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 Claims Specialist to join a high-performing, collaborative team focused on air ambulance claims, member appeals, and insurance reimbursement. This detail-oriented role emphasizes out-of-network claims and involves member advocacy, relationship-building with employers, patients, and insurance providers. Thorough, on-the-job training is provided for candidates with a strong foundation in medical A/R, collections, and RCM.

Key Responsibilities

• Manage 25–30 insurance claims per day, ensuring accuracy, compliance, and timeliness.
• Navigate out-of-network claims and reimbursement workflows.
• Conduct eligibility and benefits verifications specific to air ambulance criteria.
• Investigate and process member appeals.
• Gather and submit prior authorizations, medical records, and required documentation.
• Collaborate with patients, families, employers, and insurance providers via phone, email, and online chat.
• Maintain detailed records according to HIPAA and internal documentation standards.
• Track personal productivity and quality metrics for monthly incentive bonuses.

Qualifications

• Minimum 2+ years of A/R and collections experience with good tenure.
• Must have out-of-network experience.
• Hospital or single-specialty background with commercial insurance is a plus.
• Strong critical thinking, problem-solving skills, adaptability, and communication skills.

Experience

• Minimum 2+ years of experience in A/R and collections.
• Experience in handling out-of-network claims.

Skills

• Proactive, inquisitive, and resourceful approach.
• Strong problem-solving and communication skills.
• Ability to work in a team-focused, collaborative environment.

Additional Requirements

• Hybrid model preferred with the ability to commute to office 1–2 times a month; fully remote considered for the right candidate.
• Equipment provided must be picked up in person on the first day.

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).

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.

^*As a job position within our Revenue Cycle division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, handling financial and other payment data, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the 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.