Medical Claims Specialist Jobs Near Me

Our team is seeking a Claims Specialist to help manage our P&C claims - primarily worker's compensation and commercial auto. We are looking for someone who is both practical and cost-focused; who knows when to settle and when/how to push back. This position will report directly to CFO. There will be broad autonomy to operate with increasing authority once trust and competence are established. The Ideal Candidate for This Position Is a self-starter who likes to solve complex problems Builds and maintains relationships Is highly organized and detail oriented Is an excellent communicator and a good listener Has a great attitude and a strong work ethic Is comfortable operating and making decision within their level of authority What You'll Need 5+ years of carrier side adjusting experience Preference given to candidates with experience in the following California Work Comp Claims Commercial Auto - BI claims A solid understanding of liability and comparative negligence and be able to identify subrogation opportunities Ability to get a California Independent Adjuster's License with 9 months of hire Familiarity with the claims litigation process Experience with captive insurance programs is a plus What You'll Do Stay current on the status of our open claims Work with adjusters to create action plans to move claims towards closure Track and manage claim reserves Collaborate with adjusters, defense counsel and other stakeholders to keep costs low without sacrificing quality outcomes Report new losses to the appropriate carrier(s) Determine which claims need to be escalated internally and/or with the carrier(s) and proceed appropriately Prepare loss trend analysis and other claim reports as needed Special projects as needed Other duties as assigned Why DIO DIO has quickly grown to be a wide-reaching regional carrier for the CA/NV/AZ area. We are always striving to provide the best service to our clients and their customers. We are proud to have built a team that has a passion for logistics and pushing the company forward. Now is a great time to join DIO since we are on the eve of a major push for expansion into other regions of the US. Our Mission DI will strive to create mutually rewarding relationships with team members, stake holders, and customers by providing an exceptional final mile delivery experience through innovative solutions, technology, and effective teamwork. We also offer A competitive base salary with an annual performance-based bonus PTO package Health benefit options with you in mind; affordable medical plan with open network options. Life Insurance, Vision, and Dental benefits. Company paid short-term disability and long-term disability coverage 401(k) retirement plan Other Information Regarding This Position: Ideally, the successful candidate can office out of the DIO HQ in Anaheim or a satellite office in Midvale, UT. Though we are open to a fully remote option for the right candidate. Quarterly travel to DIO office will be required. DIO is open to W2 or 1099 candidates

We are seeking a detail-oriented and knowledgeable Claims Specialist I to join our team. Under the direction of the Provider Claims Resolution & Recovery Supervisor, the Claims Specialist I - Provider Claims is responsible for evaluating professional, high dollar and outpatient/inpatient institutional claims while determining coverage and payment levels. Responsible for evaluating and resolving provider disputes & appeals, issuing resolution letters, and processing adjustment requests timely and accurately in accordance with standard procedures that ensure compliance with regulatory guidelines. Additional responsibilities include payment adjustment projects and complex claims as assigned. *Candidate will report to the Supervisor, Provider Claims Resolution and Recovery. * *This position is fully remote. Candidates must reside in California. No out of state candidates will be reviewed.* *Duties* * *Review and process provider dispute resolutions according to state and federal designated timeframes.* * *Research reported issues; adjust claims and determine the root cause of the dispute.* * *Draft written responses to providers in a professional manner within required timelines.* * *Independently review and price complex edits related to all claim types to determine the appropriate handling for each including payment or denial. * * *Complete the required number of weekly reviews deemed appropriate for this position. * * *Respond to provider inquiries regarding disputes that have been submitted.* * *Maintain, track, and prioritize assigned caseload through IEHP's provider dispute database to ensure timely completion. * * *Maintain knowledge of claims procedures and all appropriate reference materials; participate in ongoing training as needed.* * *Communicate with a variety of people, both verbally and in writing, to perform research, gather information related to the case that is under review. * * *Recommend opportunities for improvement identified through the trending and analysis of all incoming PDRs.* * *Coordinate with other departments as necessary to facilitate resolution of claim related issues. Identify and report claim related billing issues to various departments for provider education.* * *Any other duties as required to ensure Health Plan operations are successful.* *Requirements* Minimum of four (4) years of experience evaluating and processing institutional and professional medical claims. Proficiency in the following areas: Medical claims system, ICD-10 and CPT coding, reviewing medical authorizations, Provider contract rate interpretation, medical benefit coverage determination. Prior experience handling provider disputes, appeals and claim adjustments. *Experience preferably in HMO or Managed Care setting. Medicare and/or Medi-Cal experience, as well as managed care or government payer environment is helpful. * *Education Requirement* High School Diploma or GED required. *Skills* Strong analytical and problem-solving skills. Microsoft Office, Advanced Microsoft Excel. Written communication skills. Ability to analyze data and interpret regulatory requirements. Excellent communication and interpersonal skills, strong organizational skills, and skilled in data entry required. Typing a minimum of 45 wpm. Excellent oral and written communication skills. Billing experience will not be considered as actual claims processing or adjudicating experience. Job Type: Full-time Pay: $53,872.00 - $68,681.60 per year Benefits: * 401(k) * 401(k) matching * Dental insurance * Employee assistance program * Flexible spending account * Health insurance * Life insurance * On-site gym * Paid time off * Retirement plan * Tuition reimbursement * Vision insurance Schedule: * 8 hour shift * Day shift * Monday to Friday * No weekends Experience: * Medicare and Medi-Cal Claims processing: 4 years (Required) Work Location: Remote

Carter, DeLuca, & Farrell, LLP is an established, steadily growing intellectual property law firm. We are seeking an experienced, full-time (or part-time) Legal Billing Specialist for a non-exempt position for our Melville, NY office or for our Dallas, TX office. We are seeking a Legal Billing Specialist to join our team and help to manage and/or support our New York and Dallas Offices. Please note that this role may be eligible for a flexible working schedule that allows for a hybrid and in-office presence or possibly fully remote. Our professional staff plays a key role in the firm's continued growth and success, and we look forward to adding a proactive and motivated member to our team. Visit our website for more information about us (********************** Job Responsibilities As a Billing Specialist, you will be responsible for the creation and submission of legal services and expense invoices (electronic and non-electronic) to clients based on an established timetable. Provide investigative support and answer questions from partners, attorneys, support staff and clients in all aspects related to billing. This position has the following responsibilities: • Process data and generate invoices in various invoice formats (PDF, LEDES files, Microsoft Xcel and other file formats) • Prepare and distribute prebills, edit unbilled items, process and finalize client invoices • Submit invoices either through email or client's third-party billing portals; ensure successful transmission of invoices and follow up when necessary • Implement complex billing protocols provided by clients; ensuring all client and firm's guidelines and protocols are met, ensuring invoices are processed and implemented during the creation and submission of invoices • Populate, maintain and update data on client's billing portals/ external web-based applications; ensure all relevant information is updated and correlated in client's portals • Research and respond to billing-related inquiries, communicate with partners, assistants, and accounting staff to resolve any issues and ensure bills are timely, accurate, and complete • Investigate and resolve billing-related issues, update and resubmission of invoices; ensuring corrective action is in place for future submissions • Generate, distribute monthly WIP reports to partners and follow-up to ensure non-billed items are processed • Work with firm's accounting department to review and resolve unpaid invoices; assist with monitoring unbilled and accounts receivable status. • Performing necessary technical and logistical tasks with internal staff, and clients' designated personnel in the transition of clients • All other related ad-hoc projects. Job Requirements This position has the following requirements: · An associates degree or higher is preferred but not required, certificates in finance related field welcome · Experience using web-based billing programs, preferable AppColl, Microsoft Excel, Word and Adobe Acrobat · Ability to work efficiently in a fast-paced environment with deadlines · Demonstrated ability to be flexible, work independently with limited oversight, and prioritize work tasks in an effective manner · Collaborative with a can-do attitude balanced with the ability to communicate openly · Comfortable working with all levels of business professionals, including senior management and all colleagues at other departments in a fast-paced environment · Good communication and interaction skills with all levels of firm personnel and client contacts · Proficient and accurate data entry is a must · Ability to prioritize and multitask · Excellent written and verbal communication skills · Strong attention to detail. · Strong organizational skills. The physical demands described herein are representative of those that must be met by an employee to successfully perform the essential functions of this position. While performing the duties of this position, the employee is regularly required to: · remain in a stationary position the majority of the work day · be able to move about inside the office to access various items; and · must be able to constantly operate office equipment including, but not limited to computers, computer mouse, handheld devices, and copy machines. Compensation & Benefits Successful candidates will not only be provided with an outstanding career opportunity and welcoming environment, but will also receive a generous and competitive total compensation package. The salary range for this full-time role is $45,000 - $55,000 (Annual Salary) and represents the firm's good faith and reasonable estimate of the range of possible compensation at the time of posting. Actual compensation will be dependent upon a number of factors, including but not limited to, the candidate's relevant experience, qualifications, and location. Please submit resumes to: *************************** or visit us at ***************************** Carter, Deluca & Farrell LLP is proud to promote a creative, respectful, and inclusive culture that values the diversity of people, and allows ingenuity to thrive. Carter, Deluca & Farrell LLP is an Equal Opportunity Employer. Carter, Deluca & Farrell LLP does not discriminate on-the-basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other basis covered by appropriate law. All employment is decided on-the-basis of qualifications, merit, and business need.

Responsibilities include, but are not limited to: Investigates, and responds to inquiries from payors Research errors and make necessary corrections for clean claim production and submission Follow up on accounts to ensure timely filing and prompt payment Actively review billing/collection policy changes for assigned payers Follow up on payment errors, review posting, and calculate allowable amount before approving patient statements Review Insurance EOB and initiate appeals as necessary Resolves all insurance requests, inquiries, concerns, in an expedient and respectful manner Work accounts to ensure payment meets the qualified payment amount required by the No Surprises Act Must be able to think outside of the box, critical decision making is necessary to fulfill the positions expectations Meet and exceed departmental goals set by the company and department manager EMR Used: MS Office, Excel, GoRev Ability to work remote or hybrid after training based on performance (training is anywhere from 30-45 days) Schedule/Shift Monday - Friday | 8 AM - 5 PM

We are seeking an Insurance Specialist to provide extensive support services covering all aspects of claims management including review, initiation, completion, submission, and direct follow-up to the appropriate third-party payers. Location: Middleburg Hts., Ohio - onsite for 1 month for training, then 100% remote. Must live in Ohio Pay: $18-20.00 per hour - based on experience Shift: First Direct Hire Permanent Opportunity Job Responsibilities: Follow-up with and resolve outstanding accounts receivable balances. Call payers and patients as needed to resolve claim rejections. Respond to payer correspondence. Draft appeals for denied claims. Research requests for insurance payment retractions. Research overpayments and communicate to Treasury for resolution. Monitor and notify management of payer trends and/or claim processing issues. Investigate electronic claim rejections. Research claim information through web portals. Other duties as assigned. Requirements: High School diploma or GED Previous experience working with insurance companies over the phone. Knowledge of third-party billing rules and regulations. Ability to maintain confidentiality. Working knowledge of coding and medical terminology. Excellent written and verbal communication skills. Strong problem-solving skills and the ability to adapt to changes in policies, regulations, and procedures. High attention to detail. Ability to interact effectively with others. Ability to consistently meet production and quality goals. Proficient computer skills with knowledge of Microsoft Word and Excel. *We are looking for someone who can handle stress in a fast-paced environments with multiple priorities and deadlines while adapting to a changing atmosphere. The employee will be expected to make judgement decisions, grasp new ideas, and communicate with various payers, patients, employees, and clients at all levels.

R8 Family Financial is seeking driven and passionate individuals to join our growing team as Remote Insurance Agents. Whether you are licensed or looking to become licensed, we provide comprehensive training and mentorship to help you thrive. Our education-based approach ensures you build a strong foundation and achieve sustainable success. If you're ready for an authentic, supportive environment centered on faith, integrity, and genuine relationships, we'd love to connect with you. Key Responsibilities: Build and manage your own book of business independently. Engage with clients remotely, offering tailored insurance solutions. Participate actively in our top-tier training and mentorship programs. Foster relationships built on trust, integrity, and exceptional service. Ideal Candidate: Licensed or unlicensed individuals interested in a meaningful career. Small agency owners looking for a supportive home for their teams. Dedicated individuals committed to personal and professional growth. Benefits of Joining R8 Family Financial: Fully Remote & Flexible: Work part-time or full-time from anywhere. Comprehensive Training: In-depth, ongoing education designed for your success. Leadership & Mentorship: Access to industry experts passionate about your growth. Family-Oriented Culture: A supportive, faith-driven community dedicated to your success. Zero Costs: No fees for joining, no CRM costs, and no hidden charges. Ownership: Own your book of business from day one and build a valuable asset. No Sales Minimums: Freedom to grow your business without pressure. Our Track Record: $4 Million in production last year without purchasing leads. Join the family that is redefining the industry through genuine relationships and integrity. 📞 Apply today or schedule a conversation to explore how R8 Family Financial can support your career goals! #R8FamilyFinancial #InsuranceCareer #RemoteWork #IntegrityFirst #CareerOpportunity

Tandym Group has several immediate opportunities for A/R Billing Specialists with a client in Pennsylvania. These contracts will be 100% remote. These roles will focus specifically on A/R billing, claims processing, billing adjustments, and revenue integrity, with a strong emphasis on working within the Epic system. Required Experience: 5+ years of revenue cycle experience, specifically focused on A/R billing, claim processing, and billing adjustments. Strong background in lifecycle billing, including initial claims, claim edits, and resubmitted claims. Denial management experience, particularly working to identify and resolve issues related to billing discrepancies. Full-lifecycle billing experience, from claim submission through resolution. Experience with Appeals, including preparing and submitting appeals for claims denials, and ensuring proper billing adjustments are made when necessary. Experience with Epic HB & PB software (3+ years). Proficiency in working with billing workflows and revenue integrity using the Epic system. Experience with both commercial and government billing. Ability to understand and manage work queues effectively to ensure timely billing resolution. Proven track record of managing and processing 40-60 accounts per day efficiently. Excellent customer service and communication skills, especially when interacting with internal teams and external stakeholders. Proactive and metrics-driven approach to ensure timely and accurate billing processes.

About The Firm Scopelitis, Garvin, Light, Hanson & Feary, P.C. serves the legal and business needs of the transportation industry on a full-service basis. Our legal team is experienced in not only regulatory compliance, but also business structuring and transactions, litigation, insurance, labor and employment, highway accident defense, taxation, mergers and acquisitions, workers' compensation, logistics, driver leasing, warehousing, private fleet operations, outsourcing, and customs. We also represent clients in a variety of other related industries, including those that provide services or products in insurance, alternative workforce strategies, construction and real estate development, manufacturing, retail goods, and professional services. With our principal office in Indianapolis and other offices located coast to coast, we are easily accessible to clients nationwide. The Firm has an opening for a full-time Hybrid or Remote Billing Specialist. This opening could potentially accommodate a position in the Indianapolis, Chicago or Milwaukee offices, or have the option for a fully remote position. The Firm has developed an optional 3-2 hybrid work schedule where employees are expected to work from the office at least three days per week and may opt to work from home up to two days per week. This option may be available after training and an introductory period are complete and at the discretion of the Finance Director and Billing Manager. The Opportunity The candidate will provide high level support in the delivery and processing of invoices through various electronic systems, in addition to other accounting functions such as accounts receivable and collections. Duties and Responsibilities Perform full-cycle billing functions including but not limited to client bills, client statements and audit letters Collaborate with Finance Director, Billing Manager and attorneys regarding client billing requirements and apply those requirements to monthly invoices Collaborate with attorneys regarding client budgets and client rates Analyze deductions to bills and work with attorneys to appeal deductions Proactively seek ways to improve billing process and reduce future deductions Monitor and update new clients and matters for required billing guidelines, invoice formats/settings, discount and rate arrangements Handle mid-month and month-end proforma runs with assistance from Billing Manager Demonstrate an ability to be proactive and provide best-in-class service to attorneys, staff, vendors and clients by being professional and responsiveness Understand the Firm's electronic billing system and process ebilling invoices Identify trends and issues with performance in relation to practice group profitability and client fee agreements Run reports, analyze data and prepare spreadsheets Compare and analyze financial data to propose billing solutions Review and understand discounting, rates, pricing, and volume discounts Acts as a backup to team members and be proactive in assisting others to ensure deadlines are met timely Process electronic invoicing of clients using client-determined external websites Understand technical aspects of billing software and utilize systems to maintain information Bring aging WIP to Management's attention and analyze for handling twice a year; mainly during year end close Performs other duties as assigned or required to meet Firm goals and objectives Qualifications: Associates in Accounting or related field preferred; High School Diploma required Two years related legal billing experience Experience with electronic billing sites and BillBlast or eBillingHub required Experience with Aderant, Elite or other legal billing software required Experience with LEDES formats and UTMBS codes Strong understanding of basic accounting principles Excellent communication and organization skills Excellent written and oral communication skills Strong attention to detail Project and team management/leadership skills and experience Capability of effective planning and priority setting Ability to manage several complex projects simultaneously while working under pressure to meet deadlines Strong analytical skills Strong technology skills and ability to learn Ability to work independently with minimal supervision and to prioritize duties and use good judgment Computer proficiency and technical aptitude with the ability to utilize MS Word and Excel Success Factors Personal characteristics that will contribute to success in this position are a strong work ethic; self-motivated; ownership of work product and position; a high degree of attention to detail and accuracy; the ability to effectively work in a team environment as well as independently; and the ability to multi-task. Firm Benefits The Firm offers a comprehensive benefits package including medical/HSA, dental, vision, life, disability, family care leave, 401k/profit sharing retirement package and pet insurance. Employees are also eligible to work a hybrid schedule of three days in the office with up to two days per week working from home. The Firm will supply the necessary computer and accessory equipment to facilitate this hybrid work schedule. Firm Culture The Firm has a collaborative, team culture that fosters support among peers and collegiality between assistants, paralegals, attorneys, and managers. We have a welcoming, equitable workplace with an open-door policy. For decades, the Firm and its attorneys have been recognized on the most respected awards lists in the industry, including Best Law Firms, Best Lawyers, BTI Client Service Top 30, Chambers USA, Thomson Reuters Stand-out Lawyers, and Super Lawyers. Please send resumes to *****************. Resumes with previous law firm experience will be considered first. Compensation for the Billing Specialist will be commensurate with experience and qualifications. An Equal Opportunity Employer.

Outlier helps the world's most innovative companies improve their AI models by providing human feedback. Are you interested in assisting researchers in training the next generation of audio machine-learning models? This research aims to improve the models' understanding of human speech and requests and make them more friendly and compassionate. Requirements: Native fluency in English Ability to express a wide range of emotions through voice Ability to record in a quiet environment without background noise Access to an at home recording studio Experience with any voice-related work (e. g. , voiceover acting, podcasting, audio narration) Access to a high-fidelity microphone for recordings Nice to Haves: Background in on-screen or on-stage acting, classical voice training, or vocal music Access to an audio interface device Responsibilities: Record short conversations that convey different emotions, accents, and audio modulations Review and provide feedback on recordings made by other users Review and edit scripts Ensure high-quality audio by maintaining clear, professional recordings Save files to Audacity and maintain organized file management You can view responses to frequently asked questions here - FAQ Document Payment: Currently, pay rates for core project work for voice recording are up to $40 USD per hour. Note: Candidates based in the states of Illinois, Texas, and Washington are currently not eligible. PLEASE NOTE: We collect, retain and use personal data for our professional business purposes, including notifying you of opportunities that may be of interest and sharing with our affiliates. We limit the personal data we collect to that which we believe is appropriate and necessary to manage applicants' needs, provide our services, and comply with applicable laws. Any information we collect in connection with your application will be treated in accordance with the Outlier Privacy Policy and our internal policies and programs designed to protect personal data. This is a 1099 contract opportunity on the Outlier. ai platform. Because this is a freelance opportunity, we do not offer internships, sponsorship, or employment. You must be authorized to work in your country of residence. If you are an international student, you may be able to sign up for Outlier if you are on a visa. You should contact your tax and/or immigration advisor with specific questions regarding your circumstances.

Medical Reimbursement Specialist | Atos Medical-US | New Berlin, WI This position is remote but requires you to be commutable to New Berlin, WI for orientation and training/employee events as needed. Join a growing company with a strong purpose! Do you want to make a difference for people breathing, speaking and living with a neck stoma? At Atos Medical, our people are the strength and key to our on-going success. We create the best customer experience and thereby successful business through our 1200 skilled and engaged employees worldwide. About Atos Medical Atos Medical is a specialized medical device company and the clear market and technology leader for voice and pulmonary rehabilitation for cancer patients who have lost their voice box. We design, manufacture, and sell our entire core portfolio directly to leading institutions, health care professionals and patients. We believe everyone should have the right to speak, also after their cancer. That's why we are committed to giving a voice to people who breathe through a stoma, with design solutions and technologies built on decades of experience and a deep understanding of our users. We are seeking a Medical Reimbursement Specialist to join our team! Summary: This Reimbursement Specialist will support Atos Medical Management by providing excellent customer service to our patients through the billing reimbursement cycle. Time management and organization are imperative as this position interacts with inside and outside customers including but not limited to patients, customer service and accounting departments, outside sales team, Medicare and other private insurance companies. Job Responsibilities: * Print invoices from billing system. Review invoices for completeness and accuracy according to company and department billing guidelines and insurance process. * Prepare invoices and patient insurance information to be entered into claims filing software. * Enter appropriate and necessary information into claims filing software in order to prepare required claims to be sent electronically or by paper in the mail/fax. * Prepare secondary or tertiary claims as necessary. * Review customer/patient accounts receivable/aging and take necessary steps to keep accounts current. * Contact insurance companies on claim status * Review if claims need to be sent to secondary or tertiary insurance * Obtain necessary documentation and provide to insurance company * Request refunds, write-offs as necessary * Review Medicare and Commercial EOBs to make sure it was processed properly * Contact insurance companies or submit corrected claims as necessary * Submit requests to write-off agreed amount contractual write-offs * Prepare and submit necessary appeals * Communicate with Reimbursement Supervisor as needed with regard to discrepancies and complaints. * Works cooperatively with Customer Service and Customer Support Group in order to help expedite patient orders. * Answer incoming calls from patients and clinicians about the reimbursement process using appropriate customer service skills and in a professional, knowledgeable, and courteous manner. * Maintain current files and billing records, and make changes as needed so that patient information on file is accurate and complete. * Follow-up on incomplete or missing insurance information from patients or clinicians. * Provide reports on billing activities as requested by Reimbursement Supervisor. * Establish and maintain required billing records and patient insurance information according to Medicare, HIPAA and other department guidelines. An individual in this position must be able to successfully perform the essential duties and responsibilities listed above. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position. Basic Qualifications: High School Diploma or G.E.D. Two years medical billing and or reimbursement experience Preferred Qualifications: Education: Associates Degree Experience: 2 + years of background in customer service in a health care related industry. Demonstrated proficiency in phone skills (professional attitude, clear intelligible communication), cross-trained in key areas identified by department manager, ability to work independently and set priorities. Possess effective interpersonal and communication skills. Skills and Abilities: * Exceptional customer focus and ability to work under pressure; ability to maintain awareness of, and seek to meet the needs and wants of the customer without being prompted * Ability to work in a team environment, have strong PC and keyboarding skills (including MS Office) and Brightree * The position requires strong verbal and written communication skills to individuals and business at all different education levels. * Ability to manage time and set priorities. * Must be comfortable working independently and making educated decisions. We offer: You will be part of an ambitious work environment in which teams work together to continuously grow and develop the business. You will have great opportunities to learn and develop, and you will be offered a competitive salary package and benefits. Atos Medical is a global leader with Swedish headquarters and more than 15 subsidiaries worldwide. We are committed to living our values: we listen - we inspire - we focus - we engage every day. We connect with stakeholders, involving them in our activities and striving to support and empower our users and each other every day. No matter whom we interact with - users, colleagues, health care professionals, business partners - respect and integrity are at the core of everything we do. Additional benefits for Customer Service Representative: * Flexible work schedules with summer hours * Market-aligned pay * 401k dollar-for-dollar matching up to 6% with immediate vesting * Comprehensive benefit plan offers * Flexible Spending Account (FSA) * Health Savings Account (HSA) with employer contributions * Life Insurance, Short-term and Long-term Disability * Paid Paternity Leave * Volunteer time off * Employee Assistance Program * Wellness Resources * Training and Development * Tuition Reimbursement Atos Medical, Inc. is an Equal Opportunity/Affirmative Action Employer. Our Affirmative Action Plan is available upon request at ************. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status. Equal Opportunity Employer Veterans/Disabled. To request reasonable accommodation to participate in the job application, please contact ************. Founded in 1986, Atos Medical is the global leader in laryngectomy care as well as a leading developer and manufacturer of tracheostomy products. We are passionate about making life easier for people living with a neck stoma, and we achieve this by providing personalized care and innovative solutions through our brands Provox, Provox Life and Tracoe. We know that great customer experience involves more than first-rate product development, which is why clinical research and education of both professionals and patients are integral parts of our business. Our roots are Swedish but today we are a global organization made up of about 1400 dedicated employees and our products are distributed to more than 90 countries. As we continue to grow, we remain committed to our purpose of improving the lives of people living with a neck stoma. Since 2021, Atos Medical is the Voice and Respiratory Care division of Coloplast A/S 57190 #LI-AT #LI-Remote

The Billing Specialist is responsible for all aspects of billing inpatient and outpatient claims. The Billing Specialist, a key position in the Revenue Cycle, facilitates the claims process, including accurate and timely claim creation, follow-up and correspondence with providers, insurance inquiries and patients. The incumbent will assist in the clarification and development of process improvements and inquiries in order to maximize revenues. Work is typically performed in an office environment, but this position has the option to work from home but may also be needed onsite for projects or team meetings from time to time. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements for this job description are not intended to be all inclusive. They represent typical elements considered necessary to successfully perform the job. Requirements ESSENTIAL JOB DUTIES and FUNCTIONS While living and demonstrating our Core Values, the Billing Specialist will: * Perform and monitor all steps in the billing processes to ensure maximum reimbursement from patients, government and commercial payers as well as from special billing arrangements * Prepare and submit clean claims to third party payers either electronically or by paper * Follow billing guidelines and legal requirements to ensure compliance with federal and state regulations * Respond to account inquiries from patients, payers, providers, and/or other staff as requested * Identify and resolve patient/insurance billing issues * Work closely with team members regarding claim appeals, denials, resolution, and education * Understand Medicare, Medicaid and other commercial payer rules and regulations applicable to billing. Update providers, learners, office staff, clinics, and faculty of changes as appropriate * Responsible for contributing to the areas for coding, billing, and documentation education that is being reviewed for all providers and residents, related to billing coding and errors. * Responsible for contributing to new learner education related to billing and collections * Understand the considerations of coding in Value Based payment contracts * Responsible for reviewing and implementing changes from payer bulletins * Use online healthcare databases and other resources for verification and claim status * Deliver the highest quality service to internal and external customers * Assist other members of the team with projects as needed * Maintain strictest confidentiality; adhere to all HIPAA guidelines/regulations PREFERRED QUALIFICATIONS * Certified Biller * FQHC Billing

Medical Reimbursement Specialist | Atos Medical-US | New Berlin, WI This position is remote but requires you to be commutable to New Berlin, WI for orientation and training/employee events as needed. Join a growing company with a strong purpose! Do you want to make a difference for people breathing, speaking and living with a neck stoma? At Atos Medical, our people are the strength and key to our on-going success. We create the best customer experience and thereby successful business through our 1200 skilled and engaged employees worldwide. About Atos Medical Atos Medical is a specialized medical device company and the clear market and technology leader for voice and pulmonary rehabilitation for cancer patients who have lost their voice box. We design, manufacture, and sell our entire core portfolio directly to leading institutions, health care professionals and patients. We believe everyone should have the right to speak, also after their cancer. That's why we are committed to giving a voice to people who breathe through a stoma, with design solutions and technologies built on decades of experience and a deep understanding of our users. We are seeking a Medical Reimbursement Specialist to join our team! Summary: This Reimbursement Specialist will support Atos Medical Management by providing excellent customer service to our patients through the billing reimbursement cycle. Time management and organization are imperative as this position interacts with inside and outside customers including but not limited to patients, customer service and accounting departments, outside sales team, Medicare and other private insurance companies. Job Responsibilities: Print invoices from billing system. Review invoices for completeness and accuracy according to company and department billing guidelines and insurance process. Prepare invoices and patient insurance information to be entered into claims filing software. Enter appropriate and necessary information into claims filing software in order to prepare required claims to be sent electronically or by paper in the mail/fax. Prepare secondary or tertiary claims as necessary. Review customer/patient accounts receivable/aging and take necessary steps to keep accounts current. Contact insurance companies on claim status Review if claims need to be sent to secondary or tertiary insurance Obtain necessary documentation and provide to insurance company Request refunds, write-offs as necessary Review Medicare and Commercial EOBs to make sure it was processed properly Contact insurance companies or submit corrected claims as necessary Submit requests to write-off agreed amount contractual write-offs Prepare and submit necessary appeals Communicate with Reimbursement Supervisor as needed with regard to discrepancies and complaints. Works cooperatively with Customer Service and Customer Support Group in order to help expedite patient orders. Answer incoming calls from patients and clinicians about the reimbursement process using appropriate customer service skills and in a professional, knowledgeable, and courteous manner. Maintain current files and billing records, and make changes as needed so that patient information on file is accurate and complete. Follow-up on incomplete or missing insurance information from patients or clinicians. Provide reports on billing activities as requested by Reimbursement Supervisor. Establish and maintain required billing records and patient insurance information according to Medicare, HIPAA and other department guidelines. An individual in this position must be able to successfully perform the essential duties and responsibilities listed above. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position. Basic Qualifications: High School Diploma or G.E.D. Two years medical billing and or reimbursement experience Preferred Qualifications: Education: Associates Degree Experience: 2 + years of background in customer service in a health care related industry. Demonstrated proficiency in phone skills (professional attitude, clear intelligible communication), cross-trained in key areas identified by department manager, ability to work independently and set priorities. Possess effective interpersonal and communication skills. Skills and Abilities: Exceptional customer focus and ability to work under pressure; ability to maintain awareness of, and seek to meet the needs and wants of the customer without being prompted Ability to work in a team environment, have strong PC and keyboarding skills (including MS Office) and Brightree The position requires strong verbal and written communication skills to individuals and business at all different education levels. Ability to manage time and set priorities. Must be comfortable working independently and making educated decisions. We offer: You will be part of an ambitious work environment in which teams work together to continuously grow and develop the business. You will have great opportunities to learn and develop, and you will be offered a competitive salary package and benefits. Atos Medical is a global leader with Swedish headquarters and more than 15 subsidiaries worldwide. We are committed to living our values: we listen - we inspire - we focus - we engage every day. We connect with stakeholders, involving them in our activities and striving to support and empower our users and each other every day. No matter whom we interact with - users, colleagues, health care professionals, business partners - respect and integrity are at the core of everything we do. Additional benefits for Customer Service Representative: Flexible work schedules with summer hours Market-aligned pay 401k dollar-for-dollar matching up to 6% with immediate vesting

TELCOR Inc, a nationally recognized provider of healthcare software and billing service, is looking for an energetic, focused and motivated team member for the TELCOR Revenue Cycle Services (RCS) team. The Remote Billing Specialist is responsible for performing operational revenue cycle tasks for RCS customers. This includes but is not limited working payer denials and appeals by performing analysis and investigation of individual scenarios while identifying trends within current worklists or across future/past worklists in order to continuously improve quality and efficiency for customer outcomes, as well as RCS success. The Billing Specialist will also follow-up on unpaid balances to obtain payment and determine when to bill a patient and when to assign work back to the customer to review. Employees in this position will work remotely, otherwise the employee can discuss with their supervisor if they would like the option to work in the office. Accommodations will be made based on space in the Lincoln, NE office and job duties. Employees may be asked to come to the Lincoln, NE office for meetings or training on an as needed basis. Requirements Must be able to uphold confidentiality and comply with federal, state and company policy/procedures Knowledge of CPT, HCPCs modifiers, ICD-10 codes and EOB interpretation is preferred Knowledge of payer requirements, clearinghouse portal navigation and appropriate interpretation of information is preferred Ability to meet performance expectations set forth by supervisors and leadership team Ability to effectively and professionally communicate, both in writing and verbally with tact, diplomacy and respect for others Must be able to work independently and with team to achieve individual and team goals Must have strong computer skills and be able to leverage and navigate using technology to complete daily tasks (e.g. Excel, electronic documentation storage and retrieval, keyboarding and mouse navigation, email/outlook) Self-motivated, analytical, quick learner, organized, detail oriented, multitask, resilient, self-disciplined in time management Minimum of (1) year of medical or healthcare related billing or revenue cycle experience preferred TELCOR is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status, or any other characteristic protected by law. All trademarks, service marks, trade names, trade dress, product names and logos appearing herein are the property of their respective owners. Microsoft, Windows, Crystal Reports and SQL Server are either registered trademarks or trademarks of Microsoft Corporation in the United States and/or other countries.

Rate of Pay: $23.14-24.28 per hour Schedule: 8 hrs/day, 260 days PERS Retirement: The district assumes and pays the 6% average employee contribution to the Oregon PERS system. Benefits to working at KFCS: Student loan forgiveness for those who qualify. Opportunity to work with a diverse student population. District-supported child care is available. Reports To: Director of Special Services or another designated supervisor. Position Overview: The Medicaid Billing Specialist and Grant Coordinator is a dual-role position responsible for managing Medicaid billing processes and overseeing grant-related activities. This individual ensures compliance with all regulatory requirements, maximizes funding opportunities, and supports financial operations to enhance organizational effectiveness. Key Responsibilities Medicaid Billing Specialist Duties: Claims Processing: Prepare, submit, and monitor Medicaid claims to ensure timely reimbursement for eligible services. Compliance: Ensure all billing activities comply with federal, state, and local Medicaid regulations. Documentation: Maintain accurate records of billing activities, including claim submissions, adjustments, and denials. Reconciliation: Review and reconcile remittance advice reports to identify and resolve discrepancies. Training: Provide training and support to staff on Medicaid billing procedures and documentation requirements. Coordinate MAC Billing Activities. Audits: Assist with internal and external audits by providing necessary documentation and reports. Grant Liaison Duties: Support: Help Grant Managers with fiscal oversight, budget management and tracking. Grant Management: Oversee awarded grants, including budget tracking, reporting, and ensuring compliance with funding requirements. Collaboration: Work with internal teams to gather data and develop compelling narratives for grant proposals. Communication: Serve as the primary point of contact for grant-related inquiries from funders and stakeholders. Performance Tracking: Monitor and evaluate the impact of grant-funded initiatives, ensuring objectives are met. Expense Reporting: Supports grant managers with required expense or other grant required reports. Qualifications: Bachelor's degree in Business Administration, Healthcare Management, Public Administration, or a related field. Minimum of 2 years of experience in Medicaid billing, grant writing, or a related field, preferred. Knowledge of Medicaid policies, procedures, and billing software. Strong understanding of grant management principles. Excellent analytical, organizational, and problem-solving skills. Proficient in Microsoft Office Suite and billing software platforms. Exceptional communication and interpersonal skills. Key Competencies: Attention to detail and accuracy in billing and reporting. Ability to manage multiple priorities and deadlines. Strong research and writing skills for grant proposals. Team-oriented with the ability to collaborate across departments. Proactive and self-motivated with a commitment to continuous improvement. Working Conditions: Full-time position with standard office hours; occasional evenings or weekends may be required to meet deadlines. Office-based with opportunities for remote work. Interaction with various departments, external funders, and Medicaid representatives. PRE-EMPLOYMENT REQUIREMENTS Employment for this position is contingent on clearance of the following: __X__ Background Investigation The district prohibits discrimination and harassment on any basis protected by law, including but not limited to, an individual's perceived or actual race, color, religion, sex, sexual orientation, gender identity, national or ethnic origin, marital status, age, mental or physical disability, pregnancy, familial status, economic status, or veterans' status, or because of the perceived or actual race, color, religion, sex, sexual orientation, gender identity, national or ethnic origin, marital status, age, mental or physical disability, pregnancy, familial status, economic status, or veterans' status of any other persons with whom the individual associates.

Direct Billing Specialist Hours: Full Time Setting: Corporate office GENERAL PURPOSE Performs all duties related to the timely and efficient billing and collection of private and other payer receivables for a group of clinics in a central billing environment, within the parameters established by company policies and third-party billing requirements, and as necessary to achieve reasonable collection goals. ESSENTIAL JOB DUTIES Prepares and submits all claims/statements for Private, Medicaid, Medicare, etc. including primary, secondary and supplemental, as required. Utilizes tracker spreadsheet to document and follow up on payer commitments. Responds to payer requests for documentation. Identifies payment discrepancies and unpaid claims; takes appropriate action to resolve balance. Prepares A/R adjustments and corrections as needed. Identifies, researches and resolves credit balances according to policy and payer requirements. Responds to all requests for information, documentation and account corrections, where applicable. Identifies adverse trends resulting in returned or denied claims (e.g., repeated failure to obtain prior authorization) and communicates to CBO Manager. Reports status of claims and AR balances to supervisor, upon demand and/or according to established schedule and procedures. Participates in monthly AR review. Prepares account write-off when collection efforts exhaust. QUALIFICATIONS High school diploma or equivalent Minimum of one (1) year experience in health care insurance billing, preferably for therapy billing or a skilled nursing facility provider. Must be capable of maintaining regular attendance KNOWLEDGE, SKILLS, ABILITIES & BEHAVIORS Working knowledge of Microsoft Office applications (Outlook, Word, Excel, & PowerPoint) and ability to learn company or customer systems Good knowledge of Private (Self-Pay), Medicare, Medicaid, commercial insurance and managed care plans, including basic coverage models, billing requirements, subscriber and provider responsibilities, and coordination of benefit (COB) rules. Knowledge of SMART billing system preferred. Ability to manage, analyze and reconcile billing and payment detail. Ability to work under pressure, meet changing deadlines, and maintain orderly files. Ability to work well in a team-oriented, cooperative environment. Good written, verbal, telephone communication, and organizational skills. Knowledge of how to operate a 10-key calculator. Must be able to maintain confidentiality regarding patient, employee and company proprietary information Must have the ability to relate professionally and positively and work cooperatively with patients, families, and other employees at all levels EEO Statement: Aegis Therapies and its Family of Companies is committed to a diverse workforce and is an Equal Opportunity Employer. For detailed information on your rights, Click Here OR ***************************************************************************************

Greenberg Traurig (GT), a global law firm with locations across the world in 15 countries, has an exciting opportunity for an International Billing Specialist to join our Revenue Management Department. We offer competitive compensation and an excellent benefits package, along with the opportunity to work within an innovative and collaborative environment within the legal industry. Join our Revenue Management Team as an International Billing Specialist We are seeking a detail-driven and highly organized International Billing Specialist to support our global billing operations in a fast-paced, deadline-oriented environment. In this role, you will assist with the preparation and processing of international client invoices, ensuring accuracy, compliance with regional billing requirements, and timely delivery. You will collaborate closely with attorneys, clients, and cross-functional teams to resolve billing inquiries and maintain adherence to client-specific guidelines and international regulations. Strong communication skills, cultural awareness, and a proactive mindset are essential for success. If you thrive on precision, efficiency, and adaptability, we invite you to join our team and make a play a key role in driving our international financial operations. This role will be fully remote. This position reports to the International Revenue Manager of Revenue Management. The candidate must be flexible to work overtime as needed. Position Summary The International Billing Specialist will be assisting the International Revenue Manager with managing and supporting international billing functions and collection efforts, as well as ensuring accurate and efficient processing of client invoices. This role will involve working closely with attorneys, various teams (internal and external), and clients across multiple international locations. The candidate must be flexible to work outside usual business hours to accommodate varying time zones, as needed. Key Responsibilities Supports international offices with revenue management and financial operations, ensuring compliance within various jurisdictions. Researches and responds to international inquiries from attorneys, staff, and clients. Reviews and verifies the accuracy of billing documentation and supporting materials. Assists international billing teams with executing and processing of complex bills using Prebill Viewer and Aderant. Assists with collections, including reviewing accounts receivable, tracking outstanding balances, and working with attorneys and clients to resolve payment issues. Assists with analysis of client balances, including application and re-application of deposits, retainers, and unapplied funds. Monitors intake and processing of client data being converted to an electronic format, facilitating submission to third-party vendors. Assist with year-end and mid-year financial clean-up, including collection drives. Submits electronic client invoices and accruals via various e-billing websites. Works on special projects and generate ad hoc reports. Qualifications Skills & Competencies Excellent interpersonal and communication skills (oral and written), professional demeanor, and presentation. Effectively prioritize workload and adapt to a fast-paced environment. Highly motivated self-starter who can work well under supervision, as well as take a proactive approach in a team setting. Excellent organizational skills and attention to detail, with the ability to manage multiple tasks and deadlines. Strong analytical and problem-solving skills. Takes initiative and uses good judgment, excellent follow-up skills. Must have the ability to work under pressure to meet strict deadlines. Ability to establish and maintain positive and effective working relationships within all levels of the firm. Education & Prior Experience Bachelor's Degree or equivalent experience in Accounting or Finance. Minimum 3+ years of experience as a Legal Biller required. Technology Aderant or Elite/3E preferred, Pre-Bill Viewer, E-Billing Hub, Bill Blast. Proficiency in Excel required. GT is an EEO employer with an inclusive workplace committed to merit-based consideration and review without regard to an individual's race, sex, or other protected characteristics and to the principles of non-discrimination on any protected basis.

For over 50 years, New Horizons Mental Health Services, a non-profit behavioral health agency, has worked to improve the health and wellbeing of individuals, families, and the community through our services. We are currently seeking a full-time Billing Specialist in Lancaster, Ohio. What do we offer you? A competitive salary, and the opportunity to work with a talented team of mental health professionals. Robust benefits, including: · Medical · Company paid Dental and Vision Insurance · Company paid Life Insurance policy · Over 3 weeks of PTO in first year · 10 paid holidays, including your birthday · 5 days of professional leave per year · 403b Retirement Plan · Generous Employer Match for Retirement Plan · Employee Assistance Plan · CEU/CME Reimbursement · Eligibility for Federal Student Loan Forgiveness (PSLF) · Paid Liability Insurance Coverage The billing specialist will complete a variety of duties including but not limited to: ADAMH/GOSH: Processing and submitting bills and payments in GOSH, completing postings, enrollments, reviewing and assisting with the processing of denied claims, and reviewing and processing un-billed services. Completing monthly processes and reporting for applicable programs. Insurance Processing and submitting bills and payments for government and commercial insurance, completing postings, enrollments, reviewing and assisting with the processing of denied claims, and reviewing and processing un-billed services. Billing Processes, creates, and sends billing statements. Client Support Meets with clients who have questions about their bill, issues with payment, or other related billing questions. Additional duties as assigned. Requirements High school diploma required, an associate degree in billing or coding is preferred. At least two years experience with billing, coding, or data entry strongly preferred. Experience with insurance companies and billing highly preferred. Excellent organizational skills are required, as well as a high degree of familiarity with business programs such as Office, and knowledge or ability to learn multiple interacting billing systems. Additionally, excellent communication and interpersonal skills are required to interface with multiple vendors or agencies. Salary Description Starting at $40,000

Job Details Affordable Home Health Care - Grandview Heights, OH Fully Remote $17.00 - $24.00 HourlyDescription The Billing/Accounts Receivable Specialist ensures the accurate and timely submission of billing for Medicare, Medicaid, private payers, and patients. This role also involves following up on outstanding accounts receivable to collect payments and resolve any issues that may result in unbilled claims. ESSENTIAL JOB FUNCTIONS/RESPONSIBILITIES 1. Processes and bills Medicare, Medicaid, private payer, and patient claims, adhering to payer requirements and organizational policies. 2. Keeps precise billing and accounts receivable records. 3. Notifies the appropriate management team regarding any late or missing documents needed for billing. 4. Capable of understanding and interpreting information in explanations of payments or benefits. 5. Aids in receivables collection by monitoring accounts, resubmitting bills to overdue accounts, and notifying the Billing management team of seriously overdue accounts. 6. Builds and sustains positive relationships with team members, patients, payers, and other customers. 7. Possess strong knowledge of HIPPA compliance and consistently maintains the confidentiality of patient and organizational information. 8. Undertakes additional projects related to billing, data entry, and company operations as needed. The statements above are intended to summarize the primary duties and responsibilities of this job. Additional job-related responsibilities not listed here may be required to fulfill essential job functions upon hire. Qualifications POSITION QUALIFICATIONS 1. A minimum of two (2) years of experience in home health care systems. 2. A minimum of one (1) year of experience in healthcare billing, with a preference for home health care billing. 3. Up-to-date knowledge of PDGM and NOA billing requirements for Medicare. 4. High school diploma or equivalent required; two (2) years of college education preferred. SKILLS REQUIRED • Microsoft products (Excel, Work, Outlook) and Foxit or Adobe PDF • Knowledge of Insurance portals (i.e., Epic, Waystar aka Zirmed, Availity, eServices) • Knowledge of Kinnser/Wellsky EMR system • Good working knowledge of different Insurance/non-Insurance Plans (i.e. Commercial payers [Aetna Signature Administrators, Cigna, QCP, UHC, etc.], Liabilities, VA, etc.) • Knowledge of processing Medical Records • Strong organizational skills and attention to detail • Efficient multitasking and time management skills • Effective verbal and written communication skills • Ability to work effectively with other team members and independently • Initiative-taking • Quick-learning and problem-solving skills

Our Billing Specialists are responsible for answering patient inquiries, reviewing outstanding or denied insurance claims, submitting insurance appeals, and maintaining assigned accounts receivables per clinic policies. Work hours: This position supports a client located in Oregon and would require work hours from 8:00am - 5:00pm PST. Essential Duties & Responsibilities: * Assist in the processing of insurance claims including worker's compensation (if assigned) for all financial classes * Communicate with insurance companies to ensure that claims are paid; identify and correct account and/or insurance error; and post all actions and maintain permanent record of patient accounts * Oversee claims appeals and reviews; review claims aging status and follow up on open claims * Answer patient questions, inquiries, and concerns regarding their accounts; verify balances and refunds for accuracy * Understand, and stay up to date with, clinic and insurance industry contract policies/ procedures and medical terminology * Participate in professional development efforts to stay current with health care best practices and trends * Actively participate in the company's efforts to create innovative data and analytics solutions for the modern orthopedic business office * Other duties as assigned Required Skills: * High school diploma or equivalent, college courses or certificate preferred * Excellent communication skills, especially phone skills, that encourage the establishment and maintenance of cooperative, positive relationships with both internal and external stakeholders (patients, physicians, colleagues, etc.) * Ability to efficiently gather, organize, and comprehend insurance information, including contracted fee schedules * Proficient computer skills with a demonstrated ability to navigate and comprehend computer software systems in an office setting, prefer 50wpm typing skill * Knowledge of, or a demonstrated capacity to learn, insurance industry practices and medical terminology in a clinic setting * Strong analytical skills and a demonstrated desire to be part of building innovative solutions that challenge the status quo * Ability to learn quickly and contribute ideas that make the team, processes, and solutions better * Share our values: resilience, altruism, communication, achievement, and determination Preferred Skills: * Two years of billing experience in a hospital and/or surgical setting