We are looking for a detail oriented Entry-level Claims Representative to join our clients' team in Ontario, California. In this role, you will provide critical support in managing claims-related tasks, ensuring accuracy and efficiency in processing, reconciling, and auditing claims. This is a long-term contract position ideal for professionals with strong organizational skills and a background in medical office operations. Responsibilities:• Match checks with remittance advice, prepare and insert them into envelopes for mailing.• Reconcile processed batches within the audit database to ensure accuracy.• Create and mail denial trailers and letters to providers.• Print and send out claim requirement letters for Covered California members.• Forward claims to the appropriate health plan when necessary.• Process and mail claims deemed unable to process, including generating the necessary correspondence.• Batch trailers created by various departments and ensure proper documentation.• Audit the batch log key to confirm claims have been assigned and logged correctly.• Verify member information to determine line of business and coordination of benefits in the system.• Collaborate on process adjustments and work independently or as part of a team.

• High school diploma or equivalent education. • Minimum of six months of experience in a medical office setting. • Proficiency in data entry with accuracy and speed, typing 35-40 words per minute. • Familiarity with Microsoft Excel, Word, and Outlook. • Knowledge of claim forms, including UB-04 and CMS-1500. • Strong attention to detail and ability to adapt to changing processes. • Excellent communication skills and ability to work collaboratively. • Understanding of benefits coordination and health plan operations.

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Ontario, CA
onsite
Temporary
24.00 - 24.00 USD / Hourly
We are looking for a detail oriented Entry-level Claims Representative to join our clients' team in Ontario, California. In this role, you will provide critical support in managing claims-related tasks, ensuring accuracy and efficiency in processing, reconciling, and auditing claims. This is a long-term contract position ideal for professionals with strong organizational skills and a background in medical office operations. Responsibilities:• Match checks with remittance advice, prepare and insert them into envelopes for mailing.• Reconcile processed batches within the audit database to ensure accuracy.• Create and mail denial trailers and letters to providers.• Print and send out claim requirement letters for Covered California members.• Forward claims to the appropriate health plan when necessary.• Process and mail claims deemed unable to process, including generating the necessary correspondence.• Batch trailers created by various departments and ensure proper documentation.• Audit the batch log key to confirm claims have been assigned and logged correctly.• Verify member information to determine line of business and coordination of benefits in the system.• Collaborate on process adjustments and work independently or as part of a team.
2025-10-02T14:49:11Z

Claims Representative Job in Ontario | Robert Half