5 claims specialist Jobs in orange, ca
Cross Country Workforce Solutions Group is Hiring a Claims Resolution Specialist Near Orange, CA
The Claims Resolution Specialist is the first line of contact for providers. The incumbent will assist providers with questions related to the payment of claims and resolution of claims payment issues.
Position Responsibilities
Claims Support
- Responds and researches issues on provider questions regarding claims payments, denials, resolves claim issues, contractual and/or agreements, established payment methodologies, division of financial responsibility, applicable regulatory legislation, claims processing guidelines and company policies and procedures.
Administrative Support
- Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
- Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.
- Ensures accurate and timely documentation regarding all issues, and/or inquiries are entered in Facets.
- Routes escalated calls to the appropriate departments and/or management.
- Other duties or projects as assigned.
- Meet and maintain established quality and production standards.
- Work independently and as part of a team.
- Develop and maintain effective working relationships with all levels of staff and providers.
- Handle multiple tasks and meet deadlines.
- Communicate clearly and concisely both verbally and written.
- Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.
CCWSG provides clinical and non-clinical staffing support to PACE centers across the country; we are the nation’s exclusive provider of non-medical, in-home caregivers for the elderly enrolled in PACE programs. Currently, we have over 3,000 caregivers supporting patients in their homes through PACE.
We are a part of the Cross Country Healthcare family, a market-leading workforce solutions, tech-enabled talent platform, and staffing, recruitment, and advisory firm with almost 40 years of industry experience and insight. We are a full-service partner, combining market expertise and services, including contingent staffing, consulting, human capital, management solutions, recruitment process outsourcing, vendor management, and direct hiring.
Cross Country Workforce Solutions Group (CCWSG) is a human resource, consulting and talent acquisition firm, specializing in PACE Programs, FQHCs/CHCs, and State Healthcare plans throughout the US. Our national operations center is located in Southern California. CCWSG provides clinical and non-clinical staffing support to PACE centers across the country; we are the nation’s exclusive provider of non-medical, in-home caregivers for the elderly enrolled in PACE programs. Currently, we have over 3,000 caregivers supporting patients in their homes through PACE. We are a part of the Cross Country Healthcare family, a market-leading workforce solutions, tech-enabled talent platform, and staffing, recruitment, and advisory firm with almost 40 years of industry experience and insight. We are a full-service partner, combining market expertise and services, including contingent staffing, consulting, human capital, management solutions, recruitment process outsourcing, vendor management, and direct hiring.
Job Summary
Full Time
$80k-98k (estimate)
06/09/2024
08/07/2024
The job skills required for Claims Resolution Specialist include Customer Service, Microsoft Office, etc. Having related job skills and expertise will give you an advantage when applying to be a Claims Resolution Specialist. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Claims Resolution Specialist. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Claims Resolution Specialist positions, which can be used as a reference in future career path planning. As a Claims Resolution Specialist, it can be promoted into senior positions as a Claims Adjuster III that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Claims Resolution Specialist. You can explore the career advancement for a Claims Resolution Specialist below and select your interested title to get hiring information.
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