We are looking for an experienced Medical Biller/Collections Specialist to join our team in Minneapolis, Minnesota. This contract position offers an excellent opportunity to utilize your expertise in medical billing, collections, and insurance claims processing. The ideal candidate will possess strong analytical skills and a solid understanding of healthcare billing and insurance procedures.<br><br>Responsibilities:<br>• Handle patient account inquiries and resolve billing issues efficiently.<br>• Process and review medical claims for accuracy and compliance with insurance requirements.<br>• Collaborate with insurance companies to address denials, appeals, and reimbursements.<br>• Maintain detailed records of billing and collections activities.<br>• Utilize electronic systems to track claims and payments.<br>• Ensure compliance with healthcare regulations and billing standards.<br>• Communicate with patients regarding account balances and payment plans.<br>• Analyze Explanation of Benefits (EOBs) to identify discrepancies and resolve them.<br>• Work closely with the team to improve billing processes and reduce errors.
<p>We are looking for a skilled Medical Billing Specialist to join our client's team in Beaverton, Oregon. This part time, long-term contract position is ideal for a detail-oriented individual with expertise in medical billing and coding. The role involves interacting with claims, denials, and insurance billing processes while ensuring compliance with industry standards.</p><p><br></p><p>Responsibilities:</p><p>• Process and submit accurate medical billing claims using Advanced MD software.</p><p>• Conduct thorough follow-ups on insurance claims and resolve any issues related to denials.</p><p>• Perform medical coding tasks, including assigning appropriate codes for new testing procedures.</p><p>• Manage collections and ensure timely payments from insurance providers such as Medicare, Medicaid, and Tricare.</p><p>• Research and analyze billing discrepancies to identify solutions and maintain financial accuracy.</p><p>• Utilize critical thinking skills to streamline operations and improve billing workflows.</p><p>• Collaborate with other departments to ensure proper documentation and coding compliance.</p><p>• Maintain up-to-date knowledge of billing regulations and industry standards.</p><p><br></p>
We are looking for a dedicated Claims Adjustor to join our team on a contract basis in Des Moines, Iowa. In this role, you will handle medical-only workers' compensation claims, ensuring accuracy and prompt processing. This position requires excellent customer service skills and attention to detail to effectively manage a low volume of daily calls and claims.<br><br>Responsibilities:<br>• Review workers' compensation claims to ensure compliance with medical and insurance standards.<br>• Process medical-only claims accurately and in a timely manner.<br>• Communicate with customers to address inquiries and provide exceptional service.<br>• Collaborate with team members to maintain organized and efficient claim workflows.<br>• Handle medical billing and insurance claim documentation with precision.<br>• Monitor and manage medical denials and appeals to resolve issues.<br>• Support hospital billing processes and ensure proper claim handling.<br>• Maintain detailed records for claims and related communications.<br>• Identify discrepancies in claim submissions and take corrective actions.<br>• Provide regular updates and reports on claim processing activities.
<p>We are looking for a skilled Surgery Medical Collections Specialist to join our team. In this role the Surgery Medical Collections Specialist will play a critical part in managing insurance follow-ups, addressing medical appeals, and resolving claim denials. This position is ideal for someone with expertise in medical billing and collections, particularly in surgical and outpatient care settings.</p><p><br></p><p>Responsibilities:</p><p>• Conduct thorough follow-ups on insurance claims to ensure timely reimbursements.</p><p>• Analyze and resolve denied claims by identifying errors and submitting appeals as necessary.</p><p>• Collaborate with insurance companies to address discrepancies and secure payment resolutions.</p><p>• Maintain accurate and up-to-date records of all collection activities and claim statuses.</p><p>• Process billing for ambulatory and outpatient surgical procedures, ensuring compliance with regulations.</p><p>• Communicate effectively with patients regarding outstanding balances and payment plans.</p><p>• Review accounts to detect patterns in denials and recommend process improvements.</p><p>• Work closely with the billing team to streamline claims submission and follow-up processes.</p><p>• Stay informed about changes in insurance policies and billing procedures to ensure compliance.</p>
We are looking for a detail-oriented Medical Billing Specialist to join our team on a long-term contract basis. In this role, you will play a critical part in ensuring accurate and timely processing of medical billing and claims for a healthcare facility in Raeford, North Carolina. This position offers the opportunity to contribute to the smooth financial operations of a trusted healthcare provider.<br><br>Responsibilities:<br>• Prepare, review, and submit medical claims to insurance companies, ensuring accuracy and compliance with regulations.<br>• Follow up on outstanding claims and resolve any issues or discrepancies promptly.<br>• Verify patient insurance coverage and eligibility to facilitate proper billing.<br>• Maintain detailed records of billing activities and ensure confidentiality of sensitive information.<br>• Collaborate with healthcare providers and administrative staff to clarify billing details and address concerns.<br>• Monitor and analyze billing trends to identify opportunities for process improvements.<br>• Respond to patient inquiries regarding billing statements and insurance claims.<br>• Ensure compliance with all relevant healthcare and billing laws, regulations, and guidelines.<br>• Assist in generating financial reports related to billing and collections.
<p>A Regional Hospital in Los Angeles tied to a large University, is looking for a skilled Medical Collections Specialist to join the medical revenue cycle team. In this role, the Medical Collections Specialist will be tasked with managing and processing medical insurance claims for acute care facilities, ensuring accuracy and efficiency in collections. The Medical Collections Specialist position offers an opportunity to utilize your expertise in UB-04 claims while collaborating with internal and external stakeholders to resolve outstanding balances.</p><p><br></p><p>Responsibilities:</p><p>• Oversee the collection process for medical insurance claims, ensuring timely and accurate submissions.</p><p>• Handle UB-04 claim forms for acute care facilities, verifying compliance with regulatory standards.</p><p>• Conduct follow-ups with insurance providers to address unpaid claims, denials, or payment discrepancies.</p><p>• Collaborate with internal teams and external payers to resolve outstanding account balances.</p><p>• Ensure all claims adhere to insurance and regulatory requirements.</p><p>• Maintain thorough documentation and records of claim statuses within organizational systems.</p><p>• Analyze and address issues related to medical billing, appeals, and denials.</p><p>• Provide expertise in managing hospital billing for both inpatient and outpatient services.</p><p>• Support the optimization of the hospital revenue cycle through accurate collections processes.</p><p><br></p><p>This company believes in its employee moral offering tuition reimbursement, medical/dental insurance and 15% 401k retirement matching,</p>
We are looking for a detail-oriented Billing Clerk to join our team in Taunton, Massachusetts. This long-term contract position requires someone with experience in medical billing, particularly in behavioral health and healthcare settings. The ideal candidate will possess strong organizational skills and the ability to work independently while handling claims and insurance-related tasks efficiently.<br><br>Responsibilities:<br>• Perform claims reconciliation for Mass Medicaid, including researching issues and addressing approvals or denials.<br>• Manage medical billing processes accurately and in compliance with healthcare standards.<br>• Ensure patient insurance and demographic records are updated and maintained correctly.<br>• Process charge entries for assigned programs promptly and with precision.<br>• Build and maintain effective communication with insurance representatives to resolve billing issues.<br>• Provide guidance to program directors and clinicians regarding billing procedures and requirements.<br>• Monitor high balance accounts and report problematic account activities to the Billing Manager.<br>• Review aging reports regularly to ensure claims are submitted within the payer’s timely filing limits.<br>• Conduct independent research to stay informed about payer specifications and healthcare billing requirements.<br>• Utilize clearing house platforms, such as Inovalon, to streamline billing processes.
We are looking for a detail-oriented Denials Specialist to join our team in Minnetonka, Minnesota on a contract basis. In this role, you will be responsible for analyzing and resolving denied or underpaid claims, ensuring compliance with regulations, and contributing to process improvements that minimize future denials. This position requires strong analytical skills and a thorough understanding of medical claims and insurance processes.<br><br>Responsibilities:<br>• Investigate and analyze denied or underpaid claims to identify underlying issues and recommend corrective actions.<br>• Prepare and submit appeals with complete and accurate supporting documentation within established deadlines.<br>• Track and document denial patterns, providing data-driven insights to billing and coding teams.<br>• Collaborate with various departments to implement strategies that prevent recurring denials.<br>• Prioritize and manage aging accounts, focusing on high-dollar or high-risk claims for efficient resolution.<br>• Ensure all activities comply with organizational policies and relevant regulations.<br>• Conduct audits on claims data to verify accuracy and identify discrepancies.<br>• Utilize Epic Clinical systems and other tools to manage claims processing workflows.<br>• Maintain detailed and organized records of claims and appeals for reporting purposes.<br>• Support collection efforts by providing necessary documentation and insights.
<p>Robert Half Legal is partnering with an insurance company located in downtown Chicago who is seeking to hire a Claims Attorney with at least 2-4+ years of experience to join their in-house team. This specialty insurance company handles complex environmental, asbestos, and other latent type insurance claims. In this position, you will be responsible for coordinating activities involving these claims, including resolution of coverage issues and establishment of adequate reserves. See further responsibilities below. Salary for the role is paying between $100-120K plus a 5% bonus while working on a 40-hour work week. In addition, the company offers a comprehensive benefits package including medical, dental, vision, generous PTO, 401k (plus match), LT/ST Disability, Life Insurance, and more. This position will start working fully in-office and begin transitioning to a hybrid schedule after 6-months. If you're looking to take your career in-house and get away from billable requirements, then this is the opportunity for you!</p><p><br></p><p><strong><u>Claims Attorney Responsibilities:</u></strong></p><ul><li>Analyzing, investigating, and evaluating new loss notices and claim tenders</li><li>Collaborating with policy search teams to find copies of alleged coverage where appropriate</li><li>Analyzing and positioning claim under applicable primary, umbrella, and excess coverage swiftly</li><li>Coordinating the retention of defense counsel with internal/external stakeholders</li><li>Establishing defense strategy with insured, defense counsel, and/or other participating insurance carriers</li><li>Managing the case resolution process and actively participating in mediations as needed</li><li>Working with the reinsurance department to provide notice of new accounts, updates on existing accounts, and responding to specific reinsurer inquiries</li><li>Collaborating with in-house Legal/management to manage declaratory judgment actions, including formation and implementation of resolution strategy, settlement valuation, and obtaining settlement authority</li><li>Coordinating timely processing of payments including verifying proper allocation of such payments across appropriate policies</li><li>Managing ALAE through strategic handling and bill review/payment processing in coordination with the billing unit.</li></ul><p><br></p><p>For immediate consideration, please email your resume directly to Justin Rambert, VP - Permanent Placement at <strong><u>justin . rambert @ robert half com</u></strong></p>
We are looking for a skilled Medical Billing Specialist to join our team in Phoenix, Arizona. This long-term contract position is ideal for professionals with a strong background in denial management and claims follow-up within the healthcare industry. You will play a key role in ensuring accurate billing processes and effective communication with insurance providers.<br><br>Responsibilities:<br>• Analyze denied insurance claims to identify underlying issues and determine appropriate follow-up actions.<br>• Communicate with insurance companies via phone and online portals to resolve claim disputes efficiently.<br>• Apply critical thinking skills to investigate claim discrepancies and ensure timely resolutions.<br>• Collaborate with team members to maintain accurate and up-to-date billing records.<br>• Utilize specialized systems and tools to process claims and manage accounts receivable.<br>• Provide support in training on organization-specific billing processes and software nuances.<br>• Ensure compliance with healthcare billing regulations and procedures.<br>• Monitor accounts for outstanding balances and take necessary steps for collection.<br>• Prepare detailed reports on billing activities and claim resolutions.<br>• Maintain professionalism and confidentiality in handling sensitive patient and insurance information.
We are looking for an experienced Healthcare Litigation Attorney to join our team on a long-term contract basis. This position is based in Pennington, New Jersey, and focuses on supporting litigation efforts related to recovering funds from auto and workers’ compensation insurance carriers. The ideal candidate will have a strong legal background, particularly in healthcare litigation, and a proven ability to manage claims and collaborate effectively within legal and billing teams.<br><br>Responsibilities:<br>• Investigate and manage cases involving unpaid or denied claims from auto insurance carriers.<br>• Represent the organization in litigation efforts to recover funds owed.<br>• Collaborate with internal teams, including legal and billing, to address complex claim issues.<br>• Conduct detailed reviews and analyses of legal documents and insurance policies.<br>• Ensure accurate record-keeping and tracking of cases throughout their lifecycle.<br>• Provide legal expertise on matters involving workers’ compensation and auto insurance claims.<br>• Develop strategies to resolve disputes and recover payments in compliance with legal standards.<br>• Support trial preparation and discovery processes as needed.<br>• Utilize case management software to organize and monitor legal activities.<br>• Maintain a high level of professionalism and efficiency in handling a large volume of cases.
A Robert Half client is looking for a Member Services Representative to join their team near Hoffman Estates, Illinois. In this role, you will serve as a key point of contact for members, fostering positive relationships and assisting with their needs. The ideal candidate is detail-oriented, customer-focused, and experienced in claims processing and member services. <br> Key Details: Role: Member Service Associate (similar to CSR/Admin within financial services, insurance, banking, risk, or even healthcare billing/claims—NOT a call center position) Schedule: Mon–Fri, 8AM–4PM, 100% on-site Compensation/Benefits: $26–$29/hour, based on experience and education; overtime opportunities available + full benefits package Position Highlights: Serve as the first point of contact for insured members to process claims, answer inquiries, and update information Handle sensitive member data and documents, ensuring privacy, security, and compliance Work closely with beneficiaries throughout claims and changes (address updates, beneficiary designations, etc.) Perform administrative/research tasks and support department projects Maintain accurate records in Salesforce and other internal systems Participate in weekly team meetings and ongoing training as you grow in the role <br> If you are interested in contributing to a friendly and committed team that makes an impact for its members—and your experience aligns with any of the above—please apply!
We are looking for a dedicated Claims specialist to join our team in Los Angeles, California. This contract-to-permanent position offers an exciting opportunity to contribute to effective claims management processes within the service industry. The ideal candidate will bring expertise in workers' compensation and a proactive approach to managing medical records, claims data, and communication with stakeholders.<br><br>Responsibilities:<br>• Oversee the management of medical records related to workplace injuries, ensuring timely submission to insurance adjusters.<br>• Input medical details from records into the system and provide updates on diagnoses and work status to supervisors.<br>• Support injured employees and managers in implementing early return-to-work programs.<br>• Schedule and monitor follow-up doctor appointments, ensuring medical statuses are documented within 24 hours of visits.<br>• Communicate appointment outcomes to adjusters and supervisors promptly, maintaining a 24-hour response time.<br>• Track and update lost time and modified work statuses in the system regularly.<br>• Maintain consistent communication with insurance adjusters every 60 days until claims are resolved.<br>• Conduct audits of claim data and other relevant records to ensure accuracy and compliance.<br>• Monitor and review organizational claim-related data on a monthly basis.
<p>We are looking for a detail-oriented Medical Billing Specialist to join our team in Baltimore, Maryland. This is a contract-to-permanent position within the medical devices industry, offering an opportunity to contribute to healthcare operations through accurate billing and coding practices. The ideal candidate will have hands-on experience in medical billing and a solid understanding of insurance processes, including Medicare, Medicaid, and third-party payers.</p><p><br></p><p>Responsibilities:</p><p>• Handle medical billing and coding tasks with precision and attention to detail.</p><p>• Reach out to insurance companies to resolve billing issues and ensure claims are processed effectively.</p><p>• Manage reimbursements and claims for Medicare, Medicaid, and third-party insurance providers.</p><p>• Collaborate with healthcare providers to verify patient insurance benefits and coverage.</p><p>• Maintain accurate records of billing and insurance communications.</p><p>• Ensure compliance with healthcare regulations and billing standards.</p><p>• Assist in identifying discrepancies in claims and resolving them promptly.</p><p>• Provide support in medical collections processes, ensuring timely payments.</p><p>• Communicate with patients regarding billing inquiries and insurance coverage.</p>
<p>A Senior Software Business Analyst is needed to play a crucial role in connecting business requirements to technical solutions. This role involves engaging with stakeholders to gather and analyze requirements, transforming them into actionable functional specifications. Responsibilities include evaluating existing processes, offering solutions to drive business value, and ensuring project success under tight timelines. The position also includes mentoring junior analysts, leading cross-departmental projects, and fostering innovation. Strong analytical and communication skills, along with a solid understanding of software development life cycles, are essential to succeed in this fast-paced environment.</p><p>The ideal candidate will work closely with development and QA teams to monitor project milestones, provide updates to stakeholders, and address any project risks and challenges. A proactive approach to improving application usability and efficiency will be critical. Focusing on the specialty pharmacy sector, the organization provides end-to-end solutions including hub services, pharmacy network management, group purchasing (GPO) services, cutting-edge technology platforms, and more. With a strong presence as an industry advocate, the focus remains on delivering strategic channel management, advanced products, and tailored services to optimize patient outcomes and improve healthcare delivery.</p><p><br></p><p><strong>** Qualified candidates should have experience with pharmacy insurance, medical insurance, and claims processing **</strong></p><p><br></p><p><strong>Key Responsibilities:</strong></p><ul><li>Collect and translate business requirements into detailed functional specifications for new and existing systems.</li><li>Perform gap analyses between current system capabilities and business needs using tools like Confluence, flowcharts, and wireframes to document workflows.</li><li>Create use cases for review during functional testing phases by developers and QA teams.</li><li>Work with IT teams to evaluate project scope and affected systems, providing strategic insights.</li><li>Assess new methodologies for feasibility and implementation efficiency.</li><li>Gain in-depth knowledge of internal software platforms and their underlying functionalities.</li><li>Analyze and optimize existing processes to identify inefficiencies and propose re-engineering solutions.</li><li>Host regular meetings with development teams to resolve obstacles and track progress.</li><li>Provide project status reports to business stakeholders.</li><li>Identify potential risks and escalate issues as required.</li><li>Continuously explore opportunities to improve application functionality, making recommendations for enhancements.</li><li>Maintain compliance with HIPAA regulations and related amendments</li></ul>
<p>We are looking for a motivated and detail-oriented Medical Accounts Receivable Specialist to join our team, working Monday through Friday from 8:00 AM to 4:30 PM. In this role, you will play a critical part in maintaining the financial health of our organization by handling Medicare billing, patient accounts, and insurance claims with precision and efficiency. Success in this position requires strong expertise in medical billing processes, exceptional customer service skills, and the ability to manage accounts through to their final resolution.</p><p><br></p><p><strong>Responsibilities:</strong></p><ul><li>Process Medicare billing activities, ensuring accurate handling and management of patient accounts.</li><li>Submit both electronic and paper insurance claims in compliance with payer guidelines.</li><li>Bill patient claims promptly and manage associated patient accounts with attention to compliance and accuracy.</li><li>Perform timely payment follow-ups to resolve outstanding balances; communicate effectively with stakeholders as needed.</li><li>Review work list activities regularly to prioritize and address accounts requiring immediate attention.</li><li>Work all assigned accounts diligently until final resolution, documenting every step accurately.</li><li>Review remittances to verify charges processed or paid align with insurance contracts and fee schedules.</li><li>Interpret and understand the billing UB04 form and 1500 form.</li></ul><p><br></p>
We are looking for a detail-oriented Medical Claims Analyst to join our team in Raleigh, North Carolina. This long-term contract position is ideal for someone with extensive experience in medical claims processing and a strong ability to manage repetitive clerical tasks effectively. The role requires a collaborative team player who is dependable, punctual, and committed to delivering high-quality results.<br><br>Responsibilities:<br>• Process and reconcile medical claims efficiently, ensuring all records are accurate and up-to-date.<br>• Resubmit denied or rejected claims, following proper protocols to secure approvals.<br>• Post payments accurately into multiple systems, maintaining consistency and precision.<br>• Utilize payer portals to manage claims and track progress effectively.<br>• Perform clerical tasks such as data entry and filing with a focus on accuracy and attention to detail.<br>• Collaborate with a team of professionals to ensure smooth workflows and timely completion of tasks.<br>• Monitor claim statuses to identify and resolve discrepancies proactively.<br>• Maintain compliance with relevant policies and regulations in the healthcare industry.<br>• Provide support in behavioral health payment posting processes.<br>• Communicate effectively with team members and external parties regarding claim-related issues.
We are looking for a Billing Clerk to join our team in Roslyn Heights, New York. In this role, you will play a critical part in ensuring the accuracy and efficiency of billing processes within a healthcare setting. Your responsibilities will include managing insurance claims, addressing patient inquiries, and contributing to the overall success of the revenue cycle.<br><br>Responsibilities:<br>• Analyze and address denials and underpaid claims from insurance carriers based on contracted fee schedules.<br>• Submit appeals for inappropriate insurance denials in a timely manner.<br>• Communicate with patients to resolve questions about their claims, coverage, and billing concerns.<br>• Validate overpayment refund requests from insurance carriers to ensure accuracy.<br>• Monitor and identify trends among payors that impact revenue.<br>• Participate in individualized accounts receivable reviews with management.<br>• Determine coordination of benefits for patients with secondary and tertiary insurance coverage.<br>• Support various tasks related to revenue cycle operations as needed.<br>• Maintain constructive and positive interactions with patients, colleagues, and managers to foster a collaborative work environment.
<p>We are looking for a skilled Medical Billing Specialist to join our team in Elizabethtown, North Carolina. This is a long-term contract position offering an excellent opportunity to contribute to a healthcare environment dedicated to patient care and operational excellence. The ideal candidate will bring expertise in medical billing processes and a commitment to accuracy and efficiency.</p><p><br></p><p>Responsibilities:</p><p>• Process and submit medical claims to insurance companies with accuracy and attention to detail.</p><p>• Review and resolve claim denials or discrepancies to ensure timely reimbursement.</p><p>• Maintain up-to-date knowledge of medical billing codes and insurance regulations.</p><p>• Collaborate with healthcare providers and administrative staff to address billing inquiries.</p><p>• Monitor and track payments, ensuring proper documentation and record-keeping.</p><p>• Generate and analyze billing reports to identify trends and improve processes.</p><p>• Assist patients with billing-related questions and provide clear and precise communication.</p><p>• Ensure compliance with all billing policies, procedures, and legal requirements.</p><p>• Support the implementation of new billing systems or updates as needed.</p>
<p>We are looking for a Medical Claims Supervisor to lead a dynamic team in Winston-Salem, North Carolina. This role requires a skilled leader with a strong background in healthcare claims and a commitment to driving performance while maintaining a supportive team environment. The ideal candidate will bring both industry expertise and leadership experience to help the department achieve its goals. This is an onsite position. </p><p><br></p><p>Responsibilities:</p><p>• Oversee the daily operations of a team handling healthcare claims inquiries and adjudications.</p><p>• Monitor performance metrics, including KPIs, to ensure the department meets its objectives.</p><p>• Provide guidance and support to team members, fostering growth and accountability.</p><p>• Address escalated claims-related issues and ensure timely resolution.</p><p>• Collaborate with team leads to implement strategies that enhance efficiency and service quality.</p><p>• Develop and maintain workflows for processing claims and customer service inquiries.</p><p>• Train and onboard new hires, ensuring they understand company policies and procedures.</p><p>• Maintain a cohesive team environment, balancing empathy with performance-driven management.</p><p>• Evaluate and improve processes related to CRM systems to optimize customer interactions.</p><p>• Coordinate with upper management to align departmental goals with organizational priorities.</p>
We are looking for a skilled Clinical Policy Coding Administrator to join our team on a contract basis. This position is based in Mountlake Terrace, Washington, and offers an excellent opportunity to contribute to the health insurance industry. The selected candidate will play a key role in analyzing medical policies, ensuring accurate coding, and supporting cross-functional collaboration to enhance policy implementation and claims processing.<br><br>Responsibilities:<br>• Analyze and interpret medical policies to identify and update accurate procedure and diagnosis codes.<br>• Collaborate with cross-functional teams to ensure seamless implementation of medical policies and utilization management guidelines.<br>• Provide coding expertise to support decision-making processes related to claims, reimbursement, and product configuration.<br>• Conduct thorough research and data analysis to evaluate the effectiveness of medical policy implementation.<br>• Facilitate meetings and discussions with stakeholders to address coding edits and mitigate downstream impacts.<br>• Ensure coding updates align with medical necessity and regulatory requirements.<br>• Act as a subject matter expert in coding-related matters for various departments.<br>• Address cross-functional requests with detailed assessments to enhance consistency in claims processing.<br>• Support the development of medical policies by providing accurate coding recommendations.<br>• Maintain compliance with industry standards and company-specific coding practices.
We are looking for a dedicated Patient Access Specialist to join our team in Bethel Park, Pennsylvania. In this role, you will handle critical tasks related to patient registration, insurance verification, and admissions while providing exceptional customer service. This is a Contract to permanent position, offering an excellent opportunity for growth in the healthcare industry.<br><br>Responsibilities:<br>• Accurately assign medical record numbers (MRNs) and perform medical necessity and compliance checks for patient admissions.<br>• Provide detailed instructions and collect insurance details from patients while maintaining a compassionate and detail-oriented demeanor.<br>• Meet assigned point-of-service goals and ensure compliance with organizational policies.<br>• Conduct quality audits on patient accounts to ensure accuracy and compliance, providing feedback and statistical data to leadership.<br>• Pre-register patient accounts by gathering demographic, insurance, and financial information through inbound and outbound calls.<br>• Explain and obtain signatures for consent forms and provide patients with required educational documents, such as Medicare or Tricare notices.<br>• Verify insurance eligibility and input benefit data to ensure smooth billing processes and clean claim submissions.<br>• Perform medical necessity screenings using the appropriate software and inform patients of potential non-payment scenarios.
<p>We are looking for a dedicated Claims Representative to join our team in Napoleon, Ohio. This position involves adjusting and settling claims across various lines of business. As a Contract to permanent role, it offers the opportunity to transition to a long-term position based on performance and company needs. The ideal candidate will have strong communication skills, a commitment to customer service, and the ability to work effectively within company systems.</p><p><br></p><p>Responsibilities:</p><p>• Manage claims in accordance with company policies and the Unfair Claims Practices Act.</p><p>• Verify coverage for assigned claims to ensure proper handling.</p><p>• Conduct investigations and evaluations to determine appropriate settlements.</p><p>• Coordinate with independent adjusters and appraisers when necessary.</p><p>• Handle subrogation, salvage, and third-party liability contributions.</p><p>• Notify supervisors about claims exceeding settlement authority limits.</p><p>• Set accurate reserves for claims and monitor their status.</p><p>• Report potential fraud, complaints, or questionable submissions to the Claims Supervisor.</p><p>• Participate in training seminars and relevant associations to enhance skills.</p><p>• Complete additional tasks assigned by the Claims Supervisor or Manager.</p>
We are looking for a dedicated Insurance Follow-Up Specialist to join our team in Tampa, Florida. This role requires a proactive individual who can effectively manage communication with funeral homes and insurance representatives while ensuring timely document processing. As a contract position with potential for long-term collaboration, it offers an opportunity for growth.<br><br>Responsibilities:<br>• Collaborate with funeral homes to obtain necessary signatures and documentation promptly.<br>• Address and resolve delays in document processing with professionalism and persistence.<br>• Establish and maintain strong relationships with insurance representatives and funeral home partners.<br>• Accurately record and organize case information to ensure seamless tracking and follow-up.<br>• Provide additional support to the Concierge team by handling extra follow-up tasks when required.
<p>We are looking for a dedicated and empathetic Customer Service Representative with expertise in healthcare call center operations. In this role, you will handle inquiries related to medical eligibility, benefits, claims, and provider information while maintaining a high level of professionalism and accuracy. This is a Contract to permanent position that offers the opportunity to grow within the organization for the right candidate. While the position is primarily remote, occasional in-office attendance may be required depending on location.</p><p><br></p><p>Responsibilities:</p><p>• Respond to a high volume of customer inquiries via phone and email regarding medical benefits, claims, and provider information.</p><p>• Provide accurate and detailed information about healthcare plans, pre-authorizations, and claim statuses.</p><p>• Utilize tracking systems to document all interactions and ensure proper follow-up.</p><p>• Stay updated on changes to healthcare policies, procedures, and benefits to provide accurate guidance.</p><p>• Resolve customer complaints and troubleshoot issues with professionalism and efficiency.</p><p>• Advise members on outstanding payments and explain billing details when necessary.</p><p>• Assist callers in navigating network provider options and understanding plan coverage.</p><p>• Escalate complex issues to supervisors or managers when required.</p><p>• Collaborate with team members to ensure seamless customer support.</p><p>• Adhere to HIPAA policies and maintain confidentiality in all interactions.</p>
