Claims and Denials Specialist Job at Robert Half (Oakland)

Medical Reimbursement Specialist

We are in search of a Medical Reimbursement Specialist to join our team. Station...

Location

United States , Princeton

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Minimum of 3 years of experience in a similar role
Proficient in benefit functions
Demonstrated expertise in billing functions
Experience in claim administration
Familiarity with collection processes
Ability to handle and resolve medical denials
Comprehensive knowledge of Medicare

Job Responsibility

Analyze and categorize outstanding claims based on payer, denial reason, and claim value
Investigate and take corrective action on unpaid, denied, or underpaid claims
Collaborate with internal teams to obtain missing documentation and expedite claim resubmission
Evaluate common denial reasons and address them accordingly, such as coding errors, medical necessity, and prior authorization
Submit corrected claims and formal appeals as required
Communicate with insurance payers to resolve aged claims and escalate unresolved claims as necessary
Maintain comprehensive records of all payer interactions
Identify the root causes of denials and implement best practices to prevent future issues
Suggest changes to workflow to enhance claim submission accuracy and speed
Conduct training for in-house billing teams on claim recovery strategies

What we offer

medical, vision, dental, and life and disability insurance
eligibility to enroll in company 401(k) plan

Fulltime

Medical Billing Specialist

We are looking for a detail-oriented Medical Billing Specialist to join a team i...

Location

United States , King of Prussia

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

At least 1 year of experience in medical billing, claims, or collections
Proficiency in accounting software systems and electronic health record (EHR) systems
Familiarity with Medicaid processes and commercial insurance claims
Strong understanding of accounts receivable, denial management, and appeals
Experience working with billing and authorization functions
Ability to accurately input and manage billing data
Excellent communication skills to collaborate with team members and external payors
Knowledge of compliance policies related to medical billing and collections

Job Responsibility

Process and submit primary and secondary claims for both commercial insurance and Medicaid
Investigate and resolve claim denials, performing appeals as necessary to ensure proper reimbursement
Manage accounts receivable by following up on claims through resolution, including correcting billing errors and addressing rejections
Input and review billing data for accuracy, ensuring compliance with company policies and procedures
Collaborate with the Billing Manager and clinic teams to ensure accurate and timely billing
Track and verify Medicaid status for clients while maintaining relationships with payors to facilitate successful claims processing
Assist intake teams with Medicaid documentation for new clients and those requiring reassessment
Utilize various insurance portals and systems, including Waystar, to handle denial responses and claims follow-ups
Ensure adherence to compliance standards in all billing and collections activities
Perform other tasks as assigned by the Billing Manager or Director

What we offer

Medical insurance
Vision insurance
Dental insurance
Life insurance
Disability insurance
401(k) plan

Fulltime

Medical Billing Specialist

Location

United States , Dothan

Salary:

Not provided

RealTime (AL)

Expiration Date

Until further notice

Requirements

Medical Billing Experience
Perform posting charges
Perform completion of claims to payers
Conduct duties in a professional and timely fashion
Submit billing data to the appropriate insurance providers
Process claims
Resolve denial instances
Perform claim follow-up
Achieve maximum reimbursement for services provided
Deploy, maintain and report on various programs

Job Responsibility

Medical billers play a vital role in the connection between health care providers, patients, and insurance companies. At RealTime, we provide excellent Revenue Cycle Management to medical practices across the Southeast and through the Midwest.

What we offer

Training
Competitive pay
Phone allowance
Generous PTO
401(k) with company match
Health & Wellness Benefits including medical, dental, and vision
Company-sponsored events for fun and fellowship

Fulltime

Revenue Cycle Specialist

Pomelo Care is a multi-disciplinary team of clinicians, engineers and problem so...

Location

United States

Salary:

55000.00 - 65000.00 USD / Year

Pomelo Care

Expiration Date

Until further notice

Requirements

3+ years experience in revenue cycle support role
Proficiency in using medical billing software and EHR systems
Proficient in Microsoft Excel and/or Google Sheets
Independent, critical thinker with meticulous attention to detail
Demonstrate proficiency in navigating multiple systems and workflows while maintaining adaptability in a rapidly changing environment

Job Responsibility

Reviewing and submitting claims within payor guidelines to ensure timely and accurate filing
Reporting on aging encounters, and partnering with clinicians to resolve them, ensuring compliance with internal best practices
Resolving and appealing claims denials, and working with the Revenue Cycle Manager to improve workflows and optimize our claim submission process
Reconciling ERAs by resolving holds, manually posting payments and adjudicating claims
Collaborating with other teams to identify and update missing patient demographic and insurance data
Proactively identifying opportunities and implementing processes to optimize efficiency and accuracy within the billing function
Collaborating effectively within a team-oriented environment and demonstrating a proactive approach to managing small projects across various functions

What we offer

Equity
Benefits
Other opportunities at Pomelo Care

Fulltime

Medical Billing Specialist

We are looking for a skilled Medical Billing Specialist to join our dynamic heal...

Location

United States , Vancouver

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Proven experience in medical billing, including familiarity with high-volume environments
Proficiency in using NextGen software for billing and data management
Strong skills in handling claim denials and resubmissions
Knowledge of accounts receivable processes and reimbursement practices
Ability to interpret and resolve discrepancies in explanation of benefits (EOBs)
Advanced proficiency in Microsoft Excel for reporting and data analysis
Excellent organizational skills and attention to detail
Strong communication skills to collaborate effectively with internal teams

Job Responsibility

Process large volumes of medical billing transactions with precision and attention to detail
Input and update patient information and billing data using NextGen software
Maintain organized and accurate records through extensive data entry efforts
Review and submit claims to insurance providers, ensuring completeness and accuracy
Address and correct claim denials by identifying underlying issues and resubmitting claims
Conduct accounts receivable follow-up to secure timely reimbursements
Examine explanation of benefits (EOBs) to identify and resolve discrepancies
Create and analyze reports using Microsoft Excel to support billing operations
Work closely with internal teams to address billing challenges and enhance workflows
Assist with special billing projects and additional responsibilities as needed

What we offer

medical, vision, dental, and life and disability insurance
eligible to enroll in our company 401(k) plan

New

Medical Billing Specialist

We are looking for an experienced Medical Billing Specialist to join a team in W...

Location

United States , Wilmington

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

High school diploma or equivalent
certification in medical billing or coding is preferred
At least 2 years of experience in medical billing and coding, particularly with UB04 forms and insurance claims
Proficiency in Medicaid and Medicare accounts receivable billing processes
Familiarity with PointClickCare and other healthcare billing software
Strong knowledge of census management and reconciliation methods
Excellent analytical and organizational skills with the ability to resolve billing issues efficiently
Effective communication skills to coordinate with internal teams and external stakeholders

Job Responsibility

Process and submit medical claims using UB04 forms while ensuring compliance with healthcare regulations and payer requirements
Perform detailed medical coding using current standards to accurately reflect resident care and services
Manage accounts receivable for Medicaid and Medicare billing, resolving discrepancies and handling claim denials effectively
Update and reconcile resident census data to ensure accurate billing for insurance providers
Coordinate billing for resident accounts, verify insurance eligibility, and maintain precise records of claim statuses
Utilize PointClickCare and other healthcare software to manage billing and documentation processes
Monitor claim statuses, investigate rejections or denials, and prepare corrected claims when necessary
Collaborate with clinical and administrative teams to ensure accurate census reporting and smooth billing operations
Uphold compliance with healthcare policies and regulations, safeguarding patient information and confidentiality

What we offer

medical, vision, dental, and life and disability insurance
eligible to enroll in our company 401(k) plan

Medical Billing Specialist

We are seeking a dedicated and detail-oriented Medical Billing Specialist to joi...

Location

United States , Hagerstown

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

High school diploma or equivalent
Associate’s degree in Health Information Technology, Business Administration, or a related field is preferred
1+ years of experience in medical billing and accounts receivable, preferably within a healthcare setting
Strong knowledge of medical terminology, coding systems (CPT, ICD-10, HCPCS), and insurance regulations
Experience with medical billing software and electronic health records (EHR) systems
Excellent communication skills, both verbal and written
Detail-oriented with strong organizational and analytical skills
Ability to manage multiple priorities and meet deadlines in a fast-paced environment
Knowledge of HIPAA regulations and confidentiality requirements

Job Responsibility

Billing & Coding: Accurately review and submit medical claims to insurance companies, government programs (e.g., Medicare, Medicaid), and patients based on services provided
Accounts Receivable Management: Monitor and follow up on unpaid claims and accounts, ensuring timely resolution and payment collection
Claim Denial Management: Investigate and resolve denied or rejected claims, working with insurance providers to rectify issues and ensure proper reimbursement
Payment Posting: Post payments, adjustments, and denials to patient accounts accurately
Patient Communication: Communicate with patients and insurance companies to resolve billing inquiries, provide payment information, and answer any questions related to their accounts
Account Reconciliation: Ensure all accounts are reconciled and balanced, identifying discrepancies and making necessary adjustments
Compliance: Maintain up-to-date knowledge of relevant billing codes, insurance policies, and regulations to ensure compliance with industry standards and government regulations
Reporting: Generate and review accounts receivable reports, aging reports, and other billing data to ensure financial goals are met and identify areas for improvement
Collaboration: Work closely with the clinical and administrative teams to resolve any billing issues, discrepancies, or concerns

What we offer

Medical, vision, dental, and life and disability insurance
Company 401(k) plan
Access to top jobs
Competitive compensation

Fulltime

Medical Collections Specialist

We are in search of a diligent Medical Collections Specialist to join our team i...

Location

United States , Sacramento

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Proficiency in Medical Collections is a must
Familiarity with Medical Terminology is required
Demonstrable knowledge of Medical Terminology is essential
Experience in handling Claim Denials is necessary
Understanding of the HealthCare Revenue Cycle is crucial
Knowledge of HealthCare Reimbursement is a significant requirement

Job Responsibility

Ensure accurate and efficient processing of medical collections
Uphold comprehensive records relating to patient accounts and collections
Proficiently read and understand medical contracts to determine the permitted amount
Display a strong comprehension of insurance products such as HMO, PPO, and Medicare Advantage plans
Exhibit strong skills in writing appeals and effectively work with insurance companies to resolve denied or underpaid claims
Comfortably communicate with patients regarding their balances and explain adjudication outcomes
Apply analytical skills to make sound decisions on claim resolutions
Exhibit efficiency in managing a fast-paced, high volume work environment, while maintaining quality and meeting production goals
Foster a team-oriented environment and excel in achieving set objectives

What we offer

medical, vision, dental, and life and disability insurance
eligible to enroll in our company 401(k) plan

Claims and Denials Specialist

Robert Half

Location:
United States , Oakland

Category:
Insurance

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:
January 16, 2026

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Claims and Denials Specialist

Robert Half

Location:United States , Oakland

Category:Insurance

Contract Type:Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:January 16, 2026

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Location:
United States , Oakland

Category:
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Contract Type:
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Job Posted:
January 16, 2026