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 dedicated Medical Claims Analyst to join our healthcare team in Minneapolis, Minnesota. In this long-term contract position, you will play a vital role in processing leave of absence claims, ensuring compliance with medical certifications, and calculating benefit allocations. This is an excellent opportunity to contribute to a fast-paced industry while leveraging your expertise in medical claims and benefits administration.<br><br>Responsibilities:<br>• Process and manage leave of absence claims by coordinating medical certifications and ensuring timely submissions.<br>• Calculate benefit amounts, including allocations from corporate and state sources, to ensure accurate disbursements.<br>• Review, approve, or deny claims based on established guidelines and medical documentation.<br>• Utilize systems such as ServiceNow and Workday to track, manage, and process claims efficiently.<br>• Maintain detailed records of claims and benefits to ensure compliance and accuracy.<br>• Communicate with healthcare providers to confirm certifications and resolve discrepancies.<br>• Address rejected claims by investigating issues and providing resolutions.<br>• Collaborate with team members to streamline leave administration processes.<br>• Provide guidance to employees regarding medical leave policies and benefits.<br>• Stay updated on state and federal regulations related to leave and benefits administration.
<p>We are looking for a skilled and detail-oriented Medical Billing Specialist to join our team on a long-term contract basis. In this role, you will play a key part in ensuring the accurate processing of medical records, billing codes, and claims for healthcare providers. Based in Oakland, California, this position requires a strong understanding of medical billing systems, particularly Welligent coding, and a commitment to maintaining compliance with healthcare standards.</p><p><br></p><p>Responsibilities:</p><p>• Analyze and process medical billing records with precision, utilizing Welligent coding systems to ensure compliance with industry regulations.</p><p>• Manage and organize billing codes and documentation for multiple healthcare entities, ensuring prompt and accurate claims submissions.</p><p>• Review patient records and procedures to verify proper billing practices and adherence to guidelines.</p><p>• Identify and resolve discrepancies in billing processes to facilitate seamless claims management.</p><p>• Collaborate with healthcare providers, insurance payers, and administrative staff to address billing issues and ensure accurate coding.</p><p>• Stay updated on changes to billing regulations, coding standards, and healthcare compliance requirements.</p><p>• Maintain detailed and organized records of all billing activities and claims submissions.</p><p>• Support the implementation of best practices for medical billing processes across the organization.</p><p><br></p><p>If you are interested in this role please apply right away and call us at (510) 470-7450</p>
We are looking for an experienced Medical Billing/Claims/Collections specialist to join our team on a contract basis. This role is based in Northbrook, Illinois, and offers an excellent opportunity to contribute your expertise in medical billing and claims management within a dynamic healthcare setting. The ideal candidate will bring a strong understanding of medical collections, appeals, and denials processes, ensuring timely and accurate handling of claims.<br><br>Responsibilities:<br>• Manage medical billing operations, including hospital billing and claims processing, to ensure accuracy and compliance.<br>• Handle medical collections and follow up on outstanding claims with payers to secure payments.<br>• Investigate and resolve medical denials by reviewing documentation and initiating appeals as needed.<br>• Collaborate with healthcare providers and insurance companies to address claim-related inquiries and discrepancies.<br>• Utilize Epic software and other electronic medical record systems to maintain and update patient billing information.<br>• Ensure adherence to healthcare billing procedures, statutory requirements, and compliance standards.<br>• Perform research to support claim administration and resolve complex billing issues.<br>• Process payments and reconcile accounts to maintain accurate financial records.<br>• Escalate unresolved issues appropriately to ensure timely resolution.<br>• Provide training and support to staff on billing processes and system functionalities.
<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>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 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>
<p>We are looking for a dedicated Claims Intake Coordinator to join our team in Ontario, California. This long-term contract position involves supporting the claims processing team by ensuring accurate intake, sorting, and preparation of medical claims for further handling. The role is vital in maintaining efficient workflows and providing support to healthcare providers across various regions.</p><p><br></p><p>Responsibilities:</p><ul><li>Open, sort, prioritize, batch, log, and track all incoming claims mail.</li><li>Distribute claims according to market, priority, appeal status, scanning need, and health plan risk.</li><li>Ensure all claims received are complete and ready for processing.</li><li>Route unclean claims back to providers for correction.</li><li>Forward out-of-state claims to the appropriate health plan for handling.</li><li>Run the Claims Fallout process and distribute Fallout Worksheets via email to relevant departments.</li><li>Assist with the distribution of checks (match checks with Explanation of Benefits, fold, and insert into correct envelopes).</li><li>Match remittance advices with checks and prepare mailing.</li><li>Reconcile processed batches within the audit database.</li><li>Create denial trailers and mail denial letters accordingly.</li></ul>
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.
We are looking for a skilled Medical Billing Specialist to join our team in Loveland, Colorado. In this long-term contract role, you will be responsible for managing essential billing operations, ensuring accuracy in claims processing, and contributing to the efficiency of healthcare administration. This position is ideal for professionals with expertise in medical billing systems who thrive in a collaborative and fast-paced environment.<br><br>Responsibilities:<br>• Submit accurate claims to insurance providers, adhering to regulatory standards and guidelines.<br>• Monitor and manage accounts receivable, resolving discrepancies and ensuring timely payments.<br>• Utilize medical billing software, including Allscripts and Cerner Technologies, to oversee daily operations.<br>• Handle appeals and follow up on denied claims to secure reimbursements.<br>• Perform medical coding and maintain detailed documentation in compliance with industry practices.<br>• Coordinate third-party billing processes and maintain effective communication with insurance carriers.<br>• Verify patient benefits and eligibility to support billing accuracy.<br>• Conduct numeric data entry and maintain meticulous records of transactions.<br>• Respond to billing inquiries from patients and healthcare providers, delivering excellent customer service.<br>• Collaborate with colleagues to optimize workflows and improve overall billing performance.
<p>If you’ve ever wanted to combine your administrative skills with the chance to truly make an impact in people’s lives, this opportunity is for you. Our client, a growing <strong>medical services provider in San Marcos</strong>, is seeking a <strong>Customer Service Representative</strong> who will provide compassionate, efficient, and professional support to patients, families, and providers. Healthcare is fast-paced, complex, and often stressful for the people navigating it. Patients rely on a system that is not always easy to understand — insurance claims, authorizations, billing, and appointment scheduling can quickly become overwhelming. That’s why this role is so critical: as a Customer Service Representative, you’ll act as both guide and advocate, helping patients get the answers they need and ensuring they feel cared for from the very first call.</p><p><br></p><p>You’ll work closely with clinical staff, billing teams, and insurance providers to untangle issues and make the process smoother for everyone involved. Every conversation is an opportunity to make a positive difference.</p><p><br></p><p><strong><u>What You’ll Do Every Day</u></strong></p><ul><li>Serve as the first point of contact for patients and providers by phone and email.</li><li>Answer questions related to scheduling, billing, and insurance verification with patience and clarity.</li><li>Research and resolve claims-related issues, including prior authorizations, coding questions, and payment discrepancies.</li><li>Keep detailed, accurate records in the patient management system to ensure smooth communication between departments.</li><li>Partner with clinical and administrative teams to provide timely updates and follow-up to patients.</li><li>Maintain confidentiality while handling sensitive medical and financial information.</li></ul>
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.
We are looking for an Insurance Follow-Up Specialist to join our team in Tampa, Florida. In this Contract to permanent position, you will play a vital role in ensuring timely insurance claim processing and maintaining strong relationships with partners. If you have a knack for organization, persistence, and excellent communication, this opportunity is designed for you.<br><br>Responsibilities:<br>• Pursue prompt collection of signatures and necessary documents from funeral home partners to expedite claim processing.<br>• Investigate delays in insurance claims and provide solutions with a proactive and detail-oriented approach.<br>• Build and nurture strong partnerships with insurance representatives and funeral home stakeholders.<br>• Maintain comprehensive and accurate records to ensure all cases are tracked and managed effectively.<br>• Collaborate with the Concierge team to provide additional follow-up support as needed.
We are looking for a detail-oriented Medical Coder to join our team on a contract basis in Sacramento, California. In this role, you will be responsible for accurately translating medical records and patient information into standardized codes, ensuring proper billing and compliance with industry standards. This position offers an opportunity to work closely with healthcare professionals and contribute to the efficient processing of medical claims.<br><br>Responsibilities:<br>• Convert medical diagnoses, procedures, and treatments into standardized numeric or alphanumeric codes.<br>• Review and analyze medical records to ensure accurate and compliant coding.<br>• Prepare and submit insurance claims while addressing any discrepancies or denials.<br>• Perform regular audits to maintain the accuracy and integrity of coding practices.<br>• Collaborate with physicians and healthcare staff to clarify medical information and coding needs.<br>• Stay informed about updates to coding guidelines, regulations, and industry best practices.<br>• Train and provide guidance to coders with less experience, as needed.<br>• Ensure confidentiality and compliance with ethical and legal standards in all coding processes.<br>• Utilize coding software and tools such as 3M, Cerner Technologies, and AHLTA to optimize workflows.
We are looking for a detail-oriented Medical Billing Specialist to join our team on a contract basis in Devens, Massachusetts. In this role, you will play a vital part in ensuring accurate and timely billing processes while addressing appeals and denials. This position offers an opportunity to contribute to a dynamic healthcare environment.<br><br>Responsibilities:<br>• Handle medical billing tasks, including claims processing and submissions.<br>• Manage appeals and denials to ensure proper resolution and reimbursement.<br>• Conduct thorough reviews of medical claims for accuracy and compliance.<br>• Collaborate with insurance providers and patients to address billing inquiries.<br>• Maintain up-to-date knowledge of medical coding standards and billing regulations.<br>• Utilize Epaces and other systems to track and manage claims effectively.<br>• Perform follow-ups on outstanding collections and payments.<br>• Assist with special projects related to billing operations as needed.<br>• Ensure confidentiality and security of patient billing information.
<p>We are looking for a detail-oriented Medical Billing Specialist to join our team on a contract basis in Fayetteville, North Carolina. In this role, you will be responsible for ensuring accurate billing processes and maintaining compliance with healthcare regulations. This position requires a strong understanding of medical billing practices and excellent organizational skills.</p><p><br></p><p>Responsibilities:</p><p>• Review and process medical claims with accuracy and attention to detail.</p><p>• Verify patient information and insurance coverage to ensure proper billing.</p><p>• Resolve discrepancies and follow up on denied claims to maximize reimbursement.</p><p>• Maintain compliance with state and federal healthcare billing regulations.</p><p>• Collaborate with healthcare providers and administrative staff to streamline billing operations.</p><p>• Generate and analyze billing reports to identify trends and areas for improvement.</p><p>• Handle inquiries from patients and insurance companies regarding billing issues.</p><p>• Stay updated on industry changes and updates to billing codes and procedures.</p><p>• Assist with audits and ensure documentation is complete and accurate.</p><p>• Support the implementation of new billing systems as needed.</p>
<p>We are looking for a skilled Medical Billing Specialist to join our team in Dallas, Texas. In this contract position, you will play a key role in ensuring accurate and efficient billing processes for healthcare providers. This opportunity is ideal for professionals with strong medical billing experience who thrive in fast-paced environments and are committed to maintaining compliance with industry standards. TMHP Or EVV software knowledge is required for this position. </p><p><br></p><p>Responsibilities:</p><p>• Manage the full cycle of medical billing, including coding verification, charge entry, claim submission, and reconciliations.</p><p>• Accurately submit government claims while adhering to established billing guidelines and compliance standards.</p><p>• Review and correct errors on claims prior to submission deadlines to ensure timely processing.</p><p>• Track and complete billing within a 5-7 day payment cycle to maintain efficiency.</p><p>• Collaborate with internal teams to address inquiries and ensure seamless billing operations.</p><p>• Analyze claim denials and implement corrective actions to resolve discrepancies.</p><p>• Verify insurance coverage and eligibility to streamline claim submissions.</p><p>• Utilize electronic billing systems and tools such as Epaces to optimize workflows.</p><p>• Ensure proper application of CPT codes and ICD standards during billing processes.</p><p>• Maintain detailed records and documentation for compliance and audits.</p>
<p><strong>Job Title: </strong>Medical Biller</p><p><strong>Location:</strong> Hatboro, PA (100% Onsite)</p><p><strong>Schedule</strong>: Monday – Friday, 8:00 AM – 5:00 PM</p><p><strong>Employment Type: </strong>Permanent, Full-Time</p><p><br></p><p><strong>Overview:</strong></p><p>A healthcare facility near Hatboro, PA is seeking an experienced and detail-oriented Medical Biller to join their team. This role is fully onsite and offers the opportunity to play a key part in the billing and revenue cycle process. The ideal candidate will have strong knowledge of medical billing practices, claims management, and coding standards, with a proven ability to ensure accuracy and timely collections.</p><p><br></p><p><strong>Responsibilities:</strong></p><ul><li>Code charges and process billing for medical procedures</li><li>Prepare, review, and complete billing cycles for accuracy and timeliness</li><li>Research and resolve billing discrepancies; identify and process refunds, credits, and write-offs</li><li>Collect and process patient payments, including credit card transactions; set up payment plans for past due balances</li><li>Generate and mail weekly patient statements</li><li>Post patient and payer Explanation of Benefits (EOB) payments into the system</li><li>Monitor and follow up on unpaid claims and denials; prepare reconciliations and appeals as necessary</li><li>Submit claims to insurance carriers electronically or by mail</li><li>Communicate with staff, physicians, and their offices to obtain billing details and updated patient demographic information</li><li>Collaborate with internal staff and physician offices to gather required documentation and ensure billing accuracy</li><li>Handle incoming patient inquiries, providing thorough and timely follow-up to resolve account issues</li></ul>
<p>Our client, in the healthcare industry focused in Behavioral Health, is in need for a Medical Billing/Claims specialist near downtown Tucson! You will be tasked with managing medical claims and ensuring accurate billing and collections. This position requires skills in various accounting software systems, knowledge of EHR systems, and EOB.</p><p><br></p><p>Responsibilities:</p><p><br></p><p>• Handle medical claims with precision and ensure timely processing</p><p>• Utilize accounting software systems to maintain accurate records and facilitate collections</p><p>• Leverage EHR systems to access patient data and manage billing functions</p><p>• Keep a meticulous record of accounts receivable and follow up on pending claims</p><p>• Address and resolve any customer inquiries related to billing and collections</p><p>• Conduct appeals and authorizations as part of the medical claims process</p><p>• Ensure compliance with all billing functions and benefit functions</p><p>• Work with NextGen or Netsmart systems for efficient management of claims and billing.</p>
<p>Our healthcare client in Carlsbad is searching for a <strong>Billing Specialist</strong> to join their fast-paced and collaborative administrative team. This role is ideal for someone who enjoys problem-solving, has strong attention to detail, and thrives in an environment where accuracy and efficiency directly support patient care. The Billing Specialist will manage insurance claims, patient accounts, and billing inquiries. You’ll play a key part in ensuring that revenue cycles flow smoothly, and that both payors and patients are served with professionalism.</p><p><br></p><p><strong><u>Responsibilities</u></strong></p><ul><li>Process billing claims accurately and in a timely manner, ensuring compliance with insurance regulations.</li><li>Work with a wide range of payor groups, from commercial carriers to government programs.</li><li>Apply knowledge of CPT, ICD-10, and HCPCS coding when preparing claims.</li><li>Review and resolve claim rejections, denials, and outstanding balances.</li><li>Communicate with insurance companies, patients, and providers to clarify and resolve billing issues.</li><li>Maintain accurate patient billing records in the system.</li><li>Support month-end reconciliation and reporting related to billing and collections.</li><li>Collaborate with internal departments to ensure proper documentation is received for claims processing.</li></ul><p><br></p>
<p>We're seeking an organized, personable, and detail-oriented <strong>Part-Time Bilingual (Spanish) Receptionist/Office Administrator</strong> with data entry experience. This role is crucial in providing a welcoming environment for patients and ensuring that the administrative side of the practice runs smoothly. The ideal candidate will be fluent in both English and Spanish, possess excellent communication skills, and have experience with clerical duties, including data entry. <strong>The schedule for this role is Monday-Wednesday, 18 hours a week.</strong></p>
<p>We are looking for a dedicated Patient Financial Services Supervisor to oversee medical billing operations in a healthcare environment. This long-term contract position is based in French Camp, California, and offers an excellent opportunity to lead a team responsible for ensuring accurate claims processing and maximizing reimbursements. The ideal candidate will have a strong background in medical billing and coding, along with proven leadership skills.</p><p><br></p><p>Responsibilities:</p><p>• Lead and manage the daily operations of the medical billing and collections team to ensure efficiency and accuracy.</p><p>• Identify and resolve complex billing issues, including denials, appeals, and system errors.</p><p>• Collaborate with insurance companies, internal departments, and external stakeholders to streamline processes and improve reimbursement outcomes.</p><p>• Train and mentor staff on billing policies, compliance standards, and industry updates.</p><p>• Audit and review claims such as UB-04 and CMS-1500 to ensure accuracy and adherence to guidelines.</p><p>• Monitor account workflows and implement strategies to enhance productivity and cash flow.</p><p>• Prepare detailed reports and analyses on billing performance and account status.</p><p>• Ensure compliance with Medicare, Medicaid, and commercial payer requirements.</p><p>• Leverage billing systems and tools to optimize operations and reduce errors.</p><p><br></p><p>For immediate consideration please call Cortney at 209-225-2014 </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.
We are looking for a detail-oriented Medical Payment Poster Specialist to join our team in Sacramento, California. This contract-to-permanent position offers an excellent opportunity for individuals skilled in medical billing, coding, and payment posting. The role requires working on-site during the contract assignment, with potential for long-term placement.<br><br>Responsibilities:<br>• Accurately post insurance payments by line item to the patient account system, ensuring all entries are precise and compliant.<br>• Verify payment amounts against contracts and organizational policies to ensure correctness.<br>• Process patient payments efficiently and update records within the designated system.<br>• Record denials, zero payments, and flag accounts for follow-up by the Medical Collections team.<br>• Apply takebacks and recoupments in accordance with established policies.<br>• Identify and communicate trends in payment discrepancies, denials, or short payments to leadership for resolution.<br>• Balance daily payment entries against settlement reports to maintain accurate financial records.<br>• Route payer correspondence to the appropriate team members for timely follow-up.<br>• Utilize knowledge of contracts and policies to ensure proper application during payment posting.
<p>Our client is hiring experienced <strong>Customer Service Representatives</strong> in a contract to hire capacity to support our <strong>Texas-based Call Center</strong> operations. This role focuses on assisting members enrolled in <strong>Texas Medicaid programs</strong>, including <strong>STAR, CHIP</strong>, and <strong>Home Health Care Services (HHCS)</strong>. If you have <strong>1+ years of healthcare call center experience</strong> and are passionate about helping families navigate their healthcare benefits and <strong>are a Texas resident</strong>, we want to hear from you!</p><p><br></p><p><strong>Key Responsibilities:</strong></p><ul><li>Handle inbound calls from members, providers, and caregivers regarding <strong>Texas Medicaid</strong> benefits, claims, authorizations, and provider details.</li><li>Provide accurate information on <strong>STAR, CHIP</strong>, and <strong>HHCS</strong> services.</li><li>Assist with pre-authorizations and explain coverage details.</li><li>Document all interactions in the system with accuracy and professionalism.</li><li>Resolve member concerns with empathy and efficiency.</li><li>Stay current on Texas Medicaid updates and Dell Children’s policies.</li><li>Maintain HIPAA compliance and patient confidentiality.</li></ul><p><br></p><p><strong>Qualifications:</strong></p><p>✅ <strong>Required:</strong></p><ul><li><strong>Minimum 1 year of healthcare call center experience</strong>, preferably with <strong>Texas Medicaid</strong>.</li><li>Must be a <strong>Texas resident</strong>.</li><li>Familiarity with <strong>Texas Medicaid</strong>, STAR, CHIP, and HHCS.</li><li>Strong understanding of medical terminology, CPT/HCPCS codes, and diagnosis codes.</li><li>Excellent verbal and written communication skills.</li><li>Ability to manage high call volumes and navigate stressful situations calmly.</li><li>Proficient in computer systems and call tracking tools.</li></ul><p>✅ <strong>Preferred:</strong></p><ul><li>Associate’s Degree or equivalent healthcare-related education.</li><li>Experience working with Dell Children’s or similar pediatric healthcare systems.</li><li>Bilingual (English/Spanish) is a plus.</li></ul><p><br></p><p><strong>Work Environment:</strong></p><ul><li><strong>Remote-first</strong> role with occasional in-office meetings or training sessions.</li><li>Standard business hours: <strong>8 AM–5 PM CST</strong>, Monday through Friday.</li></ul><p><br></p><p><strong>Apply today</strong> to join a compassionate team making a difference in the lives of Texas families!</p><p><br></p><p><br></p>
