Helpmates

We are seeking a candidate who has Medical Insurance Payment Reviewer experience in the Cerritos area. This position is on site and is temporary (covering for a medical leave). Job Title: Medical Insurance Payment Reviewer  Hours: Monday-Friday 8:30am-5:00pm Pay Rate: $27.00 - $28.00

Job Summary: The primary responsibility of this role is to review payments made by insurance companies to ensure they align with contractual agreements. The ideal candidate will have experience in insurance claims and claims auditing; however, candidates with backgrounds in medical billing and/or medical collections will also be considered. Attention to detail is critical, as this position involves scrutinizing the fine print to ensure compliance and identify any potential overpayments that may require refunds.

Key Responsibilities:

• Review and analyze insurance payments against contracts to verify accuracy and compliance.
• Identify and document discrepancies, including potential overpayments.
• Collaborate with the billing and collections team to address any identified issues.
• Ensure compliance with insurance regulations and contractual obligations.
• Prepare reports on payment discrepancies and trends for management review.
• Assist in issuing refunds for overpayments as necessary.
• Maintain organized records of all reviews and communications related to payment analysis.

Qualifications:

• Previous experience in insurance claims, claims auditing, medical billing, or medical collections is preferred.
• 4-5 years in the Insurance or Medical field 
• Strong analytical skills with a keen eye for detail.
• Ability to interpret contracts and understand complex payment structures.
• Excellent organizational and communication skills.
• Proficient in [Insert relevant software or systems, if applicable].

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