238 results for Eligibility Specialist jobs

Eligibility Specialist

Houston, TX
remote
Contract / Temporary to Hire
22.8 - 26.4 USD / Hourly
We are seeking an experienced and detail‑oriented RCM Reimbursement Specialist focused on Appeals and Denials to join our team on a contract-to-hire basis. This fully remote role is essential in maximizing reimbursement by following up on outstanding insurance balances, resolving unpaid claims, and managing appeals through multiple levels.The ideal candidate thrives in a fast‑paced environment, is meticulous in their work, and has deep expertise in medical billing, payer processes, and denial management. Responsibilities<ul><li>Resolve aged claims and appeals lacking payer responses through payer portals and outbound calls.</li><li>Identify claims requiring first, second, or third‑level appeals.</li><li>Support teammates with special projects and denial work queue management.</li><li>Prioritize an assigned work queue to ensure timely follow‑up while maximizing reimbursement opportunity.</li><li>Identify non‑payment trends and partner with Revenue Cycle leadership to escalate groups of claims to Market Access.</li><li>Investigate denial and non‑payment trends identified by Revenue Cycle Analytics and collaborate cross‑functionally to propose and implement solutions.</li><li>Communicate opportunities to improve upstream processes that may prevent future denials.</li><li>Engage patients when their involvement is required during the appeal process.</li><li>Collaborate professionally with Revenue Cycle team members and respond promptly to requests requiring assistance.</li></ul>
2026-03-13T00:00:00Z

Eligibility Specialist

Port Saint Lucie, FL
onsite
Contract / Temporary to Hire
19 - 21 USD / Hourly
We are looking for a detail-oriented Eligibility Specialist to join our team in Port St Lucie, Florida. In this Contract to permanent position, you will play a critical role in managing eligibility documentation and ensuring compliance for children in out-of-home care. This role requires a strong understanding of Medicaid processes, insurance follow-up, and preauthorization procedures. Responsibilities: • Prepare and compile comprehensive documentation to facilitate Title IV-E determinations for children entering out-of-home care. • Enroll newly eligible Medicaid recipients into the Sunshine Child Welfare Specialty Plan. • Identify and refer children potentially eligible for Social Security benefits to the Master Trust Specialist. • Process and submit applications for all children under the supervision of CCKids. • Monitor and manage Title IV-E determinations to prevent expiration and ensure timely re-determinations. • Review, approve, and organize pre-adoption files submitted by Adoption Case Managers. • Handle agreements, update placements and services, and coordinate with case managers on adoption case assignments and finalizations. • Process new Title IV-E applications for children placed in adoption settings promptly and accurately. • Assist case management teams in obtaining eligibility documentation for adoption cases or future eligibility reviews. • Address inquiries about Medicaid billing, primary care physician changes, and related matters from foster parents, caregivers, case managers, and investigators.
2026-03-16T00:00:00Z

Medical Eligibility Specialist

Long Beach, CA
onsite
Contract / Temporary to Hire
18.2115 - 23 USD / Hourly
A Medical Center in Long Beach is in the immediate need of Medical Eligibility Specialist. The Medical Eligibility Specialist will play a vital role in ensuring accurate financial screening, eligibility and insurance verification for incoming patients. The Medical Eligibility Specialist ideally will have strong experience in eligibility, microsoft excel and medi-cal insurance. Responsibilities:• Conduct financial screenings for incoming clients to determine eligibility and financial liability.• Verify Medi-Cal coverage and other insurance eligibility to ensure proper documentation and accurate billing.• Maintain and update client financial records in electronic health record systems.• Organize and track annual re-evaluations of client financial information.• Follow up with clinical staff to ensure completion of required documentation for financial folders.• Collect and manage client documents, such as Medi-Cal cards, social security cards, and identification cards.• Create and oversee electronic insurance folders, including adjustments, claims, and explanation of benefits (EOBs).• Audit financial folders upon client discharge to ensure compliance and accuracy.
2026-03-13T00:00:00Z

Benefits Specialist

Rochester, NY
onsite
Temporary
20 - 30 USD / Hourly
<ul><li>Administer and coordinate employee benefits programs, including health, dental, vision, life insurance, disability, flexible spending, and retirement plans</li><li>Serve as the primary point of contact for employee benefits inquiries, providing accurate and timely information</li><li>Support open enrollment processes, including communications, system updates, and responding to employee questions</li><li>Ensure compliance with federal, state, and local benefit regulations (COBRA, HIPAA, ACA, ERISA, etc.)</li><li>Maintain accurate benefits records and process enrollments, changes, and terminations in HRIS and with third-party providers</li><li>Collaborate with payroll to ensure correct benefit deductions and resolve discrepancies</li><li>Assist with benefits-related vendor and invoice management</li><li>Support the development of benefits communications and educational materials for employees</li><li>Participate in benchmarking, plan evaluations, and special benefits projects as needed</li></ul>
2026-03-03T00:00:00Z

Benefits Specialist

Pasadena, TX
onsite
Contract / Temporary to Hire
34 - 38 USD / Hourly
We are looking for a skilled Sr. Benefits Specialist to join our team in Pasadena, Texas. In this Contract to permanent position, you will play a key role in administering and optimizing employee benefits programs, ensuring smooth operations and compliance across various offerings. Your expertise in benefits coordination and administration will significantly contribute to enhancing employee satisfaction and the overall efficiency of our organization. Responsibilities:• Administer comprehensive benefits programs, including health, dental, vision, life, disability, and voluntary options, ensuring accuracy and compliance.• Manage employee enrollment processes, handle status changes, and resolve claims efficiently.• Maintain updated and accessible benefits resources across internal platforms to support employees.• Oversee retirement plans such as 401(k), including enrollments, loans, withdrawals, and reporting.• Provide guidance and support to employees regarding FMLA and other leave policies.• Collaborate with payroll and HR teams to ensure seamless integration and execution of benefits.• Analyze benefit packages and provide recommendations to optimize offerings.• Verify and monitor employee benefits to ensure eligibility and accuracy.• Utilize ADP Workforce Now to manage benefits administration tasks effectively.• Conduct regular audits and reporting to ensure compliance with regulations and company policies.
2026-03-16T00:00:00Z

Benefits Specialist

Rochester, NY
onsite
Permanent
52000 - 57000 USD / Yearly
We are looking for an experienced Benefits Specialist to join our team in Rochester, NY. This role is essential in ensuring employees have access to comprehensive and compliant benefit programs, while maintaining confidentiality and building trust across all levels of the organization. The ideal candidate will have strong organizational skills, excellent communication abilities, and a proactive approach to problem-solving. Responsibilities:• Administer and manage employee benefit programs, ensuring compliance with applicable laws and regulations.• Provide guidance and support to employees regarding benefits options, processes, and eligibility requirements.• Foster trust and maintain confidentiality when handling sensitive employee information.• Collaborate with internal teams to streamline benefits coordination and address employee inquiries effectively.• Analyze and evaluate current benefit offerings to propose improvements and align with industry best practices.• Manage benefits-related processes such as onboarding, FMLA administration, and other leave policies.• Utilize Microsoft Office and organizational systems to maintain accurate benefit records and reports.• Ensure timely communication of benefits updates and changes to employees.• Develop and implement strategies to enhance employee understanding and engagement with benefit programs.• Stay informed on legal and regulatory changes affecting compensation and benefits.
2026-02-18T00:00:00Z

Benefits Specialist

New York, NY
onsite
Temporary
36.1 - 38 USD / Hourly
We are looking for a dedicated Benefits Specialist to join our team on a long-term contract basis. This role is based in New York, New York, and offers an exciting opportunity to manage and enhance employee benefits programs while collaborating with vendors and internal teams. The ideal candidate will have a strong background in benefits administration, excellent communication skills, and the ability to handle complex cases and high-volume tasks efficiently. Responsibilities:• Handle daily benefits administration tasks, including managing a high-volume ticket queue and addressing employee inquiries through platforms such as Workday, Zoom, and Slack.• Research and resolve complex benefits and leave-related issues, escalating to vendors or carriers as necessary.• Validate and maintain accuracy in Workday file feed integrations and manually upload files when automated processes fail.• Administer 401(k) and retirement plans, including correcting report errors, troubleshooting account setups, and managing loan files.• Collaborate with vendors and brokers to ensure timely resolution of employee escalations and process vendor payments efficiently.• Conduct monthly premium reconciliations, verify reimbursement eligibility, and ensure accuracy across payroll and benefits reporting systems.• Create and distribute employee communications, such as newsletters and onboarding presentations, to enhance engagement and education.• Coordinate and support financial wellness initiatives, vendor engagement events, and employee education programs.• Partner with leadership to support special projects, including pilot programs, insurance RFPs, and office setup initiative
2026-03-10T00:00:00Z

Credentialing Specialist

Somerville, NJ
onsite
Temporary
25 - 30 USD / Hourly
We are looking for a detail-oriented Credentialing Specialist to join our team. In this long-term contract position, you will play a vital role in ensuring healthcare practitioners meet all credentialing and privileging requirements according to state, federal, and accreditation guidelines. This is an excellent opportunity to showcase your organizational skills and contribute to maintaining compliance and efficiency within the credentialing process. Responsibilities:<ul><li>Conduct thorough primary source verification to confirm education, licenses, and training credentials of healthcare practitioners.</li><li>Review and audit applications for accuracy and completeness, ensuring all required information is provided.</li><li>Manage and maintain credentialing records, privileging documentation, and enrollment files with precision.</li><li>Oversee provider enrollment processes for Medicaid, CAQH, and other healthcare systems, ensuring compliance with established procedures.</li><li>Upload and link critical documents in credentialing systems while maintaining accurate data entry.</li><li>Regularly update and audit on-call schedules to ensure accuracy and reliability.</li><li>Collaborate with physicians, advanced practice providers, hospital staff, and external organizations to address credentialing matters.</li><li>Ensure databases are consistently updated and maintained for seamless access and reporting.</li><li>Handle confidential information with discretion and professionalism, addressing urgent matters promptly.</li></ul>
2026-03-16T00:00:00Z

Referral Specialist

Fort Worth, TX
onsite
Temporary
20 - 22 USD / Hourly
Position: Referral Specialist (CONTRACT)Location: Fort Texas, United States of America, 76109Schedule: 100% Onsite | Monday–Friday | 8:00 AM–5:00 PMPay Range: $20–$22 per hourEmployment Type: Contract (no guarantee of extension or conversion)Position OverviewEssential Duties & Time Allocation (Must Total 100%)Advanced Remittance Duties – 70%<ul><li>Perform exception‑based remittance research and advanced reconciliation of referral fees and NPR.</li><li>Serve as secondary vendor contact for referral fee inquiries and issue resolution.</li><li>Conduct fact‑finding and resolve vendor matters requiring coding corrections or refunds.</li><li>Collaborate with ORM to ensure compliance related to referral fees, vendors, and clients.</li><li>Oversee firm‑wide referral fee payment application processes and inquiries.</li><li>Process refunds for clients when referral fees cannot be retained.</li><li>Maintain and support vendor relationships related to referral clients and fee validation.</li></ul>Training Duties – 15%<ul><li>Manage NPR referral receipt operations including: </li><li>Validation of vendors with ORM for referral fee eligibility.</li><li>Monitoring vendor payments and matching remittance documents to clients and GL accounts.</li><li>Posting client NPR to the GL via journal entries.</li><li>Ensuring referral fee acceptance processes operate correctly firm‑wide.</li><li>Accessing vendor portals to confirm accurate referral client assignments.</li></ul> Reporting & Analysis – 10%<ul><li>Deliver daily and monthly reporting on NPR to Consulting LOB leadership.</li><li>Conduct monthly reconciliation of NPR and related balance sheet accounts for the entire firm.</li></ul>Other Duties – 5%<ul><li>Perform additional tasks as assigned.</li></ul>
2026-03-16T00:00:00Z

IT Specialist

Paducah, KY
onsite
Permanent
65000 - 75000 USD / Yearly
We are looking for an experienced IT Specialist to join our client's team in Paducah, Kentucky. In this role, you will be responsible for managing and maintaining the organization’s technology infrastructure, ensuring all systems, software, and networks operate securely and efficiently. This position requires a proactive approach to troubleshooting, technical support, and the implementation of innovative solutions to meet organizational needs. Responsibilities:• Manage and maintain the organization’s systems, networks, applications, and telecommunications to ensure seamless operations.• Diagnose and resolve technical issues related to hardware, software, and network systems.• Install, configure, and update system software to enhance performance and security.• Safeguard sensitive data and communications by implementing robust security measures.• Research and recommend new technologies to improve operational efficiency.• Provide technical support and guidance to employees, ensuring timely resolution of issues.• Create and manage documentation for system processes, procedures, and configurations.• Participate in on-call support for after-hours technical needs.• Ensure compliance with relevant laws and regulations in the management of IT systems.• Prioritize and address technology needs to support organizational goals.
2026-03-06T00:00:00Z

Medical Denials Specialist

Carmel, IN
onsite
Temporary
18 - 22 USD / Hourly
Join our dynamic healthcare team as a Medical Denials Specialist and play a key role in resolving denied medical claims efficiently and accurately. Schedule: Monday–Friday, 8:00 am – 5:00 pm Key Responsibilities:<ul><li>Review insurance denial notifications and conduct thorough research to resolve outstanding claims issues.</li><li>Analyze denial patterns and root causes, recommending process enhancements to prevent future occurrences.</li><li>Communicate directly with insurance payers to troubleshoot and expedite claim resolutions.</li><li>Prepare, document, and submit appeals for denied claims.</li><li>Work closely with billing teams, healthcare providers, and insurance companies to ensure smooth claims management.</li><li>Stay informed on payer guidelines and current healthcare compliance regulations.</li><li>Consistently maintain adherence to HIPAA requirements and internal policies.</li></ul>
2026-03-04T00:00:00Z

Quality Specialist

Goleta, CA
onsite
Temporary
25 - 30 USD / Hourly
We are looking for a dedicated Quality Specialist to join our team in Santa Barbara, California. This is a long-term contract position where you will play a pivotal role in ensuring high standards of quality across processes, systems, and supplier relationships. The ideal candidate is detail-oriented and passionate about continuous improvement, with a strong background in quality management and compliance. Responsibilities: • Lead investigations into discrepancies, identifying root causes and ensuring timely resolution and documentation. • Support quality initiatives by developing and improving administrative processes and driving continuous improvement efforts. • Collaborate with teams to identify and address inefficiencies within internal workflows. • Manage and enhance the electronic Quality Management System, including designing workflows and providing staff training. • Develop and implement effective training programs, including creating training materials and evaluating their success. • Oversee and expand the supplier approval program, ensuring compliance and quality standards are met. • Design and monitor product quality initiatives as part of supplier quality management. • Conduct supplier audits, including site visits for third-party logistics providers. • Partner with cross-functional teams to promote adherence to industry regulations and best practices.
2026-03-13T00:00:00Z

Health Information Specialist

Cooperstown, NY
onsite
Temporary
20 - 22 USD / Hourly
We are seeking a highly organized, customer‑service‑focused Health Information Specialist to support a busy Health Information Management department for this onsite role. This role is part of a team of a five-person team and is responsible for handling protected health information (PHI) with accuracy, professionalism, and urgency. The Health Information Specialist opening is a longer-term onsite contract role in Cooperstown, NY. The phones ring frequently from patients, attorneys, providers, and billing departments, so strong communication skills and the ability to multitask are essential. Key Responsibilities Provide positive, detail oriented customer service via phone and in person. Answer high-volume incoming calls and route inquiries appropriately. Receive, verify, and process signed authorization forms for release of information. Retrieve, scan, copy, print, and prepare paper and electronic medical records from various media formats. Ensure timely and accurate completion of ROI requests in compliance with privacy regulations. Utilize EPIC to view and respond to messages and manage work queues. Monitor and complete assigned work queues, voicemails, and email requests. Maintain confidentiality and handle PHI in accordance with organizational and HIPAA requirements.
2026-03-13T00:00:00Z

Outreach Specialist

Houston, TX
onsite
Contract / Temporary to Hire
19.7885 - 22.913 USD / Hourly
We are looking for a dynamic Outreach Specialist to join our team in Houston, Texas. In this role, you will focus on fostering positive relationships with the community, organizing outreach initiatives, and driving engagement through media and public relations efforts. This is a Contract-to-permanent position, offering an excellent opportunity to grow your career while contributing to the success of a forward-thinking organization. Responsibilities: • Build and maintain strong relationships with community members, organizations, and stakeholders. • Plan and execute outreach events such as job fairs and career days, ensuring all logistical aspects are handled efficiently. • Draft and distribute press releases, media pitches, and other public relations materials to promote organizational initiatives. • Collaborate with internal teams to meet set quotas and achieve outreach goals. • Utilize CRM tools to track outreach activities and maintain accurate records of community engagement. • Provide administrative support to ensure smooth operations during outreach events and campaigns. • Reimburse mileage and parking expenses for travel associated with outreach activities. • Conduct intake interviews with prospective students or clients to better understand their needs and align them with organizational offerings. • Contribute to sales-oriented tasks by applying knowledge of field sales and e-commerce practices. • Monitor and analyze the success of outreach strategies, recommending improvements when necessary.
2026-03-11T00:00:00Z

Outreach Specialist

Houston, TX
onsite
Temporary
0 - 0 USD / Yearly
We are seeking a driven and results-oriented Outreach Specialist to support new business development efforts through proactive outbound prospecting. This individual will be responsible for identifying potential clients, initiating contact through cold calling and digital outreach, and qualifying leads to build a strong, consistent sales pipeline.The ideal candidate is confident, resilient, and motivated by targets. They are comfortable making high-volume calls, following up persistently, and turning cold conversations into warm opportunities. Key Responsibilities<ul><li>Conduct high-volume cold calls to generate new business opportunities.</li><li>Proactively chase and follow up on inbound and outbound leads.</li><li>Identify decision-makers and initiate conversations to uncover business needs.</li><li>Schedule qualified meetings for senior sales team members.</li><li>Maintain consistent daily outreach activity across phone, email, and LinkedIn.</li><li>Qualify prospects based on established criteria and sales readiness.</li><li>Track outreach activity and pipeline progress within CRM systems.</li><li>Nurture leads through consistent follow-up and relationship building.</li><li>Partner with sales leadership to refine messaging and outreach strategy.</li><li>Meet or exceed weekly and monthly outreach and appointment-setting targets.</li><li>Provide regular updates on call volume, conversion rates, and pipeline activity.</li><li>Identify trends and recommend improvements to outreach effectiveness.</li></ul>
2026-03-02T00:00:00Z

Regulatory Specialist

Lancaster, PA
onsite
Permanent
75000 - 85000 USD / Yearly
Position SummaryThe Regulatory Specialist ensures all regulatory policies, documentation systems, and processes meet industry standards and comply with applicable regulations across all manufacturing sites, co-manufacturers, and corporate operations. This role requires strong understanding of regulatory requirements and the ability to manage multiple quality and compliance systems. Key Responsibilities<ul><li>Manage document control processes to ensure accuracy and compliance.</li><li>Support and maintain regulatory and quality systems.</li><li>Interpret regulatory requirements and assess impacts on products and processes.</li><li>Handle customer regulatory requests, nutrition, label claims, and related documentation.</li><li>Manage export-related requests, including country suitability reviews, ingredient breakdowns, and export compliance requirements.</li><li>Review product labels to ensure regulatory accuracy.</li><li>Develop customer-requested regulatory documents and reports.</li></ul>
2026-03-03T00:00:00Z

Admissions Specialist

New York, NY
onsite
Temporary
31.6635 - 36.663 USD / Hourly
We are looking for a dedicated Admissions Specialist to join our team in New York, New York, on a contract basis. In this role, you will oversee undergraduate admissions operations, leading recruitment efforts and driving enrollment growth. This position requires strong leadership skills, the ability to collaborate cross-departmentally, and a data-driven approach to decision-making. Responsibilities: • Lead and manage the undergraduate admissions team, providing coaching, guidance, and support to ensure recruitment targets are met. • Develop and implement effective recruitment strategies, both short-term and long-term, to attract prospective students. • Oversee admissions-related workflows, databases, and communication processes to maintain data integrity and operational efficiency. • Represent the admissions department at both virtual and in-person recruitment events. • Collaborate with departments such as Marketing, Academic Affairs, and Student Financial Services to align strategies and processes. • Monitor and evaluate key performance indicators to assess admissions staff performance and identify areas for improvement. • Conduct regular team and individual meetings to address challenges, provide mentorship, and encourage attention to detail and growth. • Utilize forecasting models and research tools to analyze enrollment trends and inform recruitment strategies. • Manage technology implementations and updates to enhance admissions operations and streamline workflows. • Partner with faculty and staff to cultivate a campus-wide culture that supports recruitment and student retention efforts.
2026-03-04T00:00:00Z

Presentation Specialist

Boulder, CO
onsite
Temporary
20 - 22 USD / Hourly
We are looking for a skilled Presentation Specialist to join our team on a long-term contract basis in Columbus, OH. In this role, you will leverage your expertise in creating and refining detailed presentations and documents while collaborating with diverse teams. This position is ideal for someone who thrives in a dynamic environment and has a strong attention to detail. Responsibilities:• Design and develop high-quality pitch books and presentations utilizing the Microsoft Office Suite, including Word, Excel, and PowerPoint.• Collaborate with clients and team members to understand project requirements and deliver customized solutions.• Perform quality assurance checks on your work and that of others to ensure accuracy and high standards.• Provide assistance to colleagues in enhancing their skills and adopting efficient shortcuts within presentation tools.• Manage reprographic tasks, such as photocopying and scanning, with minimal supervision.• Communicate effectively with individuals from diverse backgrounds and functional areas.• Organize and prioritize tasks to meet deadlines in a fast-paced, changing work environment.• Follow site-specific procedures for receiving and executing work instructions.• Ensure all deliverables meet high organizational standards and client expectations.
2026-03-16T00:00:00Z

Head Start Enrollment Specialist

Los Angeles, CA
onsite
Temporary
19 - 22 USD / Hourly
Operations - Inventory Specialist 100% Onsite - Location: Los AngelesWhat We're Looking For:We are seeking an Inventory Specialist to facilitate the recording, tracking, accounting, and reporting of the agency's assets inventory.The best suited candidate will:<ul><li>Count, record, track, and classify assets.</li><li>Update asset management system for type, quantity, location, and value of capitalized and controlled assets, making appropriate data base changes pursuant to classification criteria and control procedures.</li><li>Identify and correct discrepancies in coding of assets.</li><li>Identify assets previously not recorded and barcode non-coded assets.</li><li>Track and record transfers of assets between organizational units</li><li>Identify and record records to archive.</li><li>Assist with records management.</li><li>Participate in staff development activities to improve job-related skills.</li><li>Establish and maintain effective working relationships with supervisors and coworkers.</li><li>Perform other duties as assigned.</li></ul>
2026-03-09T00:00:00Z

Sr. Benefits Specialist

Hampton, VA
onsite
Temporary
23.75 - 27.5 USD / Hourly
We are looking for a Part-Time experienced Sr. Benefits Specialist to join our team in Hampton, Virginia. In this long-term contract position, you will play a key role in managing and administering employee benefits programs, ensuring compliance with regulations, and providing exceptional support to employees and retirees. This is an excellent opportunity to contribute to a government organization while building upon your expertise in benefits coordination. Responsibilities:• Manage the daily administration of various employee benefits programs, including medical, dental, vision, life insurance, flexible spending accounts, and disability coverage.• Process benefit-related changes such as terminations, status updates, beneficiary modifications, and enrollments for employees and retirees.• Provide expert customer service and consultations to employees and retirees regarding benefit options, policies, and procedures.• Conduct orientations, webinars, and informational sessions to educate employees about available benefits and associated costs.• Oversee timely enrollment and termination activities within benefits plans, ensuring accuracy and compliance.• Track and report billing activities, missed payments, and payment submissions to third-party vendors.• Ensure adherence to federal, state, and local regulations, including processing court-ordered benefit adjustments in accordance with legal guidelines.• Assist with planning and executing Open Enrollment activities, including communication and coordination with employees.• Support payroll operations by processing payroll-related benefit deductions and performing wire transfers.• Coordinate and provide guidance on Family and Medical Leave (FMLA) and Hybrid Disability Programs, collaborating with payroll, HR, legal, and external vendors as necessary.
2026-03-12T00:00:00Z

Medical Billing Specialist

Basking Ridge, NJ
onsite
Contract / Temporary to Hire
25.3365 - 29.337 USD / Hourly
Our client is seeking an experienced Medical Billing Specialist to join their healthcare team in Basking Ridge, New Jersey. In this role, you will handle Medicare billing processes for skilled nursing facilities, ensuring compliance and accuracy in claims and collections. This is a Contract to permanent position offering an opportunity to contribute to the financial operations of senior living communities. Medicaid Medical Biller Responsibilities:• Manage end-to-end accounts receivable processes and collections for skilled nursing facilities.• Submit, monitor, and resolve Medicare Part A claims, including corrections, status checks, and eligibility verifications.• Handle billing for Medicare Part B, hospice care, and outpatient services with attention to payer status.• Investigate and follow up on unpaid, underpaid, or rejected claims, including appeals and reconsiderations.• Maintain accurate coding and documentation to ensure compliance with Medicare regulations.• Collaborate with clinical, business office, and revenue cycle teams across multiple facilities to optimize billing operations.• Monitor accounts receivable aging and escalate high-risk accounts when necessary.• Utilize systems such as PointClickCare, Inovalon, and MatrixCare to manage billing activities.• Ensure timely and accurate submissions by verifying all claim data for completeness.• Coordinate with nursing leadership and business offices to address discrepancies and improve processes.
2026-03-16T00:00:00Z

Medical Billing Specialist

Loveland, CO
onsite
Temporary
22.8 - 24 USD / Hourly
We are looking for a skilled Medical Billing Specialist to join our healthcare team in Loveland, Colorado. In this contract role, you will contribute to the accuracy and efficiency of medical billing operations, ensuring compliance with industry standards and supporting patient care. This position is ideal for professionals with expertise in medical billing systems, a keen eye for detail, and a commitment to delivering exceptional service. Responsibilities: • Process and submit insurance claims with precision, adhering to regulatory guidelines. • Monitor accounts receivable, address discrepancies, and ensure timely resolution of outstanding balances. • Utilize medical billing software, including Allscripts and Cerner Technologies, to manage billing tasks effectively. • Follow up on denied claims, manage appeals, and secure payments from insurance providers. • Perform medical coding and ensure documentation aligns with established industry standards. • Oversee third-party billing and maintain communication with insurance companies for seamless operations. • Verify patient benefits and eligibility while assisting with related administrative tasks. • Enter numeric data accurately and maintain detailed records of billing transactions. • Respond to inquiries from patients and healthcare providers, delivering excellent customer service. • Collaborate with colleagues to streamline billing processes and enhance workflow efficiency.
2026-03-13T00:00:00Z

Medical Billing Specialist

Syracuse, NY
onsite
Temporary
20 - 25 USD / Hourly
Position Description:This Billing Specialist is an experienced support role with expertise in Home Health Care billing processes, including PDGM, episodic, and institutional claims. The Billing Specialist will have work tasks and responsibilities with accounts receivable (AR) and revenue cycle management, combined with advanced knowledge of electronic billing and claims management systems. This role requires exceptional attention to detail, analytical problem-solving skills, and the ability to ensure accurate and timely claims submission and payment processing. Performance Responsibilities and Standards:1. Review and analyze claims for accuracy and completeness, obtain and/or correct any missing or inaccurate information related to Home Health Care (PDGM, Episodic, Institutional Claims) 2. Compile and submit claims/invoices to appropriate payors/clients within the timeframe designated within the department billing schedule. 3. Must have prior experience in AR/Revenue cycle to ensure timely follow up on claims/invoices. 4. Research and work/appeal unpaid claims when appropriate to ensure optimum collections. 5. Post payments timely with 100% accuracy. 6. Knowledge of electronic billing, billing exceptions and EDI software (Waystar) to ensure claims are submitted and followed up timely. 7. Communicate billing, payment and collections issues to Billing Manager on a current basis. 8. Utilize agency IT systems to carry out job requirements. 9. Attend meetings and workshops as required. 10. Required to bill and collect within the payor filing requirements. 11. All other duties as assigned
2026-03-04T00:00:00Z

Medical Billing Specialist

La Puente, CA
onsite
Contract / Temporary to Hire
23.75 - 28.23 USD / Hourly
A Larger Medical Center in the La Puente Area is in the need of a d Medical Billing Specialist with strong Medi-Cal insurance experience. The Medical Billing Specialist will play a key part in managing the revenue cycle and ensuring accurate billing for Medi-Cal programs. The Medical Billing Specialist must have expertise to maintain compliance with provider guidelines and optimize reimbursement processes. Experience in OBGYN and/or Perinatal Services is a bit plus. Responsibilities:• Verify patient eligibility for Medi-Cal and confirm Managed Care Plan assignments for services rendered.• Prepare and submit claims accurately using appropriate coding and modifiers, including electronic equivalents of CMS-1500 forms.• Post payments, reconcile accounts, and ensure adjustments and write-offs align with contractual requirements.• Analyze denied or underpaid claims, identify issues, and resubmit them to secure proper reimbursement.• Manage appeals by reviewing Explanation of Benefits and engaging with the appeals process to resolve claim discrepancies.• Maintain secure and compliant records of Protected Health Information used in billing activities.• Assist healthcare providers with billing inquiries and support case management practices to enhance revenue.• Ensure all billing activities align with Medi-Cal Provider Manual and Managed Care Plan guidelines.• Collaborate with internal teams to streamline billing processes and improve efficiency.
2026-03-16T00:00:00Z

Medical Billing Specialist

Encino, CA
onsite
Temporary
23.75 - 30.23 USD / Hourly
A Behavioral Healthcare Company is looking for an experienced Medical Billing Specialist with ABA experience to join its Revenue Cycle Team. The Medical Billing Specialist will play a vital role in managing the revenue cycle by ensuring accurate billing, payment processing, and authorizations. This Medical Billing Specialist requires someone with strong attention to detail who can navigate insurance claims, resolve discrepancies, assist patients with EOB explanation and maintain compliance with healthcare regulations. Responsibilities:• Prepare and submit medical claims to insurance companies, including commercial payers and private, ensuring accuracy and compliance.• Monitor and track the status of submitted claims to ensure timely reimbursement.• Post payments from insurance companies and patients with precision and accuracy.• Manage patient account balances, including collections and establishing payment plans when necessary.• Investigate and address claim denials, rejections, and underpayments, identifying solutions to secure proper reimbursement.• Draft and submit appeals with supporting documentation to resolve complex claim issues.• Communicate effectively with insurance carriers and patients to address billing inquiries and concerns.• Maintain detailed and accurate records of billing activities and ensure compliance with payer guidelines.• Support the organization’s financial health by optimizing the revenue cycle processes.• ABA and/or Mental/Behavioral Health is a PLUS! This company offer Medical, Dental and Vision Insurance. 401K Retirement Plan, Sick Time Off and Tuition reimbursement.
2026-03-11T00:00:00Z