<p>Job Posting: Claims Adjuster – Remote</p><p>Join our team to support a leading pet insurance organization as a Claims Adjuster. This is a fully remote role offering the opportunity to help pet parents by efficiently managing, adjudicating, and finalizing insurance claims. We are looking for detail-oriented individuals who value accuracy, organization, and clear communication.</p><p><br></p><p>Key Responsibilities:</p><ul><li>Adjudicate insurance claims in a timely and compliant manner, adhering to standard operating procedures.</li><li>Consistently meet or exceed daily claims targets.</li><li>Provide guidance, oversight, and final approval authority to non-licensed claims processors (GenPact, AdStrat, or Healthy Paws).</li><li>Maintain active adjuster licenses as required by state and municipal regulations.</li><li>Identify and recommend process improvements to enhance the claims workflow.</li><li>Ensure all claims are processed according to compliance and quality standards.</li></ul><p><br></p>
We are looking for a detail-oriented Billing Clerk to join our team in Newark, New Jersey. This role is a Contract to permanent position and requires a dedicated individual to handle billing operations efficiently in a fast-paced manufacturing environment. The ideal candidate will play a key role in ensuring accurate billing processes and maintaining strong customer service standards.<br><br>Responsibilities:<br>• Process and manage customer invoices with accuracy and attention to detail.<br>• Handle billing collections and ensure timely follow-ups with clients.<br>• Prepare and distribute billing statements in accordance with company procedures.<br>• Utilize computerized billing systems to maintain and update records.<br>• Perform data entry tasks related to invoices and billing information.<br>• Collaborate with the operations team to address customer inquiries.<br>• Maintain comprehensive documentation of billing activities for audit purposes.<br>• Assist with administrative tasks in a high-volume environment.<br>• Ensure compliance with company policies and industry standards.<br>• Provide exceptional customer service to support billing operations.
We are looking for a highly organized and detail-oriented Stop Loss Coordinator to oversee and streamline the claims process for stop loss insurance. This role involves managing claims from submission to resolution, ensuring compliance with policies and timely reimbursements. The ideal candidate will collaborate with internal teams and carriers to maintain accurate documentation and provide updates on claims progress.<br><br>Responsibilities:<br>• Manage the complete lifecycle of stop loss claims, from submission to resolution, ensuring timely and accurate processing.<br>• Coordinate with the Finance department to reconcile reimbursements and payments effectively.<br>• Monitor pending claims submissions and promptly respond to carrier requests for additional information.<br>• Review and interpret stop loss policies to confirm compliance with reimbursement and claims requirements.<br>• Maintain thorough and organized records of claims documentation and correspondence following company procedures.<br>• Analyze claims data and address carrier denials or requests for further clarification.<br>• Provide regular updates to management regarding claim statuses, pending issues, and expected resolution timelines.<br>• Collaborate with internal teams to gather necessary information for claims processing.<br>• Perform additional duties as assigned to support the overall claims management process.
We are looking for an experienced Billing Clerk to join our team in Forest Hills, New York. In this role, you will manage various billing functions, ensuring accuracy and efficiency in processing claims, invoices, and payments. This is a long-term contract position within the non-profit industry, offering an opportunity for growth and stability.<br><br>Responsibilities:<br>• Prepare and process billing statements and invoices with precision.<br>• Handle claims processing for Medicaid and healthcare-related billing.<br>• Investigate and resolve discrepancies in billing records or payments.<br>• Maintain accurate documentation and records for all billing activities.<br>• Collaborate with internal teams to ensure timely submission of claims and invoices.<br>• Monitor and track payments to ensure compliance with deadlines.<br>• Apply appropriate codes to invoices and claims based on regulations and policies.<br>• Support the implementation and maintenance of billing systems.<br>• Communicate with clients and stakeholders to address billing inquiries.<br>• Generate reports to analyze billing performance and identify areas for improvement.
<p>A busy company in the Pompton Plains area is seeking a Billing Clerk to join their growing team. This Billing Clerk will report into the Accounts Receivable Manager and be a part of a collaborative team that works great with each other. This Billing Clerk opportunity also offers career growth and work flexibility. The ideal Billing Clerk will have excellent attention to detail, be comfortable in a high volume environment, and have strong communication skills as they will be liaising with multiple departments internally. Other responsibilities of this Billing Clerk will include but not be limited to:</p><p><br></p><p>Billing Clerk Responsibilities:</p><ul><li>Review and verify daily shipment activity to ensure accurate and timely invoicing</li><li>Organize, compile, and maintain complete supporting documentation for billing and audit purposes</li><li>Process high-volume daily invoices accurately within the ERP system</li><li>Generate and distribute customer invoices through multiple channels (mail, email, customer portals, etc.)</li><li>Collaborate with the AR Supervisor and Controller to obtain approvals on final invoice edit lists</li><li>Prepare and submit daily commission reports for management review</li><li>Maintain and update daily sales and performance reports to support business decision-making</li><li>Provide prompt and professional responses to customer requests for invoice copies and billing inquiries</li><li>Support month-end close activities, including reporting, customer reconciliations, and analysis</li><li>Assist the accounting team with auditor requests and documentation during audits</li><li>Perform general clerical and administrative tasks such as filing, reporting, and correspondence</li><li>Contribute to special projects and ad hoc assignments as needed, supporting continuous process improvement</li></ul><p>This Billing Clerk role is paying between $45,000 and $55,000 annually depending on experience. If interested in this Billing Clerk position, apply today!</p>
<p>Our client is looking for a dedicated Bodily Injury Claims Representative in the Lawrenceville, NJ area to manage non-litigation auto insurance claims, including uninsured and underinsured motorist cases. This role requires a strong understanding of insurance policies and the ability to assess claims effectively. </p><p><br></p><p>Salary is 60,000 - 79,000. </p><p><br></p><p>Benefits include medical, dental, and vision coverage, PTO, life insurance, and 401k. </p><p><br></p><p>Responsibilities:</p><p>• Investigate claims thoroughly to validate their authenticity, assess policy coverages, and determine if special investigations are necessary.</p><p>• Set appropriate reserves based on claim details and adjust them as new information becomes available.</p><p>• Negotiate settlements with claimants, attorneys, and other involved parties while adhering to company policies.</p><p>• Issue accurate payments promptly and ensure all transactions align with regulatory standards.</p><p>• Recognize potential fraud or questionable claims and escalate them to the special investigation unit when required.</p><p>• Maintain organized records and follow up regularly to ensure claims are resolved in a timely manner.</p><p>• Ensure compliance with state and local regulations, including NJ, PA, and Michigan Unfair Claims Practices guidelines.</p><p>• Complete other assigned duties as needed to support the claims process.</p>
<p>Our client is looking for a dedicated Billing Specialist to join their team in the Hamilton, New Jersey area. In this role, you will oversee Medicaid reimbursement processes, resolve billing discrepancies, and ensure compliance with all relevant regulations and standards. You will play a key part in maintaining accurate financial records and providing exceptional support to internal staff and external payers.</p><p><br></p><p>Salary is 55,000 - 60,000.</p><p><br></p><p>Benefits include health insurance, 401k, and PTO. </p><p><br></p><p>Responsibilities:</p><p>• Process initial claims from electronic medical record systems by reviewing, calculating, and adjusting submissions as needed.</p><p>• Maintain billing systems to ensure accurate financial records and submit claims both manually and electronically.</p><p>• Investigate and resolve disputed claims by verifying details, providing necessary documentation, and communicating with payers.</p><p>• Monitor deadlines for claim submissions and ensure timely processing for all designated payers.</p><p>• Assist in generating required reports for regulatory agencies under the guidance of the billing supervisor.</p><p>• Review consumer records to gather private and Medicaid billing information.</p><p>• Input codes and verify data to ensure accuracy in computer processing systems.</p><p>• Set up customer accounts and generate invoices using NetSuite.</p><p>• Support inspections, inquiries, or investigations by cooperating with licensing and department staff.</p><p>• Take on additional responsibilities as assigned to meet organizational needs.</p>
<p>Model Development & Maintenance</p><p> • Develop and maintain actuarial models and data-driven processes using Python, R, and SQL to support insurance pricing, reserving, and risk management.</p><p> • Implement and enhance month-end processes, rate change calculations, and ad-hoc analyses with a focus on completeness, accuracy, and consistency to ensure data is of the highest quality.</p><p> • Work with the Actuarial and Financial Planning and Analysis (FP& A) teams to automate and improve model performance using Python-based scripting and automation.</p><p> • Ensure accuracy, consistency, and efficiency of actuarial models and methodologies.</p><p> Traditional Actuarial Tasks</p><p> • Support reserving analysis to estimate unpaid claim liabilities primarily in partnership with internal and external actuaries.</p><p> • Develop and maintain loss development triangles and incurred but not reported (IBNR) calculations both based on financial and operational data (e.g., claims closing ratios).</p><p> • Support the development and validation of actuarial assumptions for pricing, reserving, and forecasting.</p><p> • Develop and regularly report on rate change calculations including bifurcation of exposure changes from pure rate by line of business.</p><p> Financial Modeling & Risk Assessment</p><p> • Conduct stress testing and scenario analysis to assess financial impacts.</p><p> • Develop, update, and maintain models for predictive analytics, profitability analysis, and business planning.</p><p> • Assist in forecasting financial performance and evaluating risk exposure.</p><p> </p><p> </p>
<p>We are looking for a dedicated Personal Injury Claims Representative to join our team in the Lawrenceville, New Jersey area. In this role, you will manage complex personal injury protection claims, ensuring compliance with company policies and regulatory requirements. This position requires a detail-oriented individual with strong analytical skills and a commitment to delivering high-quality service.</p><p><br></p><p>Salary is 58,240 - 76,960.</p><p><br></p><p>Benefits include medical, dental, vision insurance, PTO, life insurance, and 401k. </p><p><br></p><p>Responsibilities:</p><p>• Investigate assigned claims, confirm coverage, verify eligibility, and determine the appropriate course of action.</p><p>• Evaluate gathered information to assess claim validity, injury extent, and potential exposure.</p><p>• Establish and maintain accurate reserves for each claim based on exposure estimates.</p><p>• Coordinate medical case reviews, independent medical examinations, or expert consultations when necessary.</p><p>• Respond to inquiries and concerns from subscribers, claimants, attorneys, and healthcare providers.</p><p>• Document claim files comprehensively and maintain an organized follow-up system for timely reporting.</p><p>• Ensure claims are managed in alignment with the organization's Decision Point Review Plan.</p><p>• Collaborate with internal departments and external specialists to optimize claim outcomes.</p><p>• Oversee loss adjustment expenses and manage vendor activities to ensure efficient and necessary work completion.</p><p>• Adhere to guidelines outlined in the Unfair Claim Practices Acts and other relevant regulations.</p>
We are looking for a detail-oriented Billing Clerk to join our team in Ridgefield, Connecticut. This long-term contract position is ideal for professionals who excel in managing billing tasks and have experience with invoicing, data entry, and related systems. The role offers flexibility, making it a great fit for individuals seeking part-time hours or returning to the workforce.<br><br>Responsibilities:<br>• Generate and process accurate invoices for clients using established billing systems.<br>• Review and verify billing statements to ensure completeness and accuracy.<br>• Maintain and update computerized billing records, ensuring data integrity.<br>• Perform invoice coding and ensure proper allocation to accounts.<br>• Support purchasing functions as needed to streamline operations.<br>• Utilize Sage 50 software for billing and accounting tasks.<br>• Collaborate with team members to resolve billing discrepancies efficiently.<br>• Prepare reports related to billing and purchasing activities.<br>• Ensure compliance with company policies and procedures for invoicing and billing.<br>• Provide administrative support to enhance overall billing processes.
<p>We are seeking an experienced <strong>Billing Coordinator</strong> to join a dynamic law firm’s billing team. This role is ideal for a detail-oriented professional with strong organizational skills and a background in legal billing. The position offers a hybrid schedule and the opportunity to work closely with attorneys, partners, and legal staff.</p><p><strong>Key Responsibilities:</strong></p><ul><li>Manage billing for assigned partners and coordinate new matter intake.</li><li>Generate and distribute prebills; finalize and send invoices to clients.</li><li>Submit e-bills and manage electronic billing platforms.</li><li>Handle appeals and billing rejections; monitor and follow up on open balances.</li><li>Collaborate with attorneys and legal support staff on billing-related tasks.</li></ul><p><br></p>
We are looking for a Billing Clerk to join our team in Roslyn Heights, New York. In this role, you will play a critical part in ensuring the accuracy and efficiency of billing processes within a healthcare setting. Your responsibilities will include managing insurance claims, addressing patient inquiries, and contributing to the overall success of the revenue cycle.<br><br>Responsibilities:<br>• Analyze and address denials and underpaid claims from insurance carriers based on contracted fee schedules.<br>• Submit appeals for inappropriate insurance denials in a timely manner.<br>• Communicate with patients to resolve questions about their claims, coverage, and billing concerns.<br>• Validate overpayment refund requests from insurance carriers to ensure accuracy.<br>• Monitor and identify trends among payors that impact revenue.<br>• Participate in individualized accounts receivable reviews with management.<br>• Determine coordination of benefits for patients with secondary and tertiary insurance coverage.<br>• Support various tasks related to revenue cycle operations as needed.<br>• Maintain constructive and positive interactions with patients, colleagues, and managers to foster a collaborative work environment.
