Claim Specialist jobs at Akumin - 1959 jobs

(Essential Job Responsibilities): Creates, implements, promotes, and manages Healthy Lifestyles and Sports programs and activities that promote healthy living and physical activity. Coordinates fee-based programs. Trains and ensures all staff are com Health, Specialist, Sports, Staff, Monitoring, Healthcare

Our promise to you: Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. All the benefits and perks you need for you and your family: * Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance * Paid Time Off from Day One * 403-B Retirement Plan * 4 Weeks 100% Paid Parental Leave * Career Development * Whole Person Well-being Resources * Mental Health Resources and Support * Pet Benefits Schedule: Full time Shift: Night (United States of America) Address: 1500 SW 1ST AVE City: OCALA State: Florida Postal Code: 34471 Job Description: Manages ECMO circuits and equipment during patient care, including circuit interventions and change-outs. Observes, monitors, assesses, and reports patient status and response to ECMO therapy. Collaborates with multidisciplinary teams to provide comprehensive care for ECMO patients. Participates in building and priming disposable ECMO circuits and other related equipment. Leads ECMO patient transport, both within and between hospitals. The expertise and experiences you'll need to succeed: QUALIFICATION REQUIREMENTS: Associate (Required), Bachelor's of Nursing, Master's of NursingAdvanced Cardiac Life Support Cert (ACLS) - RQI Resuscitation Quality Improvement, Basic Life Support - CPR Cert (BLS) - RQI Resuscitation Quality Improvement, NIH Stroke Scale (NIHSS) - EV Accredited Issuing Body, Registered Nurse (RN) - EV Accredited Issuing Body, State Registered Respiratory Therapist (RRT) - EV Accredited Issuing Body Pay Range: $34.71 - $64.55 This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

**Our promise to you:** Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that **together** we are even better. **All the benefits and perks you need for you and your family:** + Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance + Paid Time Off from Day One + 403-B Retirement Plan + 4 Weeks 100% Paid Parental Leave + Career Development + Whole Person Well-being Resources + Mental Health Resources and Support + Pet Benefits **Schedule:** Full time **Shift:** Day (United States of America) **Address:** 100 HOSPITAL DR **City:** HENDERSONVILLE **State:** North Carolina **Postal Code:** 28792 **Job Description:** Rotating schedule: 6 a - 630 P except Wednesday which is a 6 hour shift. Rotates working every other weekend. + Guide patients through the meal ordering process using a computerized diet office system, ensuring selections align with prescribed diets and enhancing satisfaction through personalized suggestions. + Verify patient identifiers during meal delivery, ensure tray accuracy, and confirm patients have everything they need before leaving the room to support a positive dining experience. + Round on patients and nursing staff to identify and resolve foodservice concerns, taking ownership of complaints and implementing service recovery to improve patient experience scores. + Assemble and deliver trays according to therapeutic diet guidelines and presentation standards, maintaining timely and accurate service across all patient areas. + Perform physically active duties including walking long distances, standing for extended periods, and working up to 12-hour shifts while maintaining a clean, organized, and compliant work environment. **The expertise and experiences you'll need to succeed:** **QUALIFICATION REQUIREMENTS:** High School Grad or Equiv (Required) Nutrition and Dietetics Technician Registered (NDTR) - Accredited Issuing Body **Pay Range:** $14.70 - $23.51 _This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances._ **Category:** Nutritional Services **Organization:** AdventHealth Hendersonville **Schedule:** Full time **Shift:** Day **Req ID:** 150660822

Our promise to you: Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. All the benefits and perks you need for you and your family: * Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance * Paid Time Off from Day One * 403-B Retirement Plan * 4 Weeks 100% Paid Parental Leave * Career Development * Whole Person Well-being Resources * Mental Health Resources and Support * Pet Benefits Schedule: Full time Shift: Day (United States of America) Address: 100 HOSPITAL DR City: HENDERSONVILLE State: North Carolina Postal Code: 28792 Job Description: Rotating schedule: 6 a - 630 P except Wednesday which is a 6 hour shift. Rotates working every other weekend. Guide patients through the meal ordering process using a computerized diet office system, ensuring selections align with prescribed diets and enhancing satisfaction through personalized suggestions. Verify patient identifiers during meal delivery, ensure tray accuracy, and confirm patients have everything they need before leaving the room to support a positive dining experience. Round on patients and nursing staff to identify and resolve foodservice concerns, taking ownership of complaints and implementing service recovery to improve patient experience scores. Assemble and deliver trays according to therapeutic diet guidelines and presentation standards, maintaining timely and accurate service across all patient areas. Perform physically active duties including walking long distances, standing for extended periods, and working up to 12-hour shifts while maintaining a clean, organized, and compliant work environment. The expertise and experiences you'll need to succeed: QUALIFICATION REQUIREMENTS: High School Grad or Equiv (Required) Nutrition and Dietetics Technician Registered (NDTR) - Accredited Issuing Body Pay Range: $14.70 - $23.51 This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

Job Description An Account Resolution Specialist I is responsible for researching and identifying unpaid, partially paid, incorrectly paid or denied claims. They must follow-up with insurance carriers verbally or via on-line tools and properly discuss the problem with the knowledge of how to negotiate payment/additional payments on all claims. In the event the needs arise, they will also resubmit a corrected claim and/or follow-up with patients regarding the issue(s) as needed. Minimum Education Must have a high-school diploma or a GED. Minimum Work Experience No prior work experience in this related field is required at this level. Required Skills Customer service Must have general Microsoft Office (Word, Excel, PPT, and Outlook) experience. Ability to manage their time in order to meet job requirements. Ability to review an account and come to a decision as to what the proper solution would be to resolve the account. Must be a team player. Screening Requirements: Drug Screen Tuberculosis Test Background Check Physical Exam Respirator Fit Eligible Benefits: Medical, Dental and Vision *Excellent Low Premiums!*- No copays or Deductibles when utilizing MCCH services! Life Insurance *ZERO premium* Retirement Plan Paid Time Off Bereavement Bridge Coverage *ZERO premium for self-coverage when enrolled in medical coverage Tuition Reimbursement Our Mission: To improve the lives of those we serve by providing outstanding care and services through our confident, compassionate and exceptional healthcare professionals. Our Vision: To be chosen by our community and expanded service region based on proven outcomes as the trusted provider to care for their families, friends and neighbors. Our Values: Competence, Excellence, Compassion, Respect and Integrity.

Come to work with us at Community Health Services! We offer full-time benefits, 10 paid holidays, no weekend hours and so much more! We are looking for a full-time Claims Specialist to work in our Fremont office. CHS employs those who are eager to grow professionally, gain great experience, and work with a terrific team. The Claims Specialist will be responsible for performing general finance functions, entering encounters, processing and recording claims and all other duties as assigned. Hours for this position are: Mondays 7am-7pm, Tuesdays through Thursdays 8am-5pm, Fridays 8am-1pm Qualified candidates must have the following to be considered for employment: * Associate's degree from an accredited college or university * Experience in accounting/bookkeeping * Demonstrates ability to organize and implement general accounting and bookkeeping procedures for a healthcare organization * Ability to work with clinic personnel and patients in a courteous, cooperative manner * Ability to function as part of a team * Must have excellent customer service skills * Must have excellent multi-tasking, problem solving, and decision-making skills * Ability to follow instructions with attention to detail * Demonstrates professional relationship skills, and a strong work ethic * Prioritizes responsibilities, takes initiative, and possesses excellent organizational skills * Demonstrates effective communication skills * Ability to work with a culturally diverse group of people At CHS, we value our team and the critical role they play in patient care. If you're dependable, detail-oriented, and passionate about making a difference in your community, we'd love to hear from you. CHS is a drug-free/nicotine free organization. Candidates must pass a drug and nicotine screening upon employment offer.

Job Opening: Claims Processing Specialist at Blackburn's Are you a detail-oriented professional with a passion for the healthcare industry? Blackburn's is looking for a Claims Processing Specialist to join our Corporate Claims department and perform third-party medical billing functions. If you thrive in a fast-paced environment and possess excellent organizational and communication skills, this could be the perfect opportunity for you! What You'll Do: Manage and verify third-party medical claims for accuracy and compliance. Collaborate with cross-functional teams to resolve billing discrepancies and insurance denials. Process claims efficiently while adhering to strict filing deadlines. Contribute to the improvement of billing processes to reduce denials and increase efficiency. Utilize your strong communication skills to work with internal teams and external clients. Why Join Us? At Blackburn's, we're committed to creating a positive impact in the healthcare industry by delivering quality products and services. As part of our team, you'll have access to in-house training, opportunities for career growth, and a collaborative work environment. We offer competitive pay, benefits, and the chance to be part of a company that values its employees. Work Hours: 8:00 a.m. - 4:30 p.m. or 8:30 a.m. - 5:00 p.m. If you have a passion for medical billing and enjoy working in a dynamic, fast-paced environment, we'd love to hear from you! Apply today and join us in making a difference at Blackburn's! Qualifications What We're Looking For: Prior experience in healthcare-related industries, preferably with third-party medical billing. Strong attention to detail, time management, and the ability to juggle multiple tasks. Excellent interpersonal skills, with the ability to work both independently and as part of a team. Proficiency in Microsoft Office, with knowledge of Word and Excel. Ability to work independently, prioritize workload, and adapt to changing environments.

Schedule: Monday-Friday 0800 - 1230 w/ 30 min lunch and other shifts as needed. Responsible for collecting accounts receivables on patient accounts, non-government and contracted insurances government payers and secondary billing. Responsibilities include routine follow-up on accounts, working the Rejection Report for contracted insurances, analyzing aged trial balance report for assigned charge to's, working the Antrim, Rhodes reports and miscellaneous accounts receivable reports. ESSENTIAL FUNCTIONS: 1. Collects outstanding accounts receivables on patient accounts from patient, commercial, non-government, contracted insurances or government payors via phone call to the patient or insurance company or by means of written appeal or reconsideration. 2. Pursues collection activities on assigned accounts from primary and secondary payors until worked to resolution to include claims resubmission, appeal or reconsideration. 3. Works account receivables reports (i.e. aged-trial-balance report), focusing attention on accounts over 60 days. 4. Researches adjustments and pull all necessary backup to support adjustments. 5. Utilizes on-line insurance resources to obtain and maintain current information. 6. Develops and maintains a professional working rapport with internal and external customers to include contacts with insurance company representatives. 7. Identifies trends in payment or non-payment of claims. Communicates findings to leadership and co-workers as appropriate. 8. Customizes reports in Antrim and or Excel to prioritize accounts for collecting. The above statements describe the general nature and level of work being performed by individuals assigned to this classification. This is not intended to be an exhaustive list of all responsibilities and duties required of personnel so classified. MINIMUM EDUCATION: High school diploma or equivalent MINIMUM EXPERIENCE: Must have one of the following: Six (6) months as an Apprentice in the Business Office at TriCore Minimum of one (1) year of laboratory or medical claims follow-up/collections experience Minimum of three (3) years of medical billing or claims processing experience OTHER REQUIREMENTS: Must be able to type 30 words per minute (typing test required) Must have basic PC knowledge and working expertise with keyboard, mouse, Internet, and Windows based applications PREFERENCES: Basic knowledge of Excel and Word Knowledge of medical terminology IMMUNIZATION REQUIREMENTS: Prove immunity to Hepatitis B or be immunized or sign a waiver refusing hepatitis immunization. Provide documentation of a PPD test conducted not more than 90 days prior to date of hire or have a PPD test conducted. GENERAL REQUIREMENTS: 1. Proficient in PC/data entry skills 2. Must be able to work independently with little direction and to demonstrate sound judgment and problem solving skills 3. Ability to resolve problems and follow up as needed or appropriate 4. Effective communication skills and telephone skills 5. Ability to deal with difficult clients and patients 6. Strong working knowledge of insurance and reimbursement

Family Health Care is currently seeking applications for the position of Pharmacy 340B Claims Specialist! General Function: This position functions at the highest level (III) in the series of Pharmacy Technician roles within Family Health Care. The individual in this role is a “work-leader” serving as the expert on prescription claims reimbursement and performing self-auditing for the pharmacy department. This individual will ensure prescription claim integrity by having advanced knowledge of claim requirements for the various pharmacy benefit managers (PBM) and shall use that information to identify areas of improvement by performing targeted claim audits and will provide education to the pharmacy staff on billing requirements, when needed. Responsibilities: Acts as pharmacy claims auditor and will audit claims daily into order to track claims accuracy, trends, anomalies and other critical information to help BFHC ensuring appropriate reimbursement while mitigating organizational risk for claims remediations resulting from claim processing errors. Acts as pharmacy 340B claims auditor and audits claims on a scheduled basis into order to track 340B claims accuracy, trends, anomalies, and other critical information to help BFHC maintain 340B claim integrity while ensuring adherence to 340B policies, procedures, rules and regulations. Ensures timely and accurate billing/collections of all pharmacy charges and reimbursement activities through the use of reporting and reconciliation. Ensures integrity if financial reports and provides necessary reports to the finance department upon request. Assists the Chief Pharmacist and pharmacy staff in the research, development and implementation of new and existing pharmacy services. Location(s): White Cloud, MI Employment Type: Full Time Exempt/Non-Exempt: Non-Exempt Benefits: Competitive wage and excellent benefits package. FHC is an eligible organization for State and Federal Loan Repayment Programs. Family Health Care is an Equal Opportunity Employer.

Welcome! We're excited you're considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you'll find other important information about this position. Responsible for the process of patient account review, correction, adjustment, and filing to third party payers and/or patients. Works directly with patients and third party payers as it relates to information distribution. MINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. High school diploma or equivalent. 2. State criminal background check and Federal (if applicable), as required for regulated areas. PREFERRED QUALIFICATIONS: EXPERIENCE: 1. Previous hospital billing and/or credit and collection experience. CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned. 1. Performs claims processing to third party payer according to payer guidelines. 2. Reviews and corrects billing edits prior to submitting claims. 3. Reviews edits to ensure proper billing and verifies edits with the appropriate Department leaders, if needed. 4. Works denials thoroughly and timely with little back-log. 5. Performs follow up on account, working with third party payers, patient, employer, and physician office to resolve unpaid or underpaid accounts. Works follow-up reports thoroughly within the month. 6. Communicates problems hindering workflow to management in a timely manner. 7. Posts copays collected at Medical Offices to vouchers. Maintains unassigned payments. 8. Processes collections accounts. 9. Processes patient and insurance refund documentation. PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. Prolonged periods of sitting. 2. Manual dexterity required to operate standard office equipment. WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. Standard office environment. SKILLS AND ABILITIES: 1. Excellent oral and written communication skills. 2. Basic knowledge of medical terminology. 3. General knowledge of accounts receivable and collections procedures. Additional Job Description: Scheduled Weekly Hours: 20 Shift: Exempt/Non-Exempt: United States of America (Non-Exempt) Company: CCMC Camden Clark Medical Center Cost Center: 500 CCMC Administration Address: 800 Grand Central MallViennaWest Virginia Equal Opportunity Employer West Virginia University Health System and its subsidiaries (collectively "WVUHS") is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. WVUHS strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. All WVUHS employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.

What you can expect! Find joy in serving others with IEHP! We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an authentic experience! Under the direction of the Covered California Claims (CCA) Manager, the CCA Claims Specialist is responsible for analyzing, managing, and investigating complex and high-dollar healthcare claims that require in-depth research to determine accuracy and mitigate payment errors. The Claims Specialist is also responsible for adjusting first-pass and post-pay claims that result in overpayment or underpayment due to claim processing system issues, contract amendments, processing errors, or other issues. This position collaborates with internal stakeholders, assists with claim audits (internal and regulatory) and utilizes strong analytical skills and independent judgement skills to make effective and accurate decisions. This position will also be responsible for responding to inquiries from the Provider Payment Resolution team on claims that may have been paid incorrectly. Commitment to Quality: The IEHP Team is committed to incorporate IEHP's Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Perks IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more. * Competitive salary * Telecommute schedule * State of the art fitness center on-site * Medical Insurance with Dental and Vision * Life, short-term, and long-term disability options * Career advancement opportunities and professional development * Wellness programs that promote a healthy work-life balance * Flexible Spending Account - Health Care/Childcare * CalPERS retirement * 457(b) option with a contribution match * Paid life insurance for employees * Pet care insurance Education & Requirements * Three (3) years of experience in examining and processing complex and high-dollar institutional and professional claims * Experience in a managed care environment helpful. Commercial, Exchange, and Medicare preferred * High school diploma or GED required * Associate's degree from an accredited institution preferred Key Qualifications * ICD-9/ ICD-10 and CPT coding and general practices of claims processing * CMS/DMHC and Affordable Care Act regulations and guidelines * Commercial line of business specifically Covered California/Exchange * Excellent communication and interpersonal skills * Excellent analytical, critical thinking, customer service, and organizational skills * Ability to think critically with the capacity to work independently * All IEHP positions approved for telecommute work locations may periodically be required to report to IEHP's main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership Start your journey towards a thriving future with IEHP and apply TODAY! Pay Range * $25.90 USD Hourly - $33.02 USD Hourly

What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! Under the direction of the Covered California Claims (CCA) Manager, the CCA Claims Specialist is responsible for analyzing, managing, and investigating complex and high-dollar healthcare claims that require in-depth research to determine accuracy and mitigate payment errors. The Claims Specialist is also responsible for adjusting first-pass and post-pay claims that result in overpayment or underpayment due to claim processing system issues, contract amendments, processing errors, or other issues. This position collaborates with internal stakeholders, assists with claim audits (internal and regulatory) and utilizes strong analytical skills and independent judgement skills to make effective and accurate decisions. This position will also be responsible for responding to inquiries from the Provider Payment Resolution team on claims that may have been paid incorrectly. Commitment to Quality: The IEHP Team is committed to incorporate IEHP's Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Additional Benefits Perks IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more. Competitive salary Telecommute schedule State of the art fitness center on-site Medical Insurance with Dental and Vision Life, short-term, and long-term disability options Career advancement opportunities and professional development Wellness programs that promote a healthy work-life balance Flexible Spending Account - Health Care/Childcare CalPERS retirement 457(b) option with a contribution match Paid life insurance for employees Pet care insurance Key Responsibilities Work effectively with other departments (i.e., Special Investigation Unit, Provider Payment Resolution team, and other departments/stakeholders) to investigate and identify fraud, respond to escalated provider inquiries timely, and support the claims process. Investigate and process complex and high-dollar claims determining accuracy and making timely decisions. Advise leadership and internal business units (as applicable) of findings and outcomes on identified claim issues. Research and analyze medical claims adjustment requests along with related documentation to determine payment accuracy and adjust/adjudicate as needed in the Health Rules Processing system and other platforms. Research claims that may have been paid incorrectly and communicate findings for adjustment. Adjust claims based on findings (i.e., correct coding, rates of reimbursement, authorizations, contracted amounts, etc.) ensuring that all relevant information is considered. Assist with internal and regulatory claim audits, reviewing claim accuracy. Identify trends and recommend improvements to IEHP's claim processing system. Analyze and investigate insurance claims to discover or prevent fraud. Be an active participant in the Claims Department's initiatives and participate in Claims Huddles, etc. Remain current with all claim processing changes/updates (i.e. internal processes, regulatory guidelines). Perform any other duties as required to ensure Health Plan operations and department business needs are successful. Qualifications Education & Requirements Three (3) years of experience in examining and processing complex and high-dollar institutional and professional claims Experience in a managed care environment helpful. Commercial, Exchange, and Medicare preferred High school diploma or GED required Associate's degree from an accredited institution preferred Key Qualifications ICD-9/ ICD-10 and CPT coding and general practices of claims processing CMS/DMHC and Affordable Care Act regulations and guidelines Commercial line of business specifically Covered California/Exchange Excellent communication and interpersonal skills Excellent analytical, critical thinking, customer service, and organizational skills Ability to think critically with the capacity to work independently All IEHP positions approved for telecommute work locations may periodically be required to report to IEHP's main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership Start your journey towards a thriving future with IEHP and apply TODAY! Work Model Location Telecommute (All IEHP positions approved for telecommute work locations may periodically be required to report to IEHP's main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership) Pay Range USD $25.90 - USD $33.02 /Hr.

Adjudicates claims submitted by outside purchased services for PMC's enrolled capitated population and communicates those actions. Adjusts complex claims for advanced processing needs. Responds to Customer Service Requests and resolves problem claim situations. Providence caregivers are not simply valued - they're invaluable. Join our team at Pacmed Clinics DBA Pacific Medical Centers and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Required Qualifications: + H.S. Diploma or GED or equivalent experience in Health Care Business Administration. + 2 years in Managed Care operations. + 1 year of Claims processing experience, in a TPA, MSO, HMO, PHO or large group practice setting. + Experience with areas of specialty claim processing (COB, Adjustments, Point of Service, Home Health and Encounters). + Information systems supporting the administration of managed care products. Preferred Qualifications: + IDX healthcare software application. + CHAMPUS, Medicare and/or Medicaid benefits/programs. Why Join Providence? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our mission to advocate, educate and provide extraordinary care. About Providence At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits. Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. About the Team Pacific Medical Centers (PacMed) is a private, not-for-profit, primary and integrated multi-specialty health care network with outpatient clinics and primary and specialty care providers in King, Snohomish and Pierce counties. We combine decades of patient-centered care with cutting-edge technology, first-class facilities and board-certified providers. Our strong team environment and respect for our people-at all levels and from all backgrounds-allow us to provide authentic care that achieves the highest-quality patient outcomes, backed by the strong network of resources and support through our affiliation with the Providence family, including local partners like Swedish Health Services. Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement. For any concerns with this posting relating to the posting requirements in RCW 49.58.110(1), please click here where you can access an email link to submit your concern. Requsition ID: 404135 Company: Pacific Medical Jobs Job Category: Claims Job Function: Revenue Cycle Job Schedule: Full time Job Shift: Day Career Track: Admin Support Department: 3060 WA USFHP Address: WA Seattle 1200 12th Ave S Work Location: PACMED Admin Bh-Seattle Workplace Type: On-site Pay Range: $21.01 - $32.57 The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Full-time Description Claims Specialist - Job Description Jurupa Valley, CA - Onsite Who We Are Mountain Valley Express (MVE) is a leading LTL Carrier and 3PL Services provider with locations across California, Arizona, and Nevada. With years of experience, a dedicated team, and cutting-edge technology, MVE offers a broad range of services, including less-than-truckload (LTL), full truckload, custom invoicing and auditing, optimization, warehousing and distribution, engineering solutions, and packaging and shipping supplies. Our deep understanding of the market, along with strong carrier partnerships, allows us to deliver highly tailored services that meet the unique needs of our customers. Benefits · Comprehensive medical, dental, and vision insurance. · 401(k) plan with company match. · Company-paid Life and AD&D Insurance policies. · Paid vacation, sick leave, and holidays. The Opportunity We are seeking a Claims Specialist to join our team. In this role, you will be responsible for managing the end-to-end freight claims process, including receipt, investigation, documentation, and resolution. This position is integral to maintaining MVE's reputation for accuracy, transparency, and customer service excellence. You will work closely with the Operations, Customer Service, and Accounting teams to ensure claims are resolved efficiently and in compliance with company policies and federal regulations. Essential Duties and Responsibilities • Claims Management: Receive, review, and process freight loss and damage claims in accordance with company policies and industry regulations. • Investigation and Documentation: Collect all supporting documentation, including photos, inspection reports, and terminal or driver statements, to thoroughly evaluate each claim. • Communication and Resolution: Maintain clear and professional communication with customers, internal departments, and third parties throughout the claims process. • Reporting and Analysis: Track claim data, analyze trends, and identify areas for process improvement or risk mitigation. • Compliance and Recordkeeping: Ensure all claims are handled in compliance with applicable laws and carrier liability rules while maintaining accurate digital records within the TMS system. • Collaboration: Partner with operations and leadership teams to recommend corrective actions that prevent recurring claim issues. Skills & Attributes • Strong analytical and investigative skills with excellent attention to detail. • Exceptional written and verbal communication skills. • Ability to manage multiple priorities in a fast-paced environment. • Proficiency in Microsoft Office Suite (Excel, Word, Outlook); experience with TMS or claims software preferred. • Knowledge of LTL operations, NMFC classifications, and cargo liability principles is highly desirable. • Strong organizational and problem-solving abilities with a customer service mindset. Requirements Minimum Requirements · Education: High school diploma or equivalent required; Associate's or Bachelor's degree in Business, Logistics, or a related field preferred. · Experience: Minimum of 2 years of experience in freight claims, transportation, logistics, or a related administrative role. Compensation · Compensation: $20.00 - $24.00 per hour, based on experience and location. · Classification: Non-Exempt, subject to all applicable state and federal laws. Work Environment This is a full-time, at-will position with typical work hours scheduled from Monday to Friday, 8:00 a.m. to 5:00 p.m. Physical Requirements: · Prolonged periods of sitting at a desk and working on a computer · Frequent walking throughout the facility and between departments as part of daily operational tasks · Ability to lift and/or move up to 20-25 pounds. · Ability to navigate each department and the company's facilities as needed. Equal Opportunity Employer Mountain Valley Express is an at-will and equal opportunity employer. We are committed to employing and assigning the best-qualified candidates without discrimination based on race, color, religion, gender, marital status, age, national origin, physical or mental disability, sexual orientation, veteran/reserve and National Guard status, or any other status or characteristic protected by law. Salary Description $20.00 - $24.00

Description:Claims Specialist - Job Description Jurupa Valley, CA - Onsite Who We Are Mountain Valley Express (MVE) is a leading LTL Carrier and 3PL Services provider with locations across California, Arizona, and Nevada. With years of experience, a dedicated team, and cutting-edge technology, MVE offers a broad range of services, including less-than-truckload (LTL), full truckload, custom invoicing and auditing, optimization, warehousing and distribution, engineering solutions, and packaging and shipping supplies. Our deep understanding of the market, along with strong carrier partnerships, allows us to deliver highly tailored services that meet the unique needs of our customers. Benefits · Comprehensive medical, dental, and vision insurance. · 401(k) plan with company match. · Company-paid Life and AD&D Insurance policies. · Paid vacation, sick leave, and holidays. The Opportunity We are seeking a Claims Specialist to join our team. In this role, you will be responsible for managing the end-to-end freight claims process, including receipt, investigation, documentation, and resolution. This position is integral to maintaining MVE's reputation for accuracy, transparency, and customer service excellence. You will work closely with the Operations, Customer Service, and Accounting teams to ensure claims are resolved efficiently and in compliance with company policies and federal regulations. Essential Duties and Responsibilities • Claims Management: Receive, review, and process freight loss and damage claims in accordance with company policies and industry regulations. • Investigation and Documentation: Collect all supporting documentation, including photos, inspection reports, and terminal or driver statements, to thoroughly evaluate each claim. • Communication and Resolution: Maintain clear and professional communication with customers, internal departments, and third parties throughout the claims process. • Reporting and Analysis: Track claim data, analyze trends, and identify areas for process improvement or risk mitigation. • Compliance and Recordkeeping: Ensure all claims are handled in compliance with applicable laws and carrier liability rules while maintaining accurate digital records within the TMS system. • Collaboration: Partner with operations and leadership teams to recommend corrective actions that prevent recurring claim issues. Skills & Attributes • Strong analytical and investigative skills with excellent attention to detail. • Exceptional written and verbal communication skills. • Ability to manage multiple priorities in a fast-paced environment. • Proficiency in Microsoft Office Suite (Excel, Word, Outlook); experience with TMS or claims software preferred. • Knowledge of LTL operations, NMFC classifications, and cargo liability principles is highly desirable. • Strong organizational and problem-solving abilities with a customer service mindset. Requirements:Minimum Requirements · Education: High school diploma or equivalent required; Associate's or Bachelor's degree in Business, Logistics, or a related field preferred. · Experience: Minimum of 2 years of experience in freight claims, transportation, logistics, or a related administrative role. Compensation · Compensation: $20.00 - $24.00 per hour, based on experience and location. · Classification: Non-Exempt, subject to all applicable state and federal laws. Work Environment This is a full-time, at-will position with typical work hours scheduled from Monday to Friday, 8:00 a.m. to 5:00 p.m. Physical Requirements: · Prolonged periods of sitting at a desk and working on a computer · Frequent walking throughout the facility and between departments as part of daily operational tasks · Ability to lift and/or move up to 20-25 pounds. · Ability to navigate each department and the company's facilities as needed. Equal Opportunity Employer Mountain Valley Express is an at-will and equal opportunity employer. We are committed to employing and assigning the best-qualified candidates without discrimination based on race, color, religion, gender, marital status, age, national origin, physical or mental disability, sexual orientation, veteran/reserve and National Guard status, or any other status or characteristic protected by law.

Full-time Description Claims Specialist - Job Description Manteca, CA - Onsite Who We Are Mountain Valley Express (MVE) is a leading LTL Carrier and 3PL Services provider with locations across California, Arizona, and Nevada. With years of experience, a dedicated team, and cutting-edge technology, MVE offers a broad range of services, including less-than-truckload (LTL), full truckload, custom invoicing and auditing, optimization, warehousing and distribution, engineering solutions, and packaging and shipping supplies. Our deep understanding of the market, along with strong carrier partnerships, allows us to deliver highly tailored services that meet the unique needs of our customers. Benefits · Comprehensive medical, dental, and vision insurance. · 401(k) plan with company match. · Company-paid Life and AD&D Insurance policies. · Paid vacation, sick leave, and holidays. The Opportunity We are seeking a Claims Specialist to join our team. In this role, you will be responsible for managing the end-to-end freight claims process, including receipt, investigation, documentation, and resolution. This position is integral to maintaining MVE's reputation for accuracy, transparency, and customer service excellence. You will work closely with the Operations, Customer Service, and Accounting teams to ensure claims are resolved efficiently and in compliance with company policies and federal regulations. Essential Duties and Responsibilities • Claims Management: Receive, review, and process freight loss and damage claims in accordance with company policies and industry regulations. • Investigation and Documentation: Collect all supporting documentation, including photos, inspection reports, and terminal or driver statements, to thoroughly evaluate each claim. • Communication and Resolution: Maintain clear and professional communication with customers, internal departments, and third parties throughout the claims process. • Reporting and Analysis: Track claim data, analyze trends, and identify areas for process improvement or risk mitigation. • Compliance and Recordkeeping: Ensure all claims are handled in compliance with applicable laws and carrier liability rules while maintaining accurate digital records within the TMS system. • Collaboration: Partner with operations and leadership teams to recommend corrective actions that prevent recurring claim issues. Skills & Attributes • Strong analytical and investigative skills with excellent attention to detail. • Exceptional written and verbal communication skills. • Ability to manage multiple priorities in a fast-paced environment. • Proficiency in Microsoft Office Suite (Excel, Word, Outlook); experience with TMS or claims software preferred. • Knowledge of LTL operations, NMFC classifications, and cargo liability principles is highly desirable. • Strong organizational and problem-solving abilities with a customer service mindset. Requirements Minimum Requirements · Education: High school diploma or equivalent required; Associate's or Bachelor's degree in Business, Logistics, or a related field preferred. · Experience: Minimum of 2 years of experience in freight claims, transportation, logistics, or a related administrative role. Compensation · Compensation: $20.00 - $24.00 per hour, based on experience and location. · Classification: Non-Exempt, subject to all applicable state and federal laws. Work Environment This is a full-time, at-will position with typical work hours scheduled from Monday to Friday, 8:00 a.m. to 5:00 p.m. Physical Requirements: · Prolonged periods of sitting at a desk and working on a computer · Frequent walking throughout the facility and between departments as part of daily operational tasks · Ability to lift and/or move up to 20-25 pounds. · Ability to navigate each department and the company's facilities as needed. Equal Opportunity Employer Mountain Valley Express is an at-will and equal opportunity employer. We are committed to employing and assigning the best-qualified candidates without discrimination based on race, color, religion, gender, marital status, age, national origin, physical or mental disability, sexual orientation, veteran/reserve and National Guard status, or any other status or characteristic protected by law. Salary Description $20.00 - $24.00

Peach Tree Dental - Monroe, West Monroe, Ruston, Jonesboro Insurance Claims Specialist Job Details: Salary: Starting from $16.00-$20.00/hourly Pay is based on experience, qualifications, and desired location. **Incentives after training vary and are based on performance Job Type: Full-time Qualifications For Insurance Claims Specialists: High school or equivalent (Required). Takes initiative. Has excellent verbal and written skills. Ability to manage all public dealings in a professional manner. Ability to recognize problems and problem solve. Ability to accept feedback and willingness to improve. Ability to set goals, create plans, and convert plans into action. Is a Brand Ambassador, both in and outside of the facility. Benefits Offered For Full-Time Insurance Claims Specialists: Medical, Dental, Vision Benefits Dependent Care & Healthcare Flexible Spending Account Simple IRA With Employer Match Basic Life, AD&D & Supplemental Life Insurance Short-term & Long-term Disability Perks & Rewards For Full-Time Insurance Claims Specialists: Competitive pay + bonus Paid Time Off & Sick time 6 paid Holidays a year Full Job Description: With our hearts, minds, and hands, we build better smiles, better relationships, and better lives. Living this purpose over the last 25 years has allowed us to create a world-class dental organization that continues to grow. At every turn, you will see our continued investment in leadership, the community, and advanced technologies. Do you want to be a part of developing one of the leading models of dental care in Louisiana? Do you thrive in a fast-paced, progressive environment? The role of the Insurance Claims Specialist could be for you! Please go to WWW.PEACHTREEDENTAL.COM to complete your online application and assessments or use the following URL: **********************************************

Let's do great things, together! About Moda Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we're focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let's be better together. Position Summary Review claims to determine the reason the claim did not auto-adjudicate. Make corrections as necessary and process claims according to processing policies and contract provisions. This is a hybrid position based in Milwaukie Oregon. Pay Range $17.00 - $18.00 hourly (depending on experience) **Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range. Please fill out an application on our company page, linked below, to be considered for this position. ************************** GK=27770307&refresh=true Benefits: Medical, Dental, Vision, Pharmacy, Life, & Disability 401K- Matching FSA Employee Assistance Program PTO and Company Paid Holidays Required Skills, Experience & Education: High school diploma or equivalent. 10-key proficiency of 105 kspm net on a computer numeric keypad. Type a minimum of 35 wpm net on a computer keyboard. Ability to achieve and maintain quality and quantity standards. Possess legible handwriting. Knowledge of dental terminology, and ADA codes, preferred. Data Entry experience dealing with all types of plans/claims preferred. Good reading, verbal, and written communication skills. Ability to listen and communicate clearly and interact professionally, patiently, and courteously with co-workers and supervisor. Analytical, problem solving, and decision-making skills. Detail oriented and good memory retention with ability to shift priorities. Good organizational skills, ability to work well under pressure and ability to handle a variety of functions to meet timelines. Ability to interpret contracts and apply MODA Policies and Procedures to claims processing. Ability to come into work on time and on a daily basis. Ability to maintain confidentiality and project a professional business image. Primary Functions: Use contract notes and a processing manual to apply correct group specific and standard contract benefits to process pended claims. Know benefits provided by specific plans, how to determine eligibility, how to determine if claims qualify for benefits, how system should pay and how to enter information so correct benefits are paid. Document in a clear and concise manner and analyze and interpret existing file notes and documentation. Send clinical request and missing information letters. Ability to perform some manual calculation of benefits. Analyze pended claims to determine why the claim pended from auto-adjudication. Other duties as assigned Working Conditions & Contact with Others Office environment with extensive close PC and keyboard use, constant sitting, and frequent phone communication. Must be able to navigate multiple computer screens. A reliable, high-speed, hard-wired internet connection required to support remote or hybrid work. Must be comfortable being on camera for virtual training and meetings. Work in excess of standard workweek, including evenings and occasional weekends, to meet business need. Internally with Imaging Services, Claim Support, and Professional Relations. Together, we can be more. We can be better. Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training. For more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our ***************************** email.

JOB TITLE Claims Specialist Responsible for follow-up of all third-party claims to assure maximum reimbursement for services rendered by Frontier Health staff. Must exercise sound judgment, demonstrate initiative, develop and maintain good working relationships with all corporation staff and clients. EDUCATION AND EXPERIENCE: Education: High School Diploma/GED required. Licensure: N/A Certification: N/A Experience: Medical billing experience preferred. Knowledge/Skills: ICD-10, CPT, DSM-V, and HCPCS coding knowledge. Excellent verbal/written communication skills. Skilled in use of all major computer applications, especially Excel. Able to work independently and as a team player. EQUIPMENT: Computer, fax, copier, calculator and any other equipment required to perform the functions of the position. MAJOR DUTIES AND RESPONSIBILITIES: 1. Responsible for follow-up of all third-party claims in a timely fashion. 2. Assures guidelines and billing procedures are followed. 3. Identifies problem accounts and works with Utilization Management to maximize revenue. 4. Responsible for re-billing appropriate charges to the next responsible funding source. 5. Must obtain and maintain knowledge of all collection policies and procedures. 6. Must obtain and maintain knowledge of all services rendered by the agency and the liability of each third-party contract. 7. Must have or obtain working knowledge of CPT coding, revenue coding, HCPCS coding, DSM-V, and ICD-10 coding. 8. Attend and participate in regularly scheduled staff meetings and in-services and individual program planning staffings as needed. 9. Maintains records and prepares reports related to Accounts Receivable follow-up for applicable payors. 10. Responds to questions, telephone calls and letters for follow-up of accounts and documents as necessary. 11. Works with supervisor or other team members 12. All other duties as assigned. PERFORMANCE RESPONSIBILITIES: Although each position has its own unique duties and responsibilities, the following listing applies to every employee. All employees of the organization are expected to: 1. Support the organization's mission, vision, and values of excellence and competence, collaboration, innovation, commitment to our community, and accountability and ownership. 2. Exercise necessary cost control measures. 3. Maintain positive internal and external customer service relationships. 4. Demonstrate effective communication skills by conveying necessary information accurately, listening effectively and asking questions when clarification is needed. 5. Plan and organize work effectively and ensure its completion. 6. Demonstrate reliability by arriving to work on time and utilizing effective time management. 7. Meet all productivity requirements. 8. Demonstrate team behavior and must be willing to promote a team-oriented environment. 9. Represent the organization professionally at all times. 10. Demonstrate initiative and strive to continually improve processes and relationships. 11. Follow all Frontier Health rules, policies and procedures as well as any applicable laws and standards.