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2 results for Credentialing Specialist in Thousand Oaks, CA
- Los Angeles, CA
- onsite
- Temporary / Contract
- 28 - 35 USD / Hourly
- <p>Our client is seeking a detail-oriented <strong>Medical Denials Specialist</strong> with strong experience in <strong>insurance collections</strong> to join their healthcare revenue cycle team. This role is responsible for researching, appealing, and resolving denied medical claims to ensure maximum reimbursement from insurance carriers. The ideal candidate will have a solid understanding of payer guidelines, claims follow-up, and the collections process within a medical billing environment.</p><p><strong>Key Responsibilities:</strong></p><ul><li>Review and analyze denied, underpaid, and rejected insurance claims</li><li>Investigate denial reasons and take appropriate corrective action</li><li>Prepare and submit claim appeals with supporting documentation</li><li>Perform follow-up with commercial insurers, government payers, and other third-party payers</li><li>Work insurance aging reports and prioritize outstanding accounts for collection</li><li>Resolve claim edits, authorization issues, coding discrepancies, and eligibility problems</li><li>Document all account activity accurately and thoroughly in the billing system</li><li>Collaborate with billing, coding, and provider office teams to identify denial trends and improve reimbursement</li><li>Maintain knowledge of payer rules, reimbursement policies, and regulatory requirements</li><li>Meet productivity and collection goals while ensuring accuracy and compliance</li></ul><p><br></p>
- 2026-10-20T00:00:00Z
- Los Angeles, CA
- onsite
- Temporary to Hire
- 25.13 - 30.8 USD / Hourly
- <p>A Federally Qualified Health Center (FQHC), is seeking an experienced Medical Biller/Collector to join their revenue cycle team. This Medical Biller/Collector will be responsible for billing, follow-up, and collections activities to ensure timely reimbursement from insurance carriers, government payers, and patients. The ideal candidate for the Medical Biller/Collector role will have strong knowledge of medical billing processes, payer guidelines, and accounts receivable follow-up.</p><p><br></p><p>Key Responsibilities:</p><p><br></p><ul><li>Submit accurate and timely medical claims to insurance carriers and government payers</li><li>Follow up on unpaid, denied, or underpaid claims and resolve billing discrepancies</li><li>Work accounts receivable reports and maintain collection efforts to reduce outstanding balances</li><li>Investigate claim rejections and denials, and take corrective action for resubmission or appeal</li><li>Post payments, adjustments, and denials as needed</li><li>Communicate with payers, patients, and internal staff regarding billing questions and account resolution</li><li>Maintain compliance with billing regulations, payer requirements, and organizational policies</li><li>Support revenue cycle activities including claims review, payment reconciliation, and account research</li><li>Document collection activity and account status updates accurately in the billing system</li></ul>
- 2026-11-02T00:00:00Z