Payment Posting & Denials Specialist

WE ARE TITANIUM HEALTHCARE
Titanium is a healthcare company that puts heart and compassion above all else. Millions of Americans just aren’t getting the medical care they need. We’re on a mission to change that. For patients that means exceptional support and better care. For providers it means better support and time to focus on patients, and for partners that means higher quality and lower cost.
Join us in our mission!
SUMMARY
The Payment Posting & Denials Specialist is responsible for the accurate and timely posting of health plan payments, reconciliation of remittance information, and resolution of claim denials for Enhanced Care Management (ECM), Community Supports (CS), and Outreach services. This role works closely with billing, operations, and payer representatives to ensure accurate reimbursement from Medi-Cal managed care plans. The ideal candidate will have strong payment posting experience, an understanding of Medi-Cal and managed care reimbursement, and the ability to research and resolve claims-related issues to maximize revenue recovery.
WHERE YOU’LL WORK
This position is hybrid and based out of our main office in Garden Grove, California. Standard business hours are Monday through Friday from 8:30 am to 5:00 pm.
WHAT YOU’LL DO
Accurately post payments, adjustments, recoupments, and offsets received from health plans and managed care organizations
Review and reconcile Electronic Remittance Advice (ERA), Explanation of Benefits (EOB), EFT payments, and check payments
Identify and resolve payment discrepancies, underpayments, overpayments, and unapplied payments
Research reimbursement issues and coordinate with payers to obtain additional information when needed
Monitor payer payment trends and escalate recurring reimbursement issues
Review denied claims and determine appropriate action for resolution
Submit corrected claims, disputes, reconsiderations, and appeals as appropriate
Work collaboratively with billing, authorization, and operations teams to resolve claim issues impacting reimbursement
Track and follow up on outstanding denials and high-dollar balances
Maintain accurate documentation of payment posting activities, denial resolutions, and account follow-up efforts
Assist with month-end payment reconciliation and reporting
Ensure compliance with payer guidelines, company policies, and regulatory requirements
Support special revenue cycle projects and departmental initiatives as assigned
WHO YOU ARE
Knowledge of payment posting, remittance processing, claim adjudication, denial management, and reimbursement methodologies
Strong analytical and problem-solving skills with the ability to identify payment trends and reimbursement issues
Excellent attention to detail and organizational skills
Sensory Requirements
Fluent in English (written and verbal)
Ability to communicate clearly in-person, by phone, and electronically
Adequate hearing and vision (with corrective devices if necessary) to conduct assessments and documentation
Ability to identify problems and use logic and related information to develop and implement solutions
Excellent written, verbal, and interpersonal communication skills with the ability to communicate effectively with employees and leaders at all levels of the organization
Physical Activity
Must be able to remain in a stationary position
Must be able to move around the office and/or travel throughout community
Ability to travel as needed to support business operations and organizational initiatives
Environmental Conditions
Ability to work independently and carry out assignments to completion within the parameters of established policies and procedures
Technology Use
Frequent use of computers, keyboard, and handheld/mobile devices
Ability to type for extended periods
Competent with computers, email, virtual platforms, and programs
Proficiency in Microsoft Office Suite, including Excel, with experience using business systems, reporting tools, and data analysis software
WHAT YOU’LL NEED
Diploma/GED required
Minimum 3+ years of healthcare revenue cycle experience with a strong focus on payment posting and accounts receivable follow-up
Experience reviewing ERAs, EOBs, payment reports, and claim status information
Distraction-free home workspace with a secure internet connection
NICE TO HAVES
Associate or bachelor's degree in healthcare administration, business administration, accounting, or another related field preferred
Experience working with Medi-Cal managed care plans and government-funded healthcare programs
Experience using eClinicalWorks (eCW)
Experience billing, posting payments, and resolving denials for ECM, CS, Outreach, or other Medi-Cal funded programs
Experience with claim appeals, disputes, and denial prevention strategies
WHAT YOU’LL ENJOY
Make an impact: an organization who cares about its employees, communities, and the future of healthcare
Inclusivity: be a part of a workplace where you not only belong but also can be the best version of yourself
Growth: opportunities to develop and grow your career with us
Community: you are encouraged to have a voice, share your opinions, and have an individual impact on the business
Paid Time Off: 12 holidays and up to 15 days of accrued PTO to rest and recharge plus additional time off for sick, jury duty, bereavement, reproductive loss, and therapy
Work Life Balance: enjoy flexibility to maximize your well-being and success with our hybrid work model
Medical, Dental, & Vision Benefits: we cover up to 100% of your premium and 50% of your dependents depending on the plan
Prioritize your mental health with unlimited therapy sessions funded 100% by Titanium Healthcare
Flexible Spending, Health Savings & Dependent Care Accounts
Life/AD&D insurance funded 100% by Titanium Healthcare
Supplemental Disability Plans
Employee Assistance Programs
Protect your pet(s) with Pet Insurance
Employee Referral Program: earn up to $1000 for each referral
401(k) plan and Roth IRA options
EEO Statement
At Titanium Healthcare, our mission is to fearlessly reengineer the way healthcare works to reduce costs, ensure better outcomes, and provide everyone, everywhere, with the kind of compassionate and coordinated care they deserve. We believe that achieving this mission starts with a diverse and inclusive workforce.
Titanium Healthcare is an equal opportunity employer. We are committed to promoting and celebrating all backgrounds and encourage all applicants, regardless of race, religion, gender, sexual orientation, disability, age, marital status, parental status, military or veteran status, or any other legally protected status, to apply. We believe that diversity and inclusion drive innovation and equity in healthcare, enabling us to better serve our communities and make a lasting impact.

Employment type
Full-Time

Work arrangement
No