<p>We are looking for a dedicated Pre-Authorization Specialist to join our team in Miramar, Florida. In this contract-to-hire position, you will play a key role in coordinating insurance authorizations and ensuring accurate patient documentation for medical equipment delivery. This role requires exceptional organizational skills and a strong understanding of insurance policies and billing processes.</p><p><br></p><p>Responsibilities:</p><p>• Review clinical denials, including cases related to referrals, pre-authorizations, medical necessity, and non-covered services.</p><p>• Prepare and submit medical necessity determinations to health plans or medical directors by analyzing clinical documentation in adherence to Medicare, Medicaid, and third-party payer guidelines.</p><p>• Maintain and update referral information while tracking changes in patient status.</p><p>• Verify patient eligibility and ensure insurance benefits are appropriately identified.</p><p>• Coordinate callbacks to patients regarding inquiries and provide clear guidance.</p><p>• Ensure all required documentation, such as prescriptions and physician notes, is obtained prior to medical equipment delivery.</p><p>• Determine delivery methods for medical equipment, including direct delivery to homes, physician offices, hospitals, or the company office.</p><p>• Track inventory of medical equipment and oversee shipping processes.</p><p>• Collaborate closely with nursing coordinators and instructors to support patient needs.</p><p>• Assist with general office operations to ensure smooth workflows.</p>
<p>We are in search of a Billing Specialist to become an integral part of our team. This role entails maintaining precise and up-to-date financial records with a focus on billing operations. The position is situated in Indianapolis, Indiana, where you will be using unique accounting software systems, and handling customer queries and issues efficiently.</p><p><br></p><p>Responsibilities:</p><p><br></p><p>• Handle the billing for complex customers, ensuring accuracy and efficiency at all times</p><p>• Facilitate the processing of customer credit applications, ensuring accuracy and efficiency at all times</p><p>• Oversee and manage customer credit records, maintaining their accuracy consistently</p><p>• Handle and resolve customer inquiries, providing timely and suitable solutions</p><p>• Monitor and manage customer accounts, taking necessary actions when required</p><p>• Utilize accounting software systems for various accounting functions</p><p>• Efficiently handle and respond to inbound calls from customers</p><p>• Use computerized billing systems to ensure efficient and error-free billing procedures</p><p><br></p>
<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>
<p><em>The salary for this position is up to $100,000 plus bonus, and it comes with benefits, including medical, vision, dental, life, and disability insurance.</em></p><p><strong>Job Description</strong></p><p><strong>Essential Duties and Responsibilities:</strong></p><ul><li>Tracks and reports on timekeeper hours</li><li>Prepares prebills and reviews edits by billing partner(s)</li><li>Verifies the accuracy of billing entries and supporting documentation.</li><li>Prepares invoices for submission to clients via various Ebilling platforms or by email, dependent on client requirements</li><li>Monitors accounts receivable and collection efforts</li><li>Submits budgets per client requirements</li><li>Works closely with billing partners on bill appeals</li></ul><p><strong> </strong></p><p><strong>Skills/Qualifications:</strong></p><ul><li>Detail-oriented, with excellent organizational skills</li><li>Working knowledge of various Ebilling platforms, including: ASCENT, LSS, TyMetrix, Legal-X, Legal Tracker, etc. </li><li>Working knowledge of PCLaw or similar billing application</li><li>Ability to work well under pressure, i.e., managing conflicting and fluctuating deadlines, and effectively prioritizing multiple tasks of equal urgency and importance with minimal supervision</li><li>Experience in effective problem-solving, actively using sound judgment in decision-making processes</li><li>Ability to handle confidential matters discreetly, in a mature and responsible manner conducive to the position</li><li>Effective communication skills, including the ability to be courteous in handling situations patiently and tactfully, with all audiences including partners, associates, staff and external clients and vendors</li><li>Experience with troubleshooting minor technology issues, including hardware and software</li><li>Ability to occasionally work more than 40 hours per week to perform the essential duties of the position; may require irregular hours</li></ul><p><br></p>
<p>Robert Half has partnered with a small firm on their search for a proactive, Legal Billing Specialist. As the Legal Billing Specialist, you will oversee client invoicing, assist with the collections process, update ERP system, perform mail merges, complete accounts receivable transactions, review and assign sales tax codes, perform account reconciliations, prepare supporting documents, and provide solutions to client inquiries. The ideal candidate should have strong attention to detail, excellent organizational skills, and the ability to solve problems quickly. </p><p><br></p><p>Responsibilities:</p><p>• Prepare, review, and issue accurate billing statements, ensuring all client accounts are properly updated.</p><p>• Manage trust accounts, client escrow funds, and fiduciary transactions with precision and adherence to regulations.</p><p>• Utilize QuickBooks Desktop or Online to process financial records and maintain organized bookkeeping.</p><p>• Execute mail merges efficiently to streamline communication and billing processes.</p><p>• Collaborate closely with legal teams and clients to resolve billing inquiries and discrepancies.</p><p>• Monitor and collect outstanding payments while maintaining clear and effective communication with clients.</p><p>• Generate and analyze financial reports to identify trends and improve billing operations.</p><p>• Ensure compliance with legal billing standards and maintain confidentiality of sensitive financial information.</p>
<p><em>The salary range for this position is $60,000-$65,000 and it comes with benefits, including medical, vision, dental, life, and disability insurance. To apply to this hybrid role please send your resume to [email protected]</em></p><p><br></p><p>Summer is here! Want to be with a company that will ensure you get to enjoy this beautiful weather? You don't have to be a 'people person' to want to work for a company that prioritize cultivating a healthy work environment for their employees while emphasizing the importance of a work-life balance. </p><p><br></p><p><strong>Responsibilities:</strong></p><ul><li>Ability to prioritize, multitask, manage a high volume of bills per month and meet deadlines.</li><li>Experience with various e-billing vendors (e.g., CounselLink, Bottomline Legal eXchange, Tymetrix, Collaborati, Legal Solutions Suite, Legal Tracker, etc.) and LEDES file knowledge required to perform duties and responsibilities, including but not limited to preparing and submitting bills, budgets, and timekeeper rates according to client requirements.</li><li>Management of timekeepers and coordinate/process appeals as required.</li><li>Ability to execute complex bills in a timely manner (i.e., multiple discounts by matter, split billing, preparation, submission and troubleshooting of electronic bills).</li><li>Monitor outstanding Work in Process (WIP) and Accounts Receivable (AR) balances. Collaborate with billing attorneys to ensure WIP is billed on a timely basis and AR balances are collected withina reasonable period. Follow up with billing attorney and client on all aged AR balances.</li><li>Follow up on collections as directed by either Attorneys or Accounting leadership in support of meeting firm’s financial goals.</li><li>Review and edit prebills in response to attorney requests.</li><li>Proactively monitor potential errors that may result in the rejection of e-bills.</li><li>Research and analyze deductions and provide best course of action for balances.</li><li>Process write-offs following Firm policy.</li><li>Ability to effectively interact and communicate with attorneys, legal administrative assistants, staff, and clients.</li><li>Assist with month-end close as needed.</li><li>Proactively monitor potential errors that may result in the rejection of e-bills.</li><li>Assume additional duties as needed or assigned</li></ul><p> </p>
<p>We are looking for a highly organized and detail-oriented Billing Specialist to join our client's team on a Contract basis in Hillsboro, Oregon. In this role, you will be responsible for managing various billing functions, ensuring accuracy, and maintaining strong communication with internal and external stakeholders. This position offers an opportunity to contribute to a fast-paced environment with high-volume billing demands.</p><p><br></p><p>Responsibilities:</p><p>• Process day-to-day billing tasks with quick turnaround times to meet deadlines.</p><p>• Handle project-based billing and progress invoicing with precision and attention to detail.</p><p>• Manage recurring billing processes to ensure timely and accurate invoicing.</p><p>• Collaborate closely with the sales team to transfer data and resolve discrepancies in billing information.</p><p>• Follow up with team members to gather missing data and ensure completeness of billing records.</p><p>• Handle a high volume of billing transactions</p><p>• Submit invoices through customer portals and ensure compliance with submission requirements.</p><p>• Maintain accurate accounts receivable records and monitor work-in-progress (WIP) billing.</p><p>• Deliver exceptional customer service by addressing inquiries and resolving billing issues promptly.</p>
We are looking for a detail-oriented Billing Specialist to join our team in Washington, District of Columbia. The ideal candidate will play a key role in managing billing processes, ensuring accuracy in financial records, and maintaining clear and effective communication with clients. This is a great opportunity for someone with a strong background in billing systems and collection processes.<br><br>Responsibilities:<br>• Prepare, review, and issue accurate billing statements for clients in a timely manner.<br>• Manage the end-to-end billing process, including invoicing and reconciliation of accounts.<br>• Monitor and follow up on outstanding payments to ensure timely collection of receivables.<br>• Maintain and update billing records in computerized systems, ensuring all information is accurate and up-to-date.<br>• Identify and resolve discrepancies in billing and payment records to maintain financial accuracy.<br>• Collaborate with internal teams to address any billing-related inquiries or issues.<br>• Generate reports related to billing activities and provide insights to support decision-making.<br>• Ensure compliance with company policies and financial regulations in all billing operations.<br>• Assist in the development and improvement of billing procedures and systems as needed.
<p>We are looking for a meticulous Legal Billing Specialist to join our team in Chicago, Illinois. In this role, you will manage billing processes, ensure accuracy in financial transactions, and support operational efficiency for legal services. You will collaborate closely with internal teams to maintain compliance and streamline billing functions.</p><p><br></p><p>Responsibilities:</p><p>• Process and review invoices to ensure accuracy and compliance with billing guidelines.</p><p>• Utilize accounting software systems to manage billing and time-tracking functions effectively.</p><p>• Generate and analyze financial reports</p><p>• Collaborate with team members to optimize billing workflows and resolve discrepancies.</p><p>• Maintain client billing records and ensure timely updates in CRM systems.</p><p>• Monitor and report on billing metrics to support financial decision-making.</p><p>• Support the implementation and integration of ADP financial services tools.</p><p>• Handle inquiries related to billing, providing clear and precise communication.</p><p>• Ensure proper documentation and adherence to organizational policies for billing processes.</p>
<p>Are you an experienced legal biller looking for a flexible opportunity to showcase your skills? Our client, a reputable law firm in downtown Houston, is seeking a <strong>Contract Legal Biller</strong> to support their team through end of year. This is a hybrid role offering a great work-life balance, professional growth, and excellent perks – including free lunch every Wednesday!</p><p><strong>Position Overview</strong></p><p>As the Contract Legal Biller, you will manage and execute the firm’s billing operations, collaborating with 20 partners to ensure timely and accurate financial transactions. You’ll play a key role in legal e-billing, invoice processing, and reconciliation, while supporting reporting tasks as needed.</p><p><strong>Key Responsibilities</strong></p><ul><li>Prepare, process, and send invoices (less than 200 per month), including pre-billing and mailing.</li><li>Manage legal e-billing using SurePoint, Elite, and Aderant platforms.</li><li>Reconcile credit card transactions and address billing discrepancies.</li><li>Assist with check runs and billing appeals, ensuring compliance and accuracy.</li><li>Generate percentage-of-completion reports as requested.</li><li>Collaborate with the Controller on financial reporting and data analysis.</li><li>Maintain strong partnerships with attorneys and staff to support billing needs.</li></ul><p><br></p>
We are looking for a skilled Billing Specialist to join our team on a contract basis in Charlotte, North Carolina. This role requires expertise in managing billing processes, ensuring accuracy in financial records, and supporting accounts receivable tasks. The ideal candidate will demonstrate strong attention to detail and a commitment to delivering timely and efficient service.<br><br>Responsibilities:<br>• Utilize various computer systems and tools to accurately enter, extract, and compile billing records, including timecards, purchase orders, invoices, and sales tickets.<br>• Calculate amounts due and prepare invoices for customers while ensuring precision in all transactions.<br>• Post financial transactions to customer accounting records and maintain organized documentation.<br>• Collaborate with team members to provide accurate information for follow-up on outstanding invoices and customer accounts.<br>• Assist in resolving discrepancies related to billing and accounts receivable.<br>• Support the export of customer service data as needed for financial reporting purposes.<br>• Maintain compliance with established billing procedures and guidelines.<br>• Perform additional duties as assigned to support the overall billing and accounting functions.
<p>Our recruiting firm is proud to partner with an <strong>established and fast-growing client in Carlsbad</strong> that is looking to add a <strong>Billing Specialist</strong> to their finance department. This company values precision, accountability, and a strong sense of teamwork. They are seeking someone who not only understands the technical aspects of billing but also thrives in a professional environment where accuracy and timeliness directly contribute to client satisfaction and business growth.</p><p><br></p><p>This role is ideal for an accounting professional who enjoys <strong>owning the billing process from start to finish</strong>, collaborating with multiple departments, and ensuring financial records are kept accurate and up to date. The selected candidate will become an integral member of a collaborative team that plays a key role in keeping projects, clients, and leadership aligned.</p><p><br></p><p><strong><u>Responsibilities</u></strong></p><ul><li>Prepare, review, and process invoices for clients in accordance with company policies.</li><li>Verify billing data, correct discrepancies, and ensure accurate charges are applied.</li><li>Coordinate with project managers and department leads to track billable hours, costs, and contracts.</li><li>Maintain detailed billing records and reconcile accounts regularly.</li><li>Respond to client inquiries related to invoices and payments in a timely and professional manner.</li><li>Support month-end closing processes by providing reports and reconciliations.</li><li>Assist with collections efforts for outstanding balances as needed.</li><li>Generate custom reports for management to support financial planning and forecasting.</li><li>Ensure compliance with company policies, contractual terms, and accounting standards.</li></ul>
We are looking for a Medical Biller/Collections Specialist to join our team in Kirkland, Washington. This Contract-to-permanent position offers an opportunity to work on critical processes such as payment posting, credit reconciliation, and refunds management. The ideal candidate will bring expertise in medical billing, collections, and insurance processes while demonstrating proficiency with tools like Excel and specialized billing systems.<br><br>Responsibilities:<br>• Post payments accurately by working off spreadsheets and reconciling credits within the system.<br>• Investigate and resolve credit balances, determining whether adjustments or refunds are required.<br>• Manage refund processes, ensuring compliance with payer-specific procedures and requirements.<br>• Research and reconcile overpayments, verifying amounts and issuing refunds to appropriate parties.<br>• Utilize proprietary billing systems to perform detailed analysis and tracking of credits and payments.<br>• Conduct audits to ensure accurate payment posting and adherence to payer guidelines.<br>• Collaborate with team members to streamline processes related to billing, collections, and refunds.<br>• Generate accurate reports and documentation to support financial transactions and reconciliations.<br>• Stay updated on insurance policies and regulations to ensure compliance in all billing activities.<br>• Provide support for special projects related to patient accounts and refunds.
We are looking for a detail-oriented Legal Billing Specialist to join our team in Dallas, Texas. This role requires expertise in legal billing processes and excellent organizational skills to ensure smooth and efficient operations. You will play a vital part in managing invoices, handling client communications, and supporting administrative functions.<br><br>Responsibilities:<br>• Generate and process legal invoices using TABS3 software while ensuring accuracy and compliance with client requirements.<br>• Convert invoices into appropriate billing file formats and submit them through online platforms, including eBilling systems or eBillingHub.<br>• Communicate directly with clients to assist with accounts receivable tasks and address billing inquiries.<br>• Coordinate the submission of budgets and handle invoice appeals to meet client expectations.<br>• Maintain organized records by performing retention and storage tasks.<br>• Manage general office filing activities to support a well-structured workspace.<br>• Provide administrative assistance and complete additional duties as directed by the Office Manager.
We are seeking a detail-oriented and organized Grant Billing Specialist to manage the financial aspects of grants, ensuring compliance with funding requirements and timely, accurate billing. This role plays a key part in supporting our organization’s mission by maintaining transparency and accountability in grant-related financial processes. Responsibilities: Prepare and submit grant billing and reimbursement requests in accordance with funding agency requirements. Monitor expenditures and ensure costs are allocated appropriately to grants. Reconcile grant accounts and resolve discrepancies in a timely manner. Maintain accurate financial records and documentation for all grant-related activities. Work closely with program managers and finance staff to ensure compliance with grant budgets. Prepare financial reports for internal use and external agencies. Track grant receivables and follow up on outstanding payments. Assist with audits and provide necessary documentation.
<p>We are looking for a dedicated Claims Admin Support Specialist to join our client's team in Oxford, MS. In this role, you will handle a variety of clerical tasks, ensuring smooth office operations and providing support to internal teams. This is a long-term contract position, offering an excellent opportunity to utilize your organizational skills and attention to detail.</p><p><br></p><p>Responsibilities:</p><p>• Manage and maintain office supplies to ensure adequate inventory levels.</p><p>• Operate and oversee office equipment, including fax machines, printers, and copiers, ensuring functionality and addressing issues as needed.</p><p>• Coordinate document shredding services with external vendors to maintain compliance with company policies.</p><p>• Organize, retrieve, and deliver files while performing document scanning and copying as required.</p><p>• Draft and send routine correspondence, ensuring professionalism and accuracy.</p><p>• Welcome visitors and address routine inquiries or direct them to the appropriate department.</p><p>• Sort, open, and distribute incoming mail and packages, including FedEx and other courier services.</p><p>• Assist with scheduling meetings, maintaining records, and organizing retention processes.</p><p>• Perform additional research, reporting, and administrative tasks as requested by leadership.</p><p>• Travel occasionally to fulfill job-related responsibilities.</p>
<p>We are looking for a dedicated Billing Clerk to join our team in Colorado Springs, Colorado. In this role, you will play a vital part in ensuring accurate and efficient billing processes for a healthcare organization specializing in treatments for medication-resistant depression. The ideal candidate is detail-oriented, organized, and possesses excellent communication skills to maintain seamless workflows and patient satisfaction.</p><p><br></p><p><strong>Job Description</strong></p><p>As a Medical Biller, you will play a critical role in managing all aspects of the revenue cycle process. This position blends technical billing expertise with empathetic patient interaction, making it vital for ensuring the financial health of our organization while maintaining high-quality patient experiences.</p><p><br></p><p><strong>Key Responsibilities</strong></p><ul><li><strong>Claim Management</strong>: Handle charge and code input, prior authorizations, scrubbing, timely submission of claims, secondary billing, and coordination of benefits.</li><li><strong>Payment Posting</strong>: Post patient and insurance payments using ERA and paper EOBs; identify payment discrepancies and patterns like downcoding or out-of-network adjustments by insurance companies.</li><li><strong>Appeals and Denials</strong>: Manage insurance denials through appeals and coordinate coverage by assessing patient eligibility and prior authorization details. Utilize portals such as Availity, Zelis, One Healthcare, Cigna HCP, Medicare/WPS, and others.</li><li><strong>Patient Interaction</strong>: Communicate with patients about copays, outstanding balances, payment plans, and refunds or credits, often engaging with individuals who may have severe depression.</li><li><strong>Communication Tracking</strong>: Document all communications with patients and insurance companies, ensuring HIPAA compliance.</li><li><strong>Reporting and Analysis</strong>: Generate and maintain reports from practice management systems like NextGen and update the billing escalation tracker in Excel (pivot table proficiency required).</li><li><strong>Audit Support</strong>: Assist with insurance and internal audits and handle accompanying records requests.</li><li><strong>Process Improvement</strong>: Identify opportunities to shift to automated processes wherever possible, including transitioning paper claims, checks, and EOBs to electronic formats.</li></ul>
<p>We’re hiring a detail-focused Legal Billing Coordinator to support our client's billing operations. This role involves managing billing for assigned attorneys, preparing and submitting invoices, and ensuring accuracy across electronic billing platforms. The ideal candidate will have at least 2 years of law firm billing experience, strong communication skills, and a solid grasp of billing systems—SurePoint experience is a plus.</p><p><br></p><p>What You’ll Do:</p><ul><li>Oversee billing for designated attorneys or partners</li><li>Prepare and distribute prebills and final invoices</li><li>Submit e-bills and manage billing portals</li><li>Resolve billing issues, including rejections and appeals</li><li>Track outstanding balances and follow up as needed</li><li>Collaborate with attorneys and legal staff on billing matters</li><li>Assist with new matter setup and other billing-related tasks</li></ul><p><br></p>
We are looking for a dedicated and detail-oriented individual to join our team as a Medical Billing/Claims/Collections Specialist in Sartell, Minnesota. This long-term contract position offers an excellent opportunity to utilize your expertise in medical billing and claims management while contributing to the efficiency of our operations. If you are detail-oriented and have a solid understanding of medical billing processes, this role may be a great fit for you.<br><br>Responsibilities:<br>• Review insurance explanation of benefits (EOBs) to ensure claims are processed accurately and posted correctly in the MatrixCare system.<br>• Investigate claim statuses by accessing insurance websites to confirm receipt and processing details.<br>• Identify and address denied claims, take corrective actions, and resubmit claims as necessary.<br>• Communicate effectively with insurance providers to resolve discrepancies and ensure timely claim resolutions.<br>• Maintain accurate documentation and records of claim activities for auditing and compliance purposes.<br>• Collaborate with team members to improve billing and claims workflows and ensure adherence to best practices.<br>• Analyze trends in claim denials to recommend process improvements and reduce future issues.<br>• Stay updated on insurance policies and billing regulations to ensure compliance with industry standards.
<p>Lana Funkhouser with Robert Half is looking for a skilled Revenue Cycle Manager to oversee and enhance the financial health of our organization in Emmett, Idaho. This role involves leading all aspects of revenue cycle operations, ensuring compliance with regulatory standards, and implementing strategies to improve efficiency and accuracy in billing and coding. The ideal candidate will bring strong expertise in healthcare revenue management and a proven ability to drive results through collaboration and innovation.</p><p><br></p><p>Responsibilities:</p><p>• Develop and execute strategic plans for the Revenue Cycle team, setting clear goals and objectives.</p><p>• Provide expert oversight on CPT and ICD-10 coding, while preparing for the transition to ICD-11 standards.</p><p>• Manage the Chargemaster, ensuring timely updates and accurate coding for all services to support proper billing.</p><p>• Utilize quality improvement tools to monitor billing accuracy, identify concerns, and implement corrective actions.</p><p>• Deliver training to providers and staff on updates to coding and billing practices, particularly for Critical Access Hospitals.</p><p>• Ensure compliance with privacy standards, the No Surprises Act, Hospital Price Transparency Rule, and other federal and state regulations.</p><p>• Build and maintain strong relationships with insurance companies to address issues affecting cash flow, such as claim denials or policy changes.</p><p>• Drive revenue integrity by optimizing charge capture, reimbursement processes, patient collections, and minimizing bad debt.</p><p>• Regularly evaluate team performance, ensuring goals are met and providing feedback for continuous improvement.</p><p>• Act as the subject matter expert on revenue cycle operations, advising leadership on payer relations and regulatory changes.</p><p><br></p><p>Please reach out to Lana Funkhouser with Robert Half to review this position. Job Order: 03590-0013292146</p><p><br></p>
<p>Our client is seeking a highly motivated and detail-oriented <strong>Eligibility Specialist</strong> for a remote, contract-to-hire position. The Eligibility Specialist will play a crucial role in ensuring the financial clearance of patient accounts, focusing on eligibility verification, resolving claim discrepancies, and guaranteeing the timely submission of clean claims to insurance companies. This is a fast-paced role that demands precision, analytical skills, and exceptional communication abilities.</p><p><br></p><p><strong>Key Responsibilities</strong></p><p><strong>1. Eligibility Verification</strong></p><ul><li>Conduct detailed reviews of patient insurance coverage and benefits for laboratory services.</li><li>Collaborate with teammates, clinics, patients, and insurance companies to verify coverage details and address any discrepancies.</li><li>Maintain accurate and comprehensive documentation of eligibility information in the revenue cycle management (RCM) system.</li></ul><p><strong>2. Claim Error Processing</strong></p><ul><li>Analyze and promptly resolve claim errors identified in the RCM system, including billing and coding discrepancies.</li><li>Work closely with team members to ensure compliance with policies, procedures, and medical necessity requirements.</li><li>Address and reconcile discrepancies to prepare clean claims for timely submission.</li></ul><p><strong>3. Additional Duties</strong></p><ul><li>Assist in other related tasks as assigned by leadership.</li></ul>
We are looking for a skilled Claims Examiner specializing in lost time claims to join our team on a contract basis in Jersey City, New Jersey. In this role, you will oversee the full lifecycle of workers' compensation claims, ensuring compliance with regulations while maintaining strong relationships with all involved parties. This position requires someone with excellent attention to detail, capable of managing complex claims processes and delivering high-quality service.<br><br>Responsibilities:<br>• Manage workers' compensation lost time claims from initial setup to closure, maintaining excellent customer relationships throughout the process.<br>• Conduct thorough investigations by reviewing policy details, collecting statements, and gathering facts from claimants, insured parties, and medical providers.<br>• Evaluate gathered information to determine claim compensability and communicate decisions regarding claim approvals or denials to all relevant parties.<br>• Administer statutory medical and indemnity benefits in a timely manner, ensuring compliance with applicable regulations.<br>• Set and adjust claim reserves for medical, indemnity, and related expenses, recommending changes to the Team Leader as necessary.<br>• Partner with attorneys to oversee litigation processes, including hearings, and manage legal documentation.<br>• Direct and coordinate efforts with vendors, nurse case managers, and rehabilitation managers to support medical management and return-to-work initiatives.<br>• Prepare and submit reports on claim settlements, denials, evaluations, and potential exposures to the Team Leader.<br>• Ensure compliance with state regulations by filing workers' compensation forms and electronic data accurately and on time.<br>• Identify subrogation opportunities and work to recover claim-related costs effectively.
<ul><li><strong>Position: Claims Examiner - Lost Time (Contract Role)</strong></li><li><strong>Location: 555 Long Wharf Drive New Haven CT USA 06511-5941</strong></li><li><strong>Type: 100% Onsite</strong></li><li><strong>Hourly Pay Range: $30-33/per hour</strong></li><li><strong>Interview Process: Virtual interview 1-2 round of 30 minute interview</strong></li></ul><p> </p><p><strong>Job Description: </strong></p><p>Job Schedule-100% ONSITE</p><p>Job hours-8:30am-5:00pm EST</p><p> </p><p>3 years of Workers Compensation Lost Time Claim Examiner or Commensurate Experience </p><p> </p><p>Duties and Responsibilities:</p><p>- Handles all aspects of workers compensation lost time claims from set-up to case closure ensuring strong customer relations are maintained throughout the process.</p><p>- Reviews claim and policy information to provide background for investigation.</p><p>- Conducts 3-part ongoing investigations obtaining facts and taking statements as necessary with insured claimant and medical providers.</p><p>- Evaluates the facts gathered through the investigation to determine compensability of the claim.</p><p>- Informs insureds claimants and attorneys of claim denials when applicable.</p><p>- Prepares reports on investigation settlements denials of claims and evaluations of involved parties etc.</p><p>- Timely administration of statutory medical and indemnity benefits throughout the life of the claim.</p><p>- Sets reserves within authority limits for medical indemnity and expenses and recommends reserve changes to Team</p><p>Leader throughout the life of the claim.</p><p>- Reviews the claim status at regular intervals and makes recommendations to Team Leader to discuss problems and remedial actions to resolve them.</p><p>- Prepares and submits to Team Leader unusual or possible undesirable exposures when encountered.</p><p>- Works with attorneys to manage hearings and litigation</p><p>- Controls and directs vendors nurse case managers telephonic cases managers and rehabilitation managers on medical management and return to work initiatives.</p><p>- Complies with customer service requests including Special Claims Handling procedures file status notes and claim reviews.</p><p>- Files workers compensation forms and electronic data with states to ensure compliance with statutory regulations.</p><p>- Refers appropriate claims to subrogation and secures necessary information to ensure that recovery opportunities are maximized.</p><p>- Works with in-house Technical Assistants Special Investigators Nurse</p><p>Consultants Telephonic Case Managers as well as Team Supervisors to exceed customer's expectations for exceptional claims handling service.</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.
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.
