You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Job Summary

Our client is seeking a Credit Specialist to manage and resolve Medicare Advantage insurance claim accounts with existing credit balances. This includes responsibilities such as initiating follow-ups, conducting thorough research, and addressing related correspondence.

Key Responsibilities

• Research and resolve Medicare Advantage insurance claim accounts with existing credit balances.
• Initiate refunds, retractions, and adjustments to claims.
• Ensure timely and accurate resolution of assigned claims through various payer systems and internal applications.
• Maintain production and quality standards with a target of processing over 30 accounts daily.
• Employ critical thinking for autonomous problem-solving and manage large amounts of information efficiently.
• Collaborate with peers and payer representatives using excellent communication skills.
• Stay updated on healthcare reimbursement and regulatory changes.
• Maintain confidentiality and adhere to all relevant policies and laws.

Qualifications

• High School Diploma or equivalent (proof required).
• Advanced computer proficiency with Microsoft Office Suite.
• Experience in healthcare or medical insurance claim remediation.
• 1+ years of experience with accounting or medical billing systems.
• Preferred knowledge or experience with Medicare Advantage insurance payers.

Experience

• Minimum 1 year in accounting, transactions, or medical billing.
• Experience with healthcare and insurance claims.

Skills

• Advanced computer proficiency in Microsoft Office including Excel, PowerPoint, Word, and Outlook.
• Strong organizational, communication, and critical thinking skills.

Additional Requirements

• Must pass a full 10 panel drug screen (no THC).
• Remote work setup with all equipment provided.

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

^*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.