<p><strong>Contract Medical Billing/Claims/Collections Specialist</strong></p><p><br></p><p><em>Location: Remote, Northeast Ohio (Canton, OH-Based)</em></p><p><br></p><p>We are seeking a detail-oriented and experienced Medical Billing/Claims/Collections Specialist to join our talented team on a contract basis. This role is critical for ensuring accurate coding processes, maintaining compliance with revenue integrity standards, and optimizing charge capture workflows. Although this position is fully remote, candidates must reside within the Northeast Ohio area to foster seamless collaboration with local teams and stakeholders. A coding certification is preferred to demonstrate expertise in industry standards and best practices.</p><p><strong>Responsibilities:</strong></p><ul><li>Accurately assign diagnostic and procedural codes for outpatient and inpatient billing to guarantee precise charge capture.</li><li>Conduct coding audits to identify missing documentation or discrepancies impacting revenue generation.</li><li>Ensure consistent compliance with coding and reimbursement guidelines while adhering to relevant industry standards.</li><li>Educate healthcare providers on coding specificity and quality indicators to enhance documentation accuracy and streamline workflows.</li><li>Track and report open encounters and zero charges proactively to relevant personnel.</li><li>Collaborate with department leaders, healthcare providers, and organizational leadership to address coding concerns or identify optimization opportunities.</li><li>Meet or exceed established productivity and quality benchmarks for coding tasks.</li><li>Support revenue cycle and clinical teams in performing additional administrative functions as required.</li><li>Stay current with coding policies, guidelines, and healthcare industry trends to uphold best practices.</li><li>Utilize hospital software applications and Microsoft Office tools effectively to accomplish daily responsibilities with efficiency.</li></ul><p><strong>Preferred Qualifications:</strong></p><ul><li>A coding certification (e.g., CPC, CCS, or equivalent) is strongly preferred.</li><li>Proven experience in medical billing, claims, and collections.</li><li>Expertise in diagnostic and procedural coding, coupled with familiarity with audit processes and revenue cycle optimization.</li><li>Knowledge of relevant coding guidelines and reimbursement policies.</li><li>Strong communication skills and an ability to work collaboratively with healthcare professionals and cross-functional teams.</li><li>Proficient in healthcare software applications and Microsoft Office Suite.</li></ul><p><strong>Why Join Us?</strong></p><p>This opportunity allows you to contribute to the smooth operation of a respected healthcare organization while working in a flexible remote environment. Be a part of a dynamic environment with a mission to make healthcare administration seamless and efficient.</p><p>Apply now to make an impact in the healthcare industry while showcasing your skills and expertise.</p><p><br></p><p>Want to build your career in healthcare? </p>
We are looking for a skilled Medical Billing Specialist to join our team on a short-term contract basis in Northfield, Illinois. This role focuses on processing insurance and patient payments with precision and efficiency. If you have experience in medical billing and are comfortable handling claims and collections, we encourage you to apply.<br><br>Responsibilities:<br>• Accurately post payments received from insurance providers and patients into the appropriate systems.<br>• Review and reconcile patient accounts to ensure all payments are properly allocated.<br>• Process medical claims and ensure timely submission to insurance companies.<br>• Investigate and resolve discrepancies in billing and payments.<br>• Collaborate with insurance companies and patients to address billing inquiries and issues.<br>• Maintain up-to-date knowledge of medical coding and billing regulations.<br>• Utilize Epaces software and other medical billing tools effectively.<br>• Generate reports on billing activities and payment statuses.<br>• Communicate with the team to ensure consistency and accuracy in billing processes.
<p><strong>Now Hiring: Medical Billing & Front Desk Lead – Quad Cities</strong></p><p><br></p><p>Join a respected healthcare organization as the <strong>Medical Billing & Front Desk Lead</strong>! In this role, you’ll handle medical billing accuracy, insurance verification, and front desk oversight while coaching the team for success.</p><p><br></p><p><strong><u>What You’ll Do:</u></strong></p><ul><li>Manage medical billing: claims, payments, and follow-ups</li><li>Ensure accurate scheduling & insurance verification</li><li>Lead and support front desk staff</li><li>Improve workflows for billing and front desk processes</li></ul><p>Hours: Monday–Friday, 8 AM–5 PM (occasional 7 AM shift)</p><p><br></p><p><strong>Ready to make an impact? Apply today or call Lydia, Christin, or Erin at 563-359-3995!</strong></p>
We are looking for an experienced Medical Billing Specialist to join our team in Syracuse, New York. In this Contract-to-Permanent position, you will play a vital role in managing billing processes for Home Health Care services, ensuring accuracy in claims submission and payment processing. Candidates should possess a strong background in accounts receivable management and electronic claims systems, coupled with exceptional analytical and problem-solving skills.<br><br>Responsibilities:<br>• Review and verify claims for accuracy and completeness, correcting any missing or incorrect details related to Home Health Care billing.<br>• Prepare and submit claims and invoices to payors or clients in accordance with established billing schedules.<br>• Conduct timely follow-up on outstanding claims and invoices to optimize revenue collection.<br>• Investigate and appeal unpaid claims as needed to ensure maximum reimbursement.<br>• Post payments with a high degree of accuracy and within specified timelines.<br>• Utilize electronic billing systems, including Waystar, to manage claims efficiently and address billing exceptions.<br>• Communicate billing issues, payment discrepancies, and collection challenges to the Billing Manager promptly.<br>• Leverage agency IT systems to streamline work processes and meet job requirements.<br>• Participate in meetings and training sessions to stay updated on industry standards and practices.<br>• Ensure compliance with payor filing requirements to maintain timely and accurate billing.
<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>We are seeking a highly skilled and detail-oriented <strong>Medical Biller</strong> to ensure timely and efficient processing of medical claims and support in optimizing revenue.</p><p><br></p><p><strong>Responsibilities:</strong></p><p>As a <strong>Medical Biller</strong>, your duties will include:</p><ul><li>Preparing and submitting medical claims to insurance companies, government payers, and patients in compliance with healthcare regulations.</li><li>Reviewing and verifying accuracy of patient insurance information, ensuring claims are complete and error-free.</li><li>Monitoring the progress of submitted claims and following up on delayed or denied claims, resolving discrepancies appropriately.</li><li>Generating patient invoices and explaining charges while ensuring clarity for patients regarding financial obligations.</li><li>Ensuring proper coding of procedures, diagnoses, and services using CPT, ICD-10, and HCPCS codes.</li><li>Collaborating with healthcare providers and other administrative staff to resolve complex billing issues.</li><li>Handling adjustments for payments, posting refunds or corrections, and reconciling account balances.</li><li>Staying informed of changes in regulations, policies, and industry standards related to medical billing.</li><li>Maintaining compliance with HIPAA regulations to safeguard patient information.</li></ul><p><br></p>
We are looking for a skilled Medical Billing Specialist to join our team in Rochester, New York. In this critical role, you will contribute to the healthcare revenue cycle by ensuring accurate billing, timely claim submissions, and efficient payment processing. This is a Contract-to-Permanent position, offering an opportunity to grow within the organization while supporting essential billing operations.<br><br>Responsibilities:<br>• Prepare, review, and submit accurate insurance claims in alignment with established deadlines.<br>• Process payments received from patients and insurance providers, ensuring timely updates to financial records.<br>• Follow up on unpaid claims, resolve discrepancies, and maintain account accuracy.<br>• Communicate professionally with patients to address billing inquiries, statements, and payment plans.<br>• Organize and maintain patient records, payment histories, and other billing-related documentation in compliance with healthcare regulations.<br>• Coordinate with insurance providers to clarify coverage details and resolve reimbursement issues.<br>• Stay informed on healthcare billing codes, industry standards, and policy updates to ensure compliance in all billing activities.
We are looking for a detail-oriented Medical Billing Specialist to join our team in Greenville, South Carolina. This Contract-to-Permanent position offers an excellent opportunity to contribute to a healthcare environment by ensuring accurate billing processes and effective account management. The ideal candidate will thrive in a fast-paced setting and bring expertise in medical billing systems and practices.<br><br>Responsibilities:<br>• Manage payment arrangements and actively pursue overdue accounts to support revenue generation.<br>• Establish and monitor payment plans for patients with delinquent accounts, following up on lapses in payment.<br>• Utilize collection agencies and legal avenues, including testifying in court, to recover outstanding accounts.<br>• Compile and maintain Medicare bad-debt cost reports by tracking billings and monitoring collections.<br>• Initiate claims against estates by coordinating with the legal department and court clerks to resolve unpaid accounts.<br>• Facilitate payroll deductions and automatic transfers to secure payments for employee care balances.<br>• Interview pre-delivery patients to establish payment plans for obstetrical services and ensure timely billing.<br>• Adhere to policies and procedures to maintain operational compliance and report any compliance concerns.<br>• Protect sensitive billing and collection data by adhering to confidentiality standards.<br>• Participate in ongoing educational opportunities to stay current with industry practices and updates.
<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>We are looking for a detail-oriented Medical Billing Specialist to join our team in King of Prussia, Pennsylvania. In this long-term contract position, you will play a vital role in ensuring accurate billing, timely claims management, and efficient collections processes. Your efforts will directly support our mission of providing personalized autism services by working closely with families and stakeholders to facilitate smooth billing operations.</p><p><br></p><p>Responsibilities:</p><p>• Manage denial responses and accounts receivable follow-ups using Waystar and insurance portals.</p><p>• Submit primary and secondary claims for both commercial and Medicaid payors.</p><p>• Handle claims across all aging buckets, from initial billing to final resolution, including identifying and correcting errors, rejections, and denials.</p><p>• Investigate and appeal claim denials to ensure optimal resolution.</p><p>• Review and input billing data with a focus on precision and compliance.</p><p>• Collaborate with the Billing Manager and clinic teams to ensure accurate billing processes.</p><p>• Monitor and verify Medicaid status for clients to ensure eligibility.</p><p>• Develop and maintain strong relationships with Pennsylvania Medicaid payors to streamline claims processing and payments.</p><p>• Assist the intake team with completing Medicaid documentation for new clients or reassessments.</p><p>• Perform additional tasks as assigned by the Billing Manager or Director.</p>
<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>
We are looking for a skilled Medical Biller/Collections Specialist to join our team in Berea, Ohio. This long-term contract position involves managing billing processes, addressing claims, and ensuring accurate payment collections within the healthcare industry. If you have a strong background in medical billing and collections, we encourage you to apply.<br><br>Responsibilities:<br>• Handle medical billing tasks, including processing claims and verifying data accuracy.<br>• Review and resolve medical denials efficiently to ensure proper reimbursement.<br>• Manage appeals for denied claims, following up with insurance providers as needed.<br>• Oversee hospital billing processes to guarantee compliance and timely payments.<br>• Collaborate with healthcare providers and insurance companies to address payment discrepancies.<br>• Monitor accounts receivable and ensure timely collection of outstanding balances.<br>• Maintain detailed records of billing activities to support audits and reporting.<br>• Analyze trends in denials and collections to recommend process improvements.<br>• Ensure compliance with all applicable regulations and industry standards.
<p>We are looking for a skilled Medical Billing Specialist to join our team in Burr Ridge, Illinois. In this Contract-to-permanent position, you will play a key role in managing billing operations, ensuring accuracy in claims submission, and collaborating with clinical staff to facilitate timely processes. The ideal candidate will bring expertise in medical collections and billing practices, along with familiarity with industry systems and Medicare billing.</p><p><br></p><p>Responsibilities:</p><p>• Prepare and review appointment schedules to track billing for assigned locations effectively.</p><p>• Process infusion billing daily, verifying accuracy in codes, drug quantities, and pharmacy delivery documentation.</p><p>• Submit claims to insurance companies by printing and mailing forms, attaching primary explanation of benefits for secondary claims as needed.</p><p>• Monitor and coordinate drug returns for patients who did not receive infusions, working closely with clinics and pharmacies.</p><p>• Verify patient demographics and insurance information to ensure accurate billing procedures.</p><p>• Maintain oversight of assigned billing tasks and provide regular updates to supervisors.</p><p>• Collaborate with clinical staff to address and resolve missing documentation to complete billing efficiently.</p><p>• Handle additional billing-related duties and tasks as assigned by management.</p><p>• Utilize systems such as Accurint, Allscripts, and Cerner Technologies to optimize billing processes.</p><p><br></p><p>The salary range for this position is $23 to $25. Benefits available to contract/temporary professionals, include medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit <u>roberthalf.gobenefits.net</u> for more information.</p>
<p>We are looking for a skilled Medical Billing Specialist to join our team on a contract basis in Ridgefield, Connecticut. This position, lasting 4–5 months, and will be roughly 30 hours per week, the role will involve accurately posting payments and reconciling billing data within a healthcare setting. If you have a strong background in medical billing and a keen eye for detail, we encourage you to apply.</p><p><br></p><p>Responsibilities:</p><p>• Accurately post both insurance and patient payments into the practice management system.</p><p>• Identify discrepancies in contracted rates and underpaid claims, ensuring proper resolution.</p><p>• Reconcile daily payment batches to maintain accurate financial records.</p><p>• Examine explanation of benefits (EOBs) and electronic remittance advice (ERAs) to ensure correct posting.</p><p>• Prepare appeals for denied claims and follow up with insurance payers as needed.</p><p>• Perform additional billing-related tasks as assigned by the supervisor.</p><p>• Collaborate with team members to streamline billing workflows and improve accuracy.</p>
<p>We are seeking a <strong>Medical Biller</strong> for a growing healthcare provider located in <strong>Carlsbad</strong>, CA. This role is ideal for someone with strong billing experience and a solid understanding of insurance claims, coding, and the revenue cycle process. You’ll be responsible for accurately submitting medical claims, resolving billing issues, and working directly with insurance companies to ensure timely payment. If you're detail-oriented, dependable, and experienced in medical billing systems (such as Epic, Kareo, or similar), we want to hear from you.</p><p><br></p><p><strong>Key Responsibilities:</strong></p><ul><li>Prepare and submit insurance claims accurately and efficiently</li><li>Follow up on unpaid claims and resolve denials</li><li>Verify insurance coverage and patient information</li><li>Collaborate with providers and front office staff</li><li>Maintain compliance with HIPAA and billing regulations</li></ul>
<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>We are seeking an <strong>Entry-Level Medical Biller</strong> to join our client’s dynamic team. In this role, you’ll play a vital part in the billing cycle, ensuring accurate and timely billing for medical services while contributing to a positive patient experience.</p><p><strong>Key Responsibilities:</strong></p><ul><li>Review patient charts and medical records to ensure accuracy in billing documentation and coding.</li><li>Prepare and submit insurance claims for reimbursement in compliance with payer requirements.</li><li>Follow up with insurance providers to track claim statuses and resolve discrepancies or denials.</li><li>Respond to patient inquiries regarding billing statements and insurance coverage.</li><li>Post payments and adjustments in the billing system and maintain accurate account records.</li><li>Stay up to date with billing regulations, coding guidelines, and HIPAA compliance standards.</li><li>Collaborate with healthcare providers, administrative staff, and insurance companies to streamline processes.</li></ul><p><br></p>
We are looking for a detail-oriented Medical Billing Specialist to join our team in Lexington, Kentucky. This Contract-to-Permanent position is ideal for professionals with experience in medical billing and coding who are ready to contribute to a collaborative and efficient work environment. The role involves handling high-volume authorizations, insurance claims, and patient communications, ensuring accuracy and timeliness in all billing processes.<br><br>Responsibilities:<br>• Process medical claims and ensure all billing activities comply with established policies and procedures.<br>• Verify patient insurance benefits online and obtain necessary authorizations for services.<br>• Conduct follow-ups with insurance companies to resolve denied claims and ensure timely reimbursements.<br>• Communicate with patients regarding copays, deposits, and payment arrangements, maintaining professionalism and empathy.<br>• Record and process payments within the system, ensuring accurate documentation.<br>• Collaborate with a team of billing professionals to meet departmental goals and deadlines.<br>• Utilize medical coding knowledge to accurately input data and avoid errors.<br>• Manage a high volume of authorizations with a proactive and organized approach.<br>• Stay updated on industry trends and insurance company policies to improve efficiency.<br>• Assist in maintaining a positive and productive office environment.
We are looking for an experienced Medical Accounts Receivable Team Lead to join our team in Mt. Holly, New Jersey. This long-term contract position is ideal for someone with a strong background in medical billing, claims management, and collections. If you have a passion for ensuring financial accuracy and operational efficiency in healthcare, we encourage you to apply.<br><br>Responsibilities:<br>• Oversee the daily operations of medical accounts receivable, ensuring timely and accurate processing of claims and collections.<br>• Manage and resolve billing discrepancies, appeals, and authorizations to maintain compliance and optimize revenue.<br>• Utilize accounting software systems, including Allscripts and Cerner Technologies, to streamline billing functions.<br>• Lead efforts in handling dynamic data exchange (DDE) processes for efficient communication and data sharing.<br>• Monitor accounts receivable to identify and address outstanding balances or payment issues.<br>• Collaborate with healthcare providers and insurance companies to ensure proper benefit functions are applied.<br>• Train and mentor team members on EHR systems and best practices in medical billing and claims.<br>• Develop and implement strategies to improve billing accuracy and reduce claim denials.<br>• Prepare reports and analyze data to track performance metrics and identify areas for improvement.
We are looking for a detail-oriented Medical Billing Insurance Clerk to join our team on a contract basis in Barton, Vermont. In this role, you will play a critical part in ensuring accurate billing and claim administration while maintaining confidentiality and compliance with regulations. This position is ideal for someone with a strong understanding of medical billing processes and experience working with insurance claims.<br><br>Responsibilities:<br>• Process and submit medical claims to insurance providers, ensuring accuracy and compliance with established guidelines.<br>• Utilize billing software to manage data entry and track claim statuses.<br>• Verify insurance coverage details and resolve claim discrepancies efficiently.<br>• Handle collections and follow up on outstanding payments from insurance providers.<br>• Maintain confidentiality of patient information and billing records.<br>• Collaborate with team members to ensure seamless operations and timely claim submissions.<br>• Generate and analyze reports related to billing and insurance claims.<br>• Manage Medicaid and commercial insurance billing processes, adhering to specific regulations.<br>• Update and maintain spreadsheets for tracking billing activities and payment records.<br>• Communicate effectively with insurance companies and healthcare providers to address billing concerns.
<p>Are you a skilled Medical Billing Specialist with expertise in denials management and insurance collections? A Hospital in Van Nuys is seeking a detail-oriented and driven professional to join a dynamic healthcare team. If you have the experience, passion, and commitment it takes to ensure accurate and efficient medical billing processes, we want to hear from you!</p><p><strong>Key Responsibilities:</strong></p><ul><li>Research, appeal, and resolve insurance claim denials to maximize reimbursement.</li><li>Review patient accounts to identify and address billing discrepancies.</li><li>Communicate with insurance companies to expedite claims resolution and payment collections.</li><li>Ensure compliance with relevant laws, regulations, and company standards in all billing activities.</li><li>Prepare and submit accurate claims to insurance carriers.</li><li>Monitor and analyze accounts receivable and follow up on unpaid claims.</li><li>Provide exceptional customer service to patients and providers regarding account questions.</li></ul><p><br></p>
<p>We are looking for a motivated professional to handle medical billing tasks within our organization. The successful candidate will help ensure billing processes run smoothly and efficiently. This role requires attention to detail, strong organizational skills, and the ability to work in a fast-paced environment.</p><p> </p><p>Responsibilities:</p><ul><li>Process billing and claims submissions with accuracy.</li><li>Ensure proper follow-up on outstanding payments or claims.</li><li>Help resolve issues related to billing discrepancies.</li><li>Maintain organized records and documents.</li><li>Collaborate with teams to ensure compliance with procedures and guidelines.</li></ul><p><br></p>
<p>We are looking for several detail-oriented Revenue Cycle Clerks to join our team in Federal Way, Washington. This long-term contract position focuses on managing and analyzing credit balances within the healthcare revenue cycle. The role involves critical thinking, problem-solving, and a strong ability to investigate and resolve discrepancies in medical claims. After completing a two-week in-office training, the position transitions to a fully remote setup.</p><p><br></p><p>Responsibilities:</p><p>• Analyze credit balances and determine appropriate actions to address overpayments from insurance payers.</p><p>• Conduct thorough investigations into medical claims to identify discrepancies and root causes.</p><p>• Process refunds and adjustments accurately, ensuring compliance with healthcare billing standards.</p><p>• Utilize payer portals and electronic remittance systems to review and resolve claims issues.</p><p>• Collaborate with internal teams to ensure proper documentation and resolution of revenue cycle tasks.</p><p>• Apply critical thinking to identify patterns and suggest process improvements.</p><p>• Participate in a structured training program combining classroom learning and hands-on practice.</p><p>• Handle retractions and adjust financial records based on investigative findings.</p><p>• Manage data using internal tools, Outlook, Excel, and SharePoint.</p><p>• Communicate effectively with stakeholders to address queries and provide updates.</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>
<p>We are looking for an experienced Medical Biller/Collections Specialist to join our team in Duarte, California. The Medical Biller/Collections Specialist will play a vital role in managing the revenue cycle for Skilled Nursing Facility services, ensuring claims are processed accurately and efficiently while adhering to Medicare, Medi-Cal, and other insurance guidelines. This is an excellent opportunity for a meticulous individual to contribute to a dynamic healthcare environment.</p><p><br></p><p>Responsibilities:</p><p>• Prepare and submit claims to insurance payers with accuracy and timeliness, focusing on Skilled Nursing Facility services.</p><p>• Investigate and resolve denied claims by identifying root causes and implementing corrective measures to reduce future denials.</p><p>• Draft and submit appeals for claim denials to secure appropriate reimbursements.</p><p>• Maintain comprehensive and accurate patient billing records in compliance with Medicare, Medi-Cal, and payer-specific requirements.</p><p>• Follow up with insurance companies and payers to resolve outstanding claims and ensure timely reimbursements.</p><p>• Stay up-to-date on federal, state, and local billing regulations to ensure strict adherence to compliance standards.</p><p>• Collaborate with administrative and clinical teams to streamline billing workflows and improve documentation processes.</p><p>• Generate detailed account reports that outline billing trends, claim statuses, and resolution timelines for management review.</p>
