provide account education while maintaining a positive customer experience.

· Establish payment arrangements in accordance with company policies and procedures.

Documentation and Reporting

· Document all patient interactions, account activities, payment arrangements, and account updates accurately within the billing system.

· Maintain spreadsheets and account notes to ensure continuity of follow-up and communication among staff members.

· Prepare patient statements, collection letters, delinquency notices, reports, and other correspondence as required.

· Ensure all account documentation is complete, accurate, and compliant with company policies and regulatory requirements.

Administrative Functions

· Process and post payments as assigned.

· Perform account audits and data quality reviews to identify and correct discrepancies.

· Assist with special projects and reporting requests related to patient accounts and collections.

· Maintain confidentiality and security of patient information in accordance with HIPAA regulations.

Required Skills and Qualifications

Education and Experience

· High School Diploma or equivalent required.

· Minimum of 2 years of experience in medical billing, patient accounting, healthcare collections, or revenue cycle management preferred.

· Experience in a clinical laboratory, diagnostic testing, physician practice, or healthcare environment strongly preferred.

Technical Skills

· Knowledge of medical billing, patient accounting, collections, insurance verification, and reimbursement processes.

· Proficiency with patient accounting systems, billing software, Microsoft Office applications, and payer portals.

· Ability to navigate multiple computer systems simultaneously while maintaining accuracy and efficiency.

Professional Competencies

· Strong communication, customer service, and interpersonal skills.

· Ability to remain calm, professional, and solution-oriented in stressful situations.

· Friendly, courteous, service-oriented, and flexible with a commitment to providing excellent patient service.

· Detail-oriented with strong organizational and time-management skills.

· Ability to work effectively under pressure while meeting deadlines and productivity goals.

· Capable of working independently with minimal supervision while managing multiple priorities.

· Strong problem-solving skills with the ability to identify issues, determine root causes, and implement appropriate solutions.

· Ability to establish and maintain effective working relationships with patients, staff, insurance representatives, and external organizations.

· Strong analytical and decision-making abilities.

Performance Expectations

· Meet or exceed established productivity and quality standards.

· Maintain accuracy in account documentation and account resolution activities.

· Achieve collection and reimbursement goals as established by management.

· Demonstrate professionalism and exceptional customer service in all interactions.

· Comply with all HIPAA, compliance, and company policies and procedures.

Equal Employment Opportunity

HealthQuest Esoteric is an Equal Opportunity Employer committed to fostering a diverse and inclusive workplace.

Pay: $22.00 - $25.00 per hour

Benefits:

401(k)
401(k) matching
Dental insurance
Flexible spending account
Health insurance
Paid time off
Vision insurance

Work Location: In person

Quick Apply

Refine Your Search

claims specialist jobs in orange, ca

Collection Account Specialist I

Customer Experience, Social Media & AI Operations Specialist

Grievance & Appeals Resolution Specialist

Credit Specialist

Property Claims Specialist Field I

Property Claims Specialist Field II

Member Liaison Specialist (Customer Service)

Senior Claims Specialist

Claims Receivables and Recovery Specialist

Patient Account Specialist III - Santa Ana, CA

Compliance Specialist

Healthcare Revenue Cycle Billing Specialist II (SNF)

Reimbursement Specialist

Mission Support Specialist

EHS Senior Specialist

Claims Specialist (Behavioral Health Billing)

Claim Specialist - Property Field Inspection

Government Specialist II

Claim Operations Specialist

Safety & Health Specialist III

I want to receive the latest job alert for claims specialist in orange, ca

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