Robert Half Finance & Accounting Contract Talent is currently seeking a highly skilled Healthcare Claims Processor to join our client's team.<br><br>Opportunity Overview:<br>We are in search of a detail-oriented Healthcare Claims Processor with a strong background in healthcare AR follow-up, insurance claim collection, and claims processing. This role is critical in understanding the complexities of claim denials, drafting appeal letters, and ensuring the reimbursement process operates smoothly. The position demands a commitment of 40 hours per week.<br><br>Key ResponsibIlities:<br>Conduct thorough healthcare AR follow-up, focusing on prompt reimbursement.<br>Skillfully handle the collection of insurance claims, ensuring accuracy and completeness.<br>Execute comprehensive claims processing, proactively addressing potential denial factors.<br>Demonstrate expertise in identifying and resolving issues leading to claim denials.<br>Draft persuasive appeal letters to challenge and rectify denied claims.<br>Stay informed about industry changes and insurance regulations affecting claims processing.<br><br>Qualifications:<br>Proven experience in healthcare claims processing, with a deep understanding of industry best practices.<br>Proficient knowledge of insurance claim collection procedures.<br>Familiarity with the intricacies of claim denial factors and effective resolution strategies.<br>Exceptional skills in drafting compelling appeal letters.<br>Available to commence work in March with a commitment of 40 hours per week.<br><br>Additional Details:<br>Familiarity with relevant healthcare coding systems is preferred.<br>Ability to navigate and utilize healthcare information systems effectively.<br>Understanding of healthcare compliance regulations and privacy laws.<br>Strong analytical skills to identify patterns and trends in claim denials.<br>Collaborative approach to work, ensuring seamless coordination with other healthcare professionals.<br><br>To express your interest in this role or to obtain further information, please reach out to us directly at (314) 262-4344. We are eager to discuss this exciting opportunity with you.
We are looking for a Claims Support specialist to join our team in Alpharetta, Georgia. This Contract position requires an individual with strong organizational skills who can handle claims processing, customer service, and administrative tasks with efficiency and attention to detail. The role is fully onsite, with a five-day workweek, offering an excellent opportunity to contribute to a dynamic office environment.<br><br>Responsibilities:<br>• Verify and review the accuracy of information for newly received claims in accordance with coverage guidelines.<br>• Update claim files within the system as instructed by claims representatives.<br>• Process loss payments using Claim Vision and ensure all transactions are accurately recorded.<br>• Deliver exceptional customer service to agents, insureds, clients, and other stakeholders.<br>• Handle the processing of authorized payments and maintain detailed records.<br>• Input data, correspondence, and diary updates into the system, while preparing form letters and maintaining documentation.<br>• Perform administrative duties such as typing, photocopying, indexing, and filing to support claims operations.<br>• Calculate wages and draft well-crafted correspondence related to claims.<br>• Contact insureds to request missing information required for claim file completion.<br>• Apply basic knowledge of Southeastern jurisdiction laws related to workers' compensation, when necessary.
<p>Robert Half has an exciting opening for a Claims Business Analyst with an Insurance client based here in Tampa, FL.</p><p>Position kicks off on-site for initial onboarding period, before then becoming a permanent HYBRID schedule (Must be local to Tampa Bay area).</p><p>Compensation ranges $90-110K depending on experience (years as BA, years in P& C/Insurance/Banking)</p><p>Interviews are actively being scheduled - Apply NOW!</p><p><br></p><p><br></p><p><strong>TOP Skills/Experience Looking for:</strong></p><ul><li>Business Analyst experience in the Property & Casualty Insurance industry (or Banking)</li><li>Experience w/ Guidewire Software and ClaimCenter</li></ul><p><strong>Summary:</strong></p><p>The Claims Business Analyst will work with stakeholders across the enterprise to deliver business solutions that meet the needs of the stakeholders and the organization. This role involves gathering and documenting business requirements, answering questions from Developers and Quality Analysts, performing systems analysis and testing, and managing project priorities. Additionally, the Claims Business Analyst will be responsible for UI based configuration changes, demos of functionality to the business, and developing relationships with members of the Claims management team. </p><p> </p><p><strong>Responsibilities:</strong></p><ul><li>Elicit and document detailed business requirements for systems necessary to administer claims in accordance with established rules, configurations , and guidelines</li><li>Create and maintain documentation on system functionality</li><li>Assist with development and execution of test cases to ensure system changes meet business requirements by partnering with Quality Analysts as needed</li><li>Perform systems analysis and testing to identify and resolve application system problems</li><li>Coordinate changes and ensure proper communication and demos to the business with internal departments such as Claims, Customer Service, Finance as well as external customers</li><li>Configure system changes and ensure they are implemented correctly</li><li>Collaborate with Development team and other departments to ensure seamless integration and functionality of system changes</li></ul>
<p>Robert Half is working with a great client on the North Shore seeking a Claims Adjuster to join its team. This is a permanent role, alongside an established team, responsible for visiting local claims sites for assessments, and will work in office a couple days per week as needed. Our client is looking for experience in the insurance industry, preferably property & casualty. Any experience with claims adjusting is preferred.</p><p><br></p><p>Salary is dependent on experience, but somewhere between $70-110K is the target. The benefits are competitive too.</p><p><br></p><p>If interested in and qualified for the Claims Adjuster role please message me ASAP or apply to this listing. Bill.Nichols@roberthalf. Thanks!</p>
We are looking for a highly detail-oriented Claims Data Entry Clerk to join our team in Grand Rapids NT, Michigan. This Contract-to-permanent position is ideal for someone who thrives in a structured and repetitive work environment, with a focus on maintaining accuracy and efficiency. The role involves processing medical, dental, and vision claims, requiring precision to ensure claims are entered correctly and paid accurately.<br><br>Responsibilities:<br>• Accurately input medical, dental, and vision claims into the QuickLink claims processing system.<br>• Maintain a high level of accuracy, achieving 99% audit compliance during training and beyond.<br>• Follow strict confidentiality protocols while handling sensitive claim information.<br>• Collaborate with the team and trainer to review errors and improve data entry techniques.<br>• Meet daily productivity goals, including processing up to 60 claims per day after completing training.<br>• Complete an extensive training program lasting approximately 60 days to master the system and workflow.<br>• Handle both simple and complex claims, some requiring additional attachments and knowledge.<br>• Rely on experienced team members for guidance and support during the learning process.<br>• Take on additional responsibilities as workload expands over time.<br>• Ensure the consistent transposition of information from paper claims into digital systems.
<ul><li><strong>Position: </strong>CLAIMS ADJUSTER (Contract Role) Temp to Perm opportunity.</li><li><strong>Type: 100% REMOTE</strong></li><li><strong>Hourly Pay Range: $20-$25/per hour</strong></li><li><strong>Job Hours: It is 40 hours per week. The hours of operation are 9-6 ET.</strong></li></ul><p> </p><p>Job Schedule: Fully Remote</p><p>Job Hours: 40 hours per week M-F. Start and end times are flexible but typically 9-6 ET.</p><p>Interview Process: Virtual</p><p> </p><p>Job Description:</p><p>Summary:</p><p>The Claim Adjuster is an individual contributor role responsible for successfully and compliantly adjudicating claims meeting claim execution targets and delivering a WoW! experience to our Pet Parents every day.</p><p> </p><p>Responsibilities:</p><p>- Adjudicating claims</p><p>- Meeting or exceeding daily claim targets</p><p>- Providing guidance oversight and final approval authority to non-licensed claims processors from GenPact AdStrat or Healthy Paws</p><p>- Obtaining and maintains advanced adjuster licenses according to state and municipality requirements</p><p>- Ensuring claims are compliantly processed and adjudicated following standard operating procedures and processes</p><p>- Identifying process improvement opportunities and implementing solutions</p><p> </p><p>Skills:</p><p>- Be a licensed Claim Adjuster or have the experience to become a licensed Claim Adjuster within six months</p><p>- Property and Casualty License</p><p>- Ability to effectively communicate with pet parents</p><p>- Problem solving and decision-making skills</p><p>- Organizational and time management skills</p><p>- Basic IT skills - To be successful in this fully remote role its important that they feel confident managing basic functions independently-such as attaching files to emails editing shared documents troubleshooting simple issues like screensharing and knowing when to escalate tech concerns to the right person-since all job duties are conducted online.</p><p>- Outlook</p><p>- Word</p><p>- Access</p><p>- Power Point</p><p>- Experience with ERP or CRM systems a plus</p>
<p>We are looking for a skilled Medical Accounts Receivable Specialist to join our team in Baltimore, Maryland. In this Contract to permanent role, you will play a vital part in managing patient accounts, ensuring accurate billing, and resolving payment issues for various programs. The ideal candidate will bring a strong background in medical billing, claims processing, and revenue cycle management, along with a keen eye for detail and excellent organizational skills.</p><p><br></p><p>Responsibilities:</p><p>• Process and submit claims accurately to patients, ensuring compliance with billing guidelines.</p><p>• Investigate and resolve claims denials or rejections, applying problem-solving skills to achieve successful outcomes.</p><p>• Post insurance and patient payments, denials, and adjustments with precision and attention to detail.</p><p>• Conduct follow-ups on outstanding balances and underpayments to ensure timely resolution.</p><p>• Reconcile accounts, track payment deposits, and address discrepancies effectively.</p><p>• Communicate with patients regarding account statuses and balances, maintaining a detail-oriented and empathetic approach.</p><p>• Stay up-to-date with payer-specific guidelines and industry regulations to ensure compliance.</p><p>• Manage and maintain assigned work queues, reports, and priority tasks within established timelines.</p><p>• Collaborate with management to address complex payment issues and implement process improvements.</p><p>• Accurately interpret Explanation of Benefits (EOBs) and payer remittance advice to apply payments appropriately.</p>
<p>We are looking for a dedicated Case Manager to join a stable team in Sherman Oaks looking to add a new member of the team. This firm specializes in personal injury cases, and this role is crucial to ensuring clients receive the support and advocacy they need throughout the claims process. The ideal candidate will thrive in a collaborative and focused environment while demonstrating exceptional organizational and communication skills.</p><p><br></p><p>Responsibilities:</p><p>• Manage claims processing with various insurance carriers, including health insurance providers, Medicare, and MediCal.</p><p>• Resolve property damage and loss of use claims efficiently and effectively.</p><p>• Coordinate with healthcare providers to schedule medical appointments for injury treatment.</p><p>• Advocate for clients by monitoring medical treatments and organizing care based on provider recommendations.</p><p>• Review, analyze, and interpret medical records, surgical reports, and medical bills.</p><p>• Prepare comprehensive case files for submission to the demands department.</p><p>• Maintain clear and precise communication with clients, healthcare providers, and internal staff.</p><p>• Collaborate with team members to ensure seamless case management and support.</p><p>• Utilize case management software and tools to maintain accurate and organized documentation.</p>
We are looking for a dedicated Customer Service Representative to join our team in Minneapolis, Minnesota. In this role, you will provide support to both internal and external customers by delivering exceptional service and addressing their needs with professionalism. This is a long-term contract position, offering an opportunity to make a meaningful impact in the healthcare industry.<br><br>Responsibilities:<br>• Provide outstanding customer service by addressing inquiries and resolving issues in a timely and accurate manner.<br>• Maintain detailed and precise documentation of interactions and transactions to ensure compliance with company policies.<br>• Support patients by scheduling appointments, verifying authorizations, and assisting with claims or benefit-related questions.<br>• Identify and escalate sensitive or complex issues, such as financial, medical, or legal risks, following established protocols.<br>• Translate verbal communications into clear and concise written documentation as required.<br>• Collaborate with internal teams to ensure smooth operations and a positive customer experience.<br>• Assist in training new team members and supporting colleagues with administrative tasks when necessary.<br>• Monitor and meet performance metrics related to accuracy, quality, and attendance.<br>• Utilize various systems and tools, including Microsoft Office Suite, to efficiently manage tasks and resolve customer needs.<br>• Uphold the organization’s commitment to diversity, inclusion, and superior customer care.
<p>We are looking for an experienced IT Business Analyst to join our team in the Tampa, FL office location a, on a Contract-to-Permanent basis. In this role, you will collaborate with stakeholders to deliver effective business solutions, focusing on claims systems and processes. Your work will involve gathering requirements, analyzing systems, configuring changes, and ensuring seamless integration across departments.</p><p><br></p><p>Responsibilities:</p><p>• Gather and document detailed business requirements to support claims administration systems.</p><p>• Create and maintain comprehensive documentation on system functionality and processes.</p><p>• Collaborate with Quality Analysts to develop and execute test cases, ensuring system changes align with business needs.</p><p>• Conduct systems analysis and testing to identify and resolve application issues.</p><p>• Coordinate and communicate system changes, including demos, with internal departments and external stakeholders.</p><p>• Perform UI-based configuration changes to enhance system functionality and usability.</p><p>• Build strong relationships with Claims management and other key stakeholders to align project goals.</p><p>• Partner with development teams to ensure seamless integration and proper implementation of system updates.</p><p>• Provide detailed answers to technical and functional questions from team members during project execution.</p>
<p>A client of ours is seeking a highly organized and detail-oriented <strong>ALD Claims Assistant (Temporary)</strong> to join our Claims team. In this crucial role, you will be responsible for the initial investigation, evaluation, and processing of claims for CPI, VSI, and GAP. This is a non-licensed position supporting claims review, closure tasks, and total loss processing.</p>
We are looking for a skilled Billing Clerk to join our team in White Plains, New York. In this long-term contract position, you will play a key role in managing promotional claims, investigating account discrepancies, and collaborating with various departments to ensure accurate processing. If you are detail-oriented, organized, and thrive in a fast-paced environment, this opportunity is ideal for you.<br><br>Responsibilities:<br>• Process promotional claims using trade promotion software to ensure accurate matching of bill-back payments and deductions.<br>• Investigate and validate customer account discrepancies by gathering information from sales, customer operations, and other internal teams.<br>• Research chargebacks and credit requests thoroughly to determine their validity and resolve issues efficiently.<br>• Identify and address missing or incomplete promotional setups in trade promotion software, collaborating with relevant teams to make corrections.<br>• Categorize non-promotional claims under appropriate expense types for accurate record-keeping.<br>• Obtain proofs of delivery to validate or dispute claims related to shorts or damages.<br>• Initiate requests for paybacks on unauthorized deductions to recover funds.<br>• Recommend adjusting entries for valid deductions to the Accounting Operations Assistant Manager.<br>• Maintain organized records of customer bill-back copies for finance and audit purposes.<br>• Support continuous improvement efforts by identifying opportunities to streamline processes.
We are looking for a skilled Revenue Cycle Analyst to join our team in Orlando, Florida. In this Contract-to-Permanent position, you will play a critical role in optimizing healthcare revenue cycle processes, ensuring the accuracy of medical billing, and managing claims with diligence. This is an excellent opportunity for professionals with a strong background in healthcare financial management to contribute to a dynamic and patient-focused organization.<br><br>Responsibilities:<br>• Analyze healthcare revenue cycle processes to identify areas for improvement and ensure operational efficiency.<br>• Manage medical billing functions and oversee the accurate processing of claims.<br>• Review and resolve collections issues, ensuring compliance with financial regulations.<br>• Monitor and document payment postings while maintaining thorough records for analysis.<br>• Collaborate with cross-functional teams to implement best practices in revenue cycle management.<br>• Conduct detailed financial analyses to ensure compliance with healthcare billing standards.<br>• Utilize Microsoft Excel and other Office Suite tools to prepare and present data-driven reports.<br>• Support account management activities to maintain positive client relationships.<br>• Ensure adherence to compliance functions and policies in all aspects of revenue cycle activities.
<p>We are looking for a dedicated Human Resources Administrator to join our client on a contract to permanent basis in Bradenton, Florida. This role offers the opportunity to contribute to risk management, insurance programs, and overall human resource administration while collaborating with various departments to ensure organizational efficiency and compliance. The ideal candidate will possess strong analytical and administrative skills, along with the ability to manage claims and insurance-related processes effectively.</p><p><br></p><p>Responsibilities:</p><p>• Develop and implement programs aimed at minimizing organizational risk exposure, while fostering a culture of safety and awareness across all departments.</p><p>• Oversee the processing and resolution of claims, including workers' compensation, general liability, and auto liability, ensuring timely and accurate adjudication.</p><p>• Manage property and casualty insurance programs and evaluate contractual risks in relationships with external vendors and contractors.</p><p>• Collaborate with key departments, including Administration and Planning, on disaster mitigation and recovery efforts.</p><p>• Continuously assess insurance coverage to align with market trends and organizational risk factors, recommending adjustments as needed.</p><p>• Represent the organization in contract negotiations with third-party administrators and insurance providers, ensuring favorable terms and compliance.</p><p>• Review and provide recommendations on contractual provisions related to insurance agreements to support organizational goals.</p><p>• Evaluate and advise on excess insurance coverage for organizational property and liability exposures.</p><p>• Coordinate benefit functions and ensure compliance with legal requirements in HR administration.</p><p>• Assist in the preparation and review of legal forms and correspondence related to HR and insurance matters.</p>
<p>We are looking for a detail-oriented Medical Billing Specialist to join our team in Emmett, Idaho. In this long-term contract position, you will play a crucial role in managing payment posting processes, ensuring accuracy in patient accounts, and maintaining balanced daily logs. If you have a strong background in medical billing and a commitment to excellence, we invite you to apply.</p><p><br></p><p>Responsibilities:</p><p>• Retrieve remittance advice from clearing houses daily and ensure timely processing.</p><p>• Organize and calculate insurance payment batches to confirm deposit accuracy.</p><p>• Export electronic remittance files to revenue cycle software and assist in developing electronic payment posting systems.</p><p>• Post payments manually and electronically while verifying patient details such as account numbers, dates of service, and other identifiers.</p><p>• Apply adjustments to patient accounts for deductibles, copays, coinsurance, and contractual obligations, while directing denials to the appropriate team.</p><p>• Reconcile and balance posted payment batches daily, ensuring accounts are accurate and properly closed.</p><p>• Analyze and interpret Explanation of Benefits (EOBs) to post payments correctly to patient accounts.</p><p>• Research unidentified payments and recoupments to determine proper transactions, including refund requests and takebacks.</p><p>• Collaborate with the Controller to balance daily, weekly, and monthly financial totals.</p><p>• Assist with billing work queues, insurance follow-ups, and other assigned tasks as needed.</p><p>Cerner and TruBridge knowledge preferred</p>
We are looking for a skilled HR & Payroll Specialist to oversee payroll processing and provide comprehensive support to human resource functions. This role requires attention to detail, strong organizational abilities, and a deep understanding of payroll regulations and HR practices. Based in Omaha, Nebraska, you will play a key role in ensuring employee satisfaction and compliance with all relevant laws.<br><br>Responsibilities:<br>• Calculate and process payroll deductions, including taxes, benefits, and other authorized adjustments, in compliance with federal, state, and local regulations.<br>• Enter and maintain accurate payroll data in the system, ensuring all employee information is up-to-date and error-free.<br>• Keep detailed records of payroll transactions and deductions, including supporting documentation for audits and compliance.<br>• Verify payroll calculations to ensure adherence to company policies and legal requirements.<br>• Manage benefit deductions, such as health insurance premiums, retirement contributions, and flexible spending accounts.<br>• Generate detailed payroll reports for internal use and external compliance purposes.<br>• Assist in administering employee benefits programs, including enrollments, terminations, and claims processing.<br>• Facilitate recruitment processes, onboarding, and employee relations to support the entire employee lifecycle.<br>• Provide guidance on company policies, benefits, and insurance information, particularly during open enrollment periods.<br>• Ensure compliance with employment laws and regulations while acting as a liaison between employees and management.
We are looking for a diligent and detail-oriented Medical Claims Analyst to join our team in Raleigh, North Carolina. In this long-term contract role, you will play a vital part in ensuring accurate processing and reconciliation of medical claims while supporting a collaborative team environment. If you thrive in a structured setting and have a strong background in medical billing and claims analysis, we encourage you to apply.<br><br>Responsibilities:<br>• Review and reconcile outstanding medical claims with precision and efficiency.<br>• Resubmit previously denied or rejected claims to ensure proper resolution.<br>• Accurately post payments into multiple systems, maintaining consistency and accuracy.<br>• Navigate payer portals to verify claim statuses and payment details.<br>• Perform repetitive clerical tasks with attention to detail and a focus on accuracy.<br>• Collaborate effectively with a team of professionals to meet organizational goals.<br>• Maintain punctuality and reliability to ensure smooth workflow within the team.<br>• Identify discrepancies in claims and resolve them promptly to prevent delays.<br>• Support behavioral health payment posting processes as required.
<p>Are you passionate about delivering top-tier service in a virtual healthcare setting? We are currently seeking a <strong>Remote Patient Service Representative</strong> for a dynamic 4-month temp-to-hire opportunity. This <strong>Remote Patient Service Representative</strong> role offers a competitive pay rate of $19.50 per hour and the flexibility of working remotely.</p><p><br></p><p><strong>Position Highlights:</strong></p><ul><li><strong>Remote work – </strong>California, Texas, and Illinois residents not eligible</li><li><strong>Pay: </strong>$19.50 per hour</li><li><strong>Hours: </strong>Training (first 6-weeks) Monday – Friday 10:00 AM – 6:30 PM CST and standard hours 10:30 AM – 7:00 PM CST<strong> </strong></li><li><strong>Duration: </strong>4 months with potential for temp-to-hire</li></ul><p><br></p><p><strong>Responsibilities:</strong></p><ul><li>Deliver exceptional service to patients and internal teams in a remote call center environment</li><li>Handle a high volume of back-to-back calls efficiently and professionally</li><li>Meet performance goals related to satisfaction, quality, and attendance</li><li>Use dual monitors to manage data entry, live calls, and various resources</li><li>Assist with documentation, claims processing, and insurance benefits</li><li>Maintain confidentiality while handling sensitive patient data</li><li>Provide support for Telehealth and other administrative functions</li></ul><p><br></p>
<p>Are you passionate about delivering top-tier service in a virtual healthcare setting? We are currently seeking a <strong>Remote Bilingual Patient Service Representative</strong> for a dynamic 4-month temp-to-hire opportunity. This <strong>Patient Service Representative</strong> role offers a competitive pay rate of <strong>$19.50</strong> per hour and the flexibility of working remotely.</p><p><br></p><p><strong>Position Highlights:</strong></p><ul><li><strong>Remote work – </strong>California, Texas, and Illinois residents not eligible</li><li><strong>Pay: </strong>$19.50 per hour</li><li><strong>Hours: </strong>Training (first 6-weeks) Monday – Friday 10:00 AM – 6:30 PM CST and standard hours 10:30 AM – 7:00 PM CST<strong> </strong></li><li><strong>Duration: </strong>4 months with potential for temp-to-hire</li></ul><p><br></p><p><strong>Responsibilities:</strong></p><ul><li>Deliver exceptional service to patients and internal teams in a remote call center environment</li><li>Handle a high volume of back-to-back calls efficiently and professionally</li><li>Meet performance goals related to satisfaction, quality, and attendance</li><li>Use dual monitors to manage data entry, live calls, and various resources</li><li>Assist with documentation, claims processing, and insurance benefits</li><li>Maintain confidentiality while handling sensitive patient data</li><li>Provide support for Telehealth and other administrative functions</li></ul><p><br></p>
<p>We are looking for a detail-oriented PART TIME Medical Administrator to join our team in Greenville, South Carolina. In this Contract-to-Permanent position, you will play a vital role in ensuring the accurate processing of medical claims while adhering to industry regulations and organizational policies. This opportunity is ideal for professionals with strong analytical skills and experience in claims administration.</p><p><br></p><p>Responsibilities:</p><p>• Conduct thorough reviews of pended claims to identify and rectify billing errors, duplicate claims, and unbundling issues.</p><p>• Manually correct system-generated errors with high precision prior to final adjudication.</p><p>• Process medical claims in compliance with provider contracts, pricing agreements, and regulatory standards.</p><p>• Address and resolve complex claims issues, escalating advanced cases to management when required.</p><p>• Utilize electronic health record (EHR) systems and other software tools to support claims processing and administration.</p><p>• Collaborate with team members to ensure consistent application of organizational policies and procedures.</p><p>• Communicate effectively with providers and stakeholders to clarify claim-related discrepancies.</p><p>• Maintain accurate documentation and reporting for all claims activities.</p><p>• Stay updated on industry trends and regulatory changes to ensure compliance.</p><p>• Support continuous improvement initiatives to enhance claims processing efficiency.</p>
<p>We are looking for an organized and meticulous Accounting Specialist to join our team in New Orleans, Louisiana. In this short-term contract to full time role, you will play a key part in managing funding applications, ensuring compliance with program regulations, and delivering exceptional customer service. This position offers an opportunity to support small food and agriculture businesses by overseeing reimbursement processes and maintaining accurate financial records.</p><p><br></p><p>Responsibilities:</p><p>• Process and finalize funding applications submitted by food and agriculture companies, ensuring adherence to organizational guidelines.</p><p>• Serve as a liaison to assist companies throughout the application and reimbursement process, providing clear communication and support.</p><p>• Review submitted documentation to ensure compliance with program regulations and process expense claims or reimbursements accordingly.</p><p>• Notify companies of claims that fall outside established guidelines and provide guidance on required corrections.</p><p>• Maintain accurate records of reimbursements and claims to ensure compliance with government funding requirements.</p><p>• Utilize intermediate-level Excel skills to analyze data and manage financial information effectively.</p><p>• Prioritize and manage multiple deadlines, ensuring timely processing of applications and reimbursements.</p><p>• Deliver exceptional customer service by addressing inquiries and providing solutions in a thoughtful and approachable manner.</p><p>• Collaborate with team members to ensure the smooth operation of funding and reimbursement programs.</p><p>• Take initiative to follow up with companies and ensure all required documentation is submitted on time.</p>
We are looking for a dedicated Claims Coordinator to join our team in Oklahoma City, Oklahoma. This Contract-to-Permanent position offers an exciting opportunity to showcase your skills in claims management and collections while working in a collaborative and fast-paced environment. In this role, you will handle diverse tasks related to billing, account resolution, and customer communication, ensuring efficient claims processing.<br><br>Responsibilities:<br>• Manage the full lifecycle of claims, including billing, collections, account adjustments, and resolution.<br>• Conduct thorough research and tracking of collection activities to ensure accuracy.<br>• Communicate effectively with customers, insurance carriers, and internal teams to address claims and resolve issues.<br>• Adhere to established procedures for account reviews and customer follow-ups.<br>• Collaborate with internal departments to address sensitive or complex account matters.<br>• Maintain detailed documentation of all claims and collection activities.<br>• Perform additional duties and responsibilities as assigned to support the team.
A Healthcare Company in Lynwood California is in the need of a Medical Biller with expertise in DMH billing and a strong background in insurance collections. The DMH Medical Biller will navigated denials management and appeals processes. If you meet these qualifications, we have an exciting opportunity for you! For experienced DMH professionals, remote work opportunities may be available.<br><br>Key Responsibilities:<br><br>Submit and process medical claims accurately to Medi-Cal, commercial insurance, government payers, and other third-party entities.<br>Perform insurance collections for outstanding Medi-Cal and medical insurance accounts to ensure timely and accurate reimbursements.<br>Manage denials and appeals, researching root causes, documenting issues, and resubmitting claims as needed.<br>Collaborate with payers and providers to resolve complex billing issues and discrepancies efficiently.<br>Maintain compliance with DMH-specific guidelines and payer regulations, ensuring accuracy in claims processing.<br>Prepare and analyze aging reports to proactively monitor unpaid claims and optimize collections.<br>Work with internal teams to support clinical documentation and authorization workflows for DMH services where required.
We are looking for a Medical Collections Specialist to join our team in Federal Way, Washington. In this long-term contract position, you will play a vital role in ensuring the accurate management of medical billing, collections, and insurance claims. This is a remote opportunity within the healthcare industry, offering flexibility while maintaining regular communication with clinics, payers, and patients.<br><br>Responsibilities:<br>• Investigate and resolve insurance denials by conducting thorough account reviews from the start of patient treatment.<br>• Verify patient benefits and eligibility to ensure accurate billing and collection processes.<br>• Manage back-end collections by coordinating with payers and filing appeals to recover owed payments.<br>• Communicate effectively with clinics, payers, and patients to address outstanding balances and resolve discrepancies.<br>• Perform root cause analysis to identify underlying issues in billing or claims processing.<br>• Utilize spreadsheets and internal systems to organize and manage financial data efficiently.<br>• Collaborate with team members to meet revenue cycle goals and optimize collection efforts.<br>• Handle pre-authorizations and eligibility verifications for accurate claims submission.<br>• Demonstrate technical proficiency in Microsoft Excel and other internal systems used for billing and collections.<br>• Maintain an organized and methodical approach to all tasks, ensuring compliance with healthcare regulations.
<p>Hybrid Monday and Friday work remotely </p><p><br></p><p>Responsibilities:</p><p>• Manage customer accounts by addressing inquiries, resolving complaints, and ensuring high-quality service.</p><p>• Handle escalated issues, including executive-level complaints and matters raised by media or legal representatives.</p><p>• Collaborate with vendor partners and internal teams to resolve customer concerns effectively.</p><p>• Process claims, invoices, and enrollment requests with accuracy and efficiency.</p><p>• Ensure consistent and timely billing and fulfillment for customers.</p><p>• Support onboarding processes and validate account information to maintain accuracy.</p><p>• Address issues escalated to regulatory bodies such as the Public Service Commission with professionalism.</p><p>• Maintain strong communication with suppliers and business units to ensure smooth operations.</p><p>• Follow established procedures and guidelines to meet organizational standards.</p><p>• Provide exceptional customer support under direct supervision while adhering to company policies.</p>
