Claims Appeals Specialist Sr.

Long Beach, CA | Full time

Job ID: [CE] Industry: Healthcare Pay Rate: $24


The Claims Appeals Specialist is responsible for researching provider disputes by contracted and non-contracted providers.

How you will make a difference:

  • Identify root causes of disputes in order to identify and escalate issues
  • Understand and review provider contracts, and determine outcome of provider changes
  • Claims appeals specialist will be responsible for adverse claim determinations
  • Tracking and reporting appeals request
  • Claims appeals specialist will compile and prepare necessary documents


  • Ability to adapt to pace of environment
  • Knowledge of medical terminology
  • Managed health care claims processing 3+ years
  • Medicare benefits 3+ years
  • Education: Associates degree, or equivalent experience
  • Software: MS Office Suites: Outlook, Word, and Excel

Must be willing to submit to a background check, application, and online assessment process.

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