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3 results for Insurance Referral Coordinator in Cerritos, CA

Clinical Appeals Coordinator

Ontario, CA
onsite
Temporary / Contract
24.5 - 25 USD / Hourly
We are looking for a detail-oriented Clinical Appeals Coordinator to support clinical appeals activity for a health insurance organization in Eden Prairie, Minnesota. This Long-term Contract opportunity is well suited for someone who can manage high-volume documentation, coordinate with provider offices, and keep appeal-related records accurate and current. The person in this role will help ensure information is collected promptly, tracked carefully, and processed within required service timelines while working primarily remotely with occasional office visits as needed. Responsibilities:• Review and manage clinical appeal files, ensuring each case is documented accurately and updated in the appropriate databases.• Communicate with provider offices and other involved parties to obtain missing records, confirm required information, and support timely case progress.• Track request deadlines closely and follow up on outstanding items to keep work moving within established health plan turnaround expectations.• Maintain organized records for incoming and outgoing documentation, including receipt, status updates, and final case support materials.• Perform high-volume data entry with a strong focus on accuracy, completeness, and quality standards.• Support mail-related processing activities when needed, including occasional trips to the Eden Prairie, Minnesota office for physical document handling.• Participate in training and apply department procedures consistently to help maintain compliance and service quality.• Collaborate with internal teams and external contacts to resolve documentation gaps and keep appeals work aligned with operational requirements.Clinical
2026-06-01T00:00:00Z

Medical Insurance Collections Specialist

North Hollywood, CA
onsite
Temporary / Contract
23.01 - 31.23 USD / Hourly
A respected hospital in the San Fernando Valley is seeking an experienced and results-driven Hospital Medical Collections Specialist to join its revenue cycle team. This role is ideal for a motivated professional with a strong background in hospital collections, payer follow-up, and denial resolution. The ideal candidate will play a key role in accelerating reimbursements, reducing aging accounts receivable, and ensuring accurate resolution of inpatient and outpatient claims across a variety of payer sources.The hospital is open to candidates with 2+ years of medical collections experience, particularly within an acute care or hospital setting.Key Responsibilities<ul><li>Perform comprehensive follow-up on outstanding hospital accounts to secure accurate and timely reimbursement from insurance carriers and third-party payers</li><li>Review inpatient and outpatient claims to identify billing issues, denials, payment delays, and underpayments, and take proactive steps toward resolution</li><li>Manage collection efforts across multiple payer types, including Medicare Managed Care, Medi-Cal Managed Care, commercial insurance plans, HMOs, and PPOs</li><li>Prepare and submit appeals, reconsiderations, and supporting documentation for denied or improperly processed claims</li><li>Research and resolve account discrepancies by reviewing billing records, remittance advice, payer correspondence, and claim history</li><li>Collaborate with billing, coding, admissions, and clinical departments to correct claim issues and improve reimbursement outcomes</li><li>Maintain accurate and detailed documentation of collection activity, payer communications, and account status updates</li><li>Monitor assigned accounts to reduce aging AR and improve overall collection performance</li><li>Support departmental goals related to cash collections, denial management, and revenue cycle efficiency</li></ul>
2026-06-05T00:00:00Z

Medical EOB Reviewer

Los Angeles, CA
onsite
Temporary to Hire
25 - 29.01 USD / Hourly
A Hospital in Los Angeles is seeking a Medical EOB Reviewer to support our healthcare revenue cycle team. This Medical EOB Reviewer role is ideal for someone who understands medical billing workflows and can confidently evaluate Explanation of Benefits documents, payment activity, and claim-related paperwork. The Medical EOB Reviewer will help keep billing operations organized, respond to questions from patients and payors, and ensure supporting documentation is handled accurately and on time. Must be bilingual in Spanish. Responsibilities:• Examine Explanation of Benefits documents to confirm billing accuracy, identify discrepancies, and support compliance with healthcare reimbursement guidelines.• Manage incoming mail by opening, sorting, and routing EOBs, payments, and related correspondence to the appropriate workflow.• Log and organize live checks received from insurance payors with a high level of accuracy and attention to detail.• Obtain authorizations from carriers or provider offices when additional approval is needed to move billing activity forward.• Address questions from patients, providers, insurance representatives, and internal teams regarding charges, payments, and EOB-related items.• Compile and submit supporting records required for claims follow-up, billing review, appeals, or other reimbursement activities.• Maintain clear and organized documentation of reviewed EOBs, authorizations, payment records, and submitted materials.• Partner with billing, collections, and medical records staff to investigate issues, resolve variances, and keep accounts progressing appropriately.
2026-06-05T00:00:00Z