Claim processor jobs in Coconut Creek, FL - 64 jobs

THIS ROLE IS FOR: 1571 Sawgrass Parkway, Sunrise FL The Role is 100% ON SITE Investigates, evaluates, reserves, negotiates and settles assigned claims in accordance with Best Practices. Provides quality claim handling and superior customer service on assigned claims, while engaging in indemnity and expense management. Promptly manages claims by completing essential functions including contacts, investigation, damages development, evaluation, reserving, and disposition. Responsibilities: Provides voice to voice contact within 24 hours of first report. Conducts timely coverage analysis and communication with insured based on application of policy information, facts or allegations of each case. Consults with Unit Manager on use of Claim Coverage Counsel. Investigates each claim through prompt contact with appropriate parties such as policyholders, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent of liability, damages, and contribution potential. Records necessary statements. Identifies resources for specific activities required to properly investigate claims such as Subro, Fire or Fraud investigators and to other experts. Requests through Unit Manager and coordinates the results of their efforts and findings. Verifies the nature and extent of injury or property damage by obtaining and reviewing appropriate records and damages documentation. Maintains effective diary management system to ensure that all claims are handled timely. Evaluates liability and damages exposure, and establishes proper indemnity and expense reserves, at required time intervals. Utilizes evaluation documentation tools in accordance with department guidelines. Responsible for prompt, cost effective, and proper disposition of all claims within delegated authority. Negotiate disposition of claims with insured's and claimants or their legal representatives. Recognizes and implements alternate means of resolution. Maintains and document claim file activities in accordance with established procedures. Attends depositions and mediations and all other legal proceedings, as needed. Protects organization's value by keeping information confidential. Maintains compliance with Claim Department's Best Practices. Provides quality customer service and ensures file quality Supports workload surges and/or Catastrophe operations as needed to include working significant overtime during designated CATs. Communicates with co-workers, management, clients, vendors, and others in a courteous and professional manner. Participates in special projects as assigned. Some overnight travel maybe required. Maintains the integrity of the company and products offered by complying with federal and state regulations as well as company policies and procedures. Qualifications: Associate's Degree required; Bachelor's Degree preferred. A combination of education and significant directly related experience may be considered in lieu of degree. 620 Licensure required. One to three years of experience processing claims; property and casualty segment preferred. Experience with Xactware products preferred. Demonstrated ability to research, conduct proactive investigations and negotiate successful resolutions. Proficiency with Microsoft Office products required; internet research tools preferred. Demonstrated customer service focus / superior customer service skills. Excellent communication skills and ability to interact on a professional level with internal and external personnel Results driven with strong problem solving and analytical skills. Ability to work independently in a fast paced environment; meets deadlines, and manages changing priorities effectively. Detail-oriented and exceptionally organized Collaborative partner; ability to contribute to a positive work environment. General Information: All employees must pass a pre-employment background check. Other checks may be needed based on position: driving history, credit report, etc. The preceding has been designed to indicate the general nature of work performed; the level of knowledge and skills typically required; and usual working conditions of this position. It is not designed to contain, or be interpreted as, a comprehensive listing of all requirements or responsibilities that may be required by employees in this job. Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time. Heritage Insurance Holdings, Inc. is an Equal Opportunity Employer. We will not discriminate unlawfully against qualified applicants or employees with respect to any term or condition of employment based on race, color, national origin, ancestry, sex, sexual orientation, age, religion, physical or mental disability, marital status, place of birth, military service status, or other basis protected by law.

Job Description The Claims Examiner III ensures that claims are processed according to department standards and assists the Claims manager in maintaining the workflow and processes, in order to achieve set goals. Key Responsibilities: Review and release professional and institutional claims Process Member Reimbursement claims Coordinates with the Assistant Director the weekly/monthly workflow issues and set goals for the department Assists the Assistant Director on generating reports to track productivity and pending items Collaborate in the application of policies and procedures of the department Collaborate with the Assistant Director to ensure the team is meeting production and quality metrics Communicate effectible to the department staff the strategy to improve performance and meet stablished goals Maintain a positive environment that support staff well-being and foster an atmosphere that builds teamwork Ensure that the team utilizes the system capabilities to its maximum potential Performs other duties as necessary Qualifications: High School Diploma or GED 3+ years as Medical Claims Examiner Experience in contract interpretation Knowledge of CMS guidelines and regulations Ability to work Windows and other computer applications Ability to work well with others Note: This description indicates, in general terms, the type and level of work performed and responsibilities held by the team member(s). Duties described are not to be interpreted as being all-inclusive or specific to any individual team member. No Third Party Agencies or Submissions Will Be Accepted. Our company is committed to creating a diverse environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. DFWP Opportunities posted here do not create any implied or express employment contract between you and our company / our clients and can be changed at our discretion and / or the discretion of our clients. Any and all information may change without notice. We reserve the right to solely determine applicant suitability. By your submission you agree to all terms herein. Powered by JazzHR f4pdPp1WXY

We are seeking a Claims Examiner to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations. About the Role: The Claims Examiner plays a critical role in the health care and social assistance industry by thoroughly reviewing and evaluating insurance claims to ensure accuracy, compliance, and appropriateness of payments. This position involves analyzing medical documentation, policy details, and billing information to determine the validity of claims and identify any discrepancies or potential fraud. The Examiner collaborates with healthcare providers, insurance agents, and internal teams to resolve claim issues and facilitate timely reimbursement. By maintaining up-to-date knowledge of healthcare regulations and insurance policies, the Examiner helps protect the organization from financial loss and supports the delivery of fair and efficient claims processing. Ultimately, this role contributes to the integrity and sustainability of the healthcare insurance system by ensuring claims are processed accurately and ethically. Minimum Qualifications: High school diploma or GED Minimum of 2 years experience in claims examination, medical billing, or healthcare insurance processing. Strong understanding of medical terminology, insurance policies, and healthcare billing codes (e.g., ICD-10, CPT). Proficiency with claims management software and Microsoft Office suite. Preferred Qualifications: Associate's degree or Bachelor's degree in health administration, healthcare management, or a related discipline. Certification such as Certified Professional Coder (CPC) or Certified Claims Professional (CCP). Experience working within the health care and social assistance industry or with government healthcare programs. Familiarity with regulatory frameworks such as HIPAA and the Affordable Care Act. Responsibilities: Review and analyze health insurance claims for completeness, accuracy, and compliance with policy terms and regulatory requirements. Verify medical codes, treatment documentation, and billing information to ensure services are properly covered and billed. Investigate and resolve claim discrepancies by communicating with providers, members, and internal departments. Identify and escalate potential fraudulent claims or billing errors to compliance or legal teams. Maintain detailed records of claim evaluations and stay current with healthcare laws and industry standards to support audits and improve processing workflows.

The Insurance Claims Specialist will be responsible for assisting with the management of all aspects of complex Construction Defect and Property Damage incidents and claims for DPR (and DPR-related entities), as assigned. Reporting: Role reports to Insured Claims Manager and Insured Claims Leader Specific Duties Include: Claims & Incident Management (General): * Initial triage and processing of incidents received from project teams for DPR (and DPR-related entities). * Input and/or review all incidents reported in DPR's RMIS system. * Working with the incident triage group to ensure timely and appropriate review of all incidents * Ensure all necessary information is compiled to properly manage claims. This includes working with the DPR teams to collect relevant documents such as the Prime contract, Subcontracts, Certificates of Insurance, Owner Policy Documents, Project Documents and Project Specific Coverage information, etc. * Assess all potential risks, as well as identify all contractual risk transfer mechanisms. * Analyzing potential insurance coverage for all applicable lines of coverage and report, with all appropriate documents and information, potential claims for DPR (and DPR-related entities) to the broker for any applicable program (Traditional, CCIP, OCIP). * Assist with the development and training of other DPR Workgroups (and DPR-related entities) around CD/PD Best Practices. Construction Defect & Property Damage (CD/PD) Specific Claims Management: * Manage all assigned claims in DPR's RMIS system relating to Construction Defect and Property Damage matters for DPR (and DPR-related entities). This would include using all appropriate lines of coverage such as Commercial General Liability, Builder's Risk, Property, Contractor's Pollution Liability and Professional Liability, whether the policies are placed by DPR or our Clients. * Act as a liaison between all parties involved, including but not limited to, carriers, clients, trade partners, brokers, consultants, attorneys and DPR project teams (and DPR-related entities), as it relates to claim progress, strategy, expenses, and settlements. * Management of and coordination with DPR's consultants and outside attorneys throughout the claim process. * Continuously analyze claim-specific details as the claim progresses to devise key strategies in conjunction with all internal stakeholders and outside consultants. * Proactive management and coordination of all phases of the DPR CD/PD Claims Workflow. Key Skills: * Basic working knowledge and familiarity of: * Commercial General Liability * Property Insurance (Including Inland Marine and Builder's Risk * Pollution Liability * Professional Liability * Controlled Insurance Programs (CCIP/OCIP) * RMIS Systems * Construction Industry Expertise * Strategic thinking * Strong written and oral communication skills * High level of EQ (Soft skills) * Self-Starter * Highly organized and responsive; ability to meet deadlines * Detail Oriented * Contractual risk assessment * Dispute management * Integrity * Ability to mentor and inspire others * Team player * Willingness to understand and advance the DPR Culture * Proactive Learner Qualifications: * 5-7 years relevant construction industry and/or insurance industry experience preferred. * Previous experience in construction company Risk Management highly desired. * Position location - TBD based on location of most qualified candidate. DPR Construction is a forward-thinking, self-performing general contractor specializing in technically complex and sustainable projects for the advanced technology, life sciences, healthcare, higher education and commercial markets. Founded in 1990, DPR is a great story of entrepreneurial success as a private, employee-owned company that has grown into a multi-billion-dollar family of companies with offices around the world. Working at DPR, you'll have the chance to try new things, explore unique paths and shape your future. Here, we build opportunity together-by harnessing our talents, enabling curiosity and pursuing our collective ambition to make the best ideas happen. We are proud to be recognized as a great place to work by our talented teammates and leading news organizations like U.S. News and World Report, Forbes, Fast Company and Newsweek. Explore our open opportunities at ********************

We are united in our mission to make a positive impact on healthcare. Join Us! South Florida Business Journal, Best Places to Work 2024 Inc. 5000 Fastest-Growing Private Companies in America 2024 2024 Black Book Awards, ranked #1 EHR in 11 Specialties 2024 Spring Digital Health Awards, “Web-based Digital Health” category for EMA Health Records (Gold) 2024 Stevie American Business Award (Silver), New Product and Service: Health Technology Solution (Klara) Who we are: We Are Modernizing Medicine (WAMM)! We're a team of bright, passionate, and positive problem-solvers on a mission to place doctors and patients at the center of care through an intelligent, specialty-specific cloud platform. Our vision is a world where the software we build increases medical practice success and improves patient outcomes. Founded in 2010 by Daniel Cane and Dr. Michael Sherling, we have grown to over 3400 combined direct and contingent team members serving eleven specialties, and we are just getting started! ModMed's global headquarters is based in Boca Raton, FL, with a growing office in Hyderabad, India, and a robust remote workforce across the US, Chile, and Germany. ModMed is hiring a driven Patient Claim Specialist who will play a pivotal role in shaping a positive patient experience within our passionate, high-performing Revenue Cycle Management team. As a critical team member, you will support patients receiving care from ModMed BOOST service providers and doctors, ensuring their account needs are met excellently. This direct interaction with our customers' patients makes you an integral part of ModMed's business. It opens the door to an exhilarating career path for individuals driven by a passion for healthcare and exceptional customer service within a fast-paced Healthcare IT company that is genuinely Modernizing Medicine! Your Role: Serve as primary contact for all inbound and outbound patient calls regarding patient balance inquiries, claims processing, insurance updates, and payment collections Initiate outbound calls to patients of RCM clients to understand and address any account/payment issues, such as demographic and insurance updates Input and update patient account information and document calls into the Practice Management system Special Projects: Other duties as required to support and enhance our customer/patient-facing activities Skills & Requirements: High School Diploma or GED required Availability to work 9:30-5:30pm PST or 11:30am to 8:30 pm EST Minimum of 1-2 years of previous healthcare administration or related experience required Basic understanding of medical billing claims submission process and working with insurance carriers required (e.g., Medicare, private HMOs, PPOs) Manage/ field 60+ inbound calls per day Bilingual required (Spanish & English) Proficient knowledge of business software applications such as Excel, Word, and PowerPoint Strong communication and interpersonal skills with an emphasis on the ability to work effectively over the telephone Ability and openness to learn new things Ability to work effectively within a team in order to create a positive environment Ability to remain calm in a demanding call center environment Professional demeanor required Ability to effectively manage time and competing priorities #LI-SM2 ModMed Benefits Highlight: At ModMed, we believe it's important to offer a competitive benefits package designed to meet the diverse needs of our growing workforce. Eligible Modernizers can enroll in a wide range of benefits: India Meals & Snacks: Enjoy complimentary office lunches & dinners on select days and healthy snacks delivered to your desk, Insurance Coverage: Comprehensive health, accidental, and life insurance plans, including coverage for family members, all at no cost to employees, Allowances: Annual wellness allowance to support your well-being and productivity, Earned, casual, and sick leaves to maintain a healthy work-life balance, Bereavement leave for difficult times and extended medical leave options, Paid parental leaves, including maternity, paternity, adoption, surrogacy, and abortion leave, Celebration leave to make your special day even more memorable, and company-paid holidays to recharge and unwind. United States Comprehensive medical, dental, and vision benefits 401(k): ModMed provides a matching contribution each payday of 50% of your contribution deferred on up to 6% of your compensation. After one year of employment with ModMed, 100% of any matching contribution you receive is yours to keep. Generous Paid Time Off and Paid Parental Leave programs, Company paid Life and Disability benefits, Flexible Spending Account, and Employee Assistance Programs, Company-sponsored Business Resource & Special Interest Groups that provide engaged and supportive communities within ModMed, Professional development opportunities, including tuition reimbursement programs and unlimited access to LinkedIn Learning, Global presence and in-person collaboration opportunities; dog-friendly HQ (US), Hybrid office-based roles and remote availability for some roles, Weekly catered breakfast and lunch, treadmill workstations, Zen, and wellness rooms within our BRIC headquarters. PHISHING SCAM WARNING: ModMed is among several companies recently made aware of a phishing scam involving imposters posing as hiring managers recruiting via email, text and social media. The imposters are creating misleading email accounts, conducting remote "interviews," and making fake job offers in order to collect personal and financial information from unsuspecting individuals. Please be aware that no job offers will be made from ModMed without a formal interview process, and valid communications from our hiring team will come from our employees with a ModMed email address (*************************). Please check senders' email addresses carefully. Additionally, ModMed will not ask you to purchase equipment or supplies as part of your onboarding process. If you are receiving communications as described above, please report them to the FTC website.

Reports to: Claims Supervisor Employment Status: Full-Time FLSA Status: Non-Exempt Job Summary: We are searching for a diligent Claims Follow-Up Specialist to ensure a timely and accurate collection of medical claims. The specialist will work closely with insurance companies to rectify payment denials, settle disputes, and receive due reimbursements. The ideal candidate will possess strong communication skills, a deep understanding of medical billing and coding, and the determination to resolve outstanding claims. Duties/Responsibilities: · Reviews and works on unpaid claims, identifying and rectifying billing issues. · Communicates with insurance companies regarding any discrepancy in payments if necessary. · Conducts research and appeals denied claims timely. · Reviews Explanation of Benefits (EOBs) to determine denials or partial payment reasons. · Provides detailed notes on actions taken and next steps for unpaid claims. · Collaborates with the billing team to ensure accurate claim submission. · Maintains a comprehensive understanding of the insurance follow-up process, payer guidelines, and compliance requirements. · Resubmits claims with necessary corrections or supporting documentation when needed. · Tracks and documents trends related to denials and work towards a resolution with the billing team. · Assists patients with inquiries related to their insurance claims, providing clear and accurate information. · All other duties as assigned. Required Skills/Abilities: · Proficiency in healthcare billing software. · Strong analytical, organizational, and multitasking skills. · Excellent verbal and written communication abilities. · Ability to navigate payer websites and use online resources to resolve outstanding claims. Education and Experience: · High school diploma or equivalent required. · Experience in medical billing collections or a similar role in a Behavioral Health industry specializing in Substance abuse and Mental Health is strongly preferred. · Knowledge of medical terminology, CPT and ICD-10 coding is a plus. · Knowledge of HIPAA and other healthcare industry regulations. Benefits · Health Insurance · Vision Insurance · Dental Insurance · 401(k) plan with matching contributions View all jobs at this company View all jobs at this company

Hybrid-Sunrise Florida Responsible for the accurate and timely adjudication of health insurance claims in accordance with established production and quality department standards by performing the following duties: Essential Duties and Responsibilities: Adjudicates and enters claims for all lines of business according to benefit plan designs and regulatory standards. Reviews claims based on coverage benefits, coding guidelines, medical review determination, billing discrepancies and cost containment measures. Thorough knowledge of coding structures (CPT, HCPCS, Revenue codes, ICD10, DRG etc.) Identifies third party or coordination of benefits issues and notifies designated claims department Coordination of Benefits (COB) personnel for timely review and resolution. Knowledgeable of COB and familiarity with benefits and benefit calculations Ability to understand and manually calculate all types of claims pricing (Medicaid, Medicare, and UCR - Usual, Customary and Reasonable, etc.) Identifies inappropriate or questionable claims and refers to Claims Analysts for review. Researches all complex claims, disputes and appeals thoroughly to make accurate payment decisions in a timely manner with input from the Claims Analysts for quality assurance. Processes claim corrections and COB updates via interdepartmental customer relationship management process. Generates and reviews production reports daily for quality and training purposes. Maintain quantity/quality department goals regarding the number of claims entered and accuracy percentages. Complete side by side and peer training as necessary for educational opportunities. Assists with projects and clerical support as needed. This job description in no way states or implies that these are the only duties performed by the employee occupying this position. Employees will be required to perform any other job-related duties assigned by their supervisor or management. Qualifications: High School or General Education Diploma (GED) and two to four years related experience and/or training; or equivalent combination of education and experience. Medical Coding Certification, CPC or equivalent preferred. Knowledge of word processing software, spreadsheet software, internet software, and Epic software. Skills and Abilities: Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Verbal and written communication skills. Ability to perform arithmetic calculations. Ability to work independently. Ability to meet deadlines. Ability to maintain a good rapport and cooperative working relationship with the team. Ability to speak effectively before groups of customers or employees of organization. Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume. Ability to apply concepts of basic algebra and geometry. Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations. Work Schedule: Community Care Plan is currently following a hybrid work schedule. The company reserves the right to change the work schedules based on the company needs. Physical Demands: 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. While performing the duties of this job, the employee is regularly required to sit, use hands, reach with hands and arms, and talk or hear. The employee is frequently required to stand, walk, and sit. The employee is occasionally required to stoop, kneel, crouch or crawl. The employee may occasionally lift and/or move up to 15 pounds. Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of the job. The environment includes work inside/outside the office, travel to other offices, as well as domestic, travel. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate. We are an equal opportunity employer who recruits, employs, trains, compensates and promotes regardless of age, color, disability, ethnicity, family or marital status, gender identity or expression, language, national origin, physical and mental ability, political affiliation, race, religion, sexual orientation, socio-economic status, veteran status, and other characteristics that make our employees unique. We are committed to fostering, cultivating, and preserving a culture of diversity, equity and inclusion. Background Screening Notice: In compliance with Florida law, candidates selected for this position must complete a Level 2 background screening through the Florida Care Provider Background Screening Clearinghouse. The Clearinghouse is a statewide system managed by the Agency for Health Care Administration (AHCA) and is designed to help protect children, seniors, and other vulnerable populations while streamlining the screening process for employers and applicants. Additional information is available at: ???? h********************************

Job Description Join our dynamic team at Quadrant Health Group! Quadrant Billing Solutions, a proud member of the Quadrant Health Group, is seeking a passionate and dedicated Claims Specialist to join our growing team. You will play a vital role focused on ensuring that healthcare services are delivered efficiently and effectively. Why Join Quadrant Health Group? Competitive salary commensurate with experience. Comprehensive benefits package, including medical, dental, and vision insurance. Paid time off, sick time and holidays. Opportunities for professional development and growth. A supportive and collaborative work environment. A chance to make a meaningful impact on the lives of our clients. Compensation: $18 - $24 per hour - Full-time What You'll Do: The ideal candidate is organized, persistent, and results-driven, with deep knowledge of out-of-network billing for Substance Use Disorder (SUD) and Mental Health (MH) services. You'll join a high-performing team focused on maximizing collections, reducing aging A/R, and ensuring every dollar is pursued. Major Tasks, Duties and Responsibilities: Proactively follow up on unpaid and underpaid claims for Detox, Residential, PHP, and IOP levels of care. Manage 500-700 claims per week, prioritizing efficiency and accuracy. Handle 4-5 hours of phone time per day with strong communication skills. Communicate with payers via phone, portals, and written correspondence to resolve billing issues. Identify trends in denials and underpayments and escalate systemic issues. Dispute and overturn wrongly denied claims. Update and track claims using CMD (CollaborateMD) and internal task systems. Follow QBS workflows using Google Drive, Docs, Sheets, and Kipu EMR. Maintain professional and timely communication with internal teams and facility partners. Bonus Experience (Not Required): Handling refund requests and appeals. Preparing and submitting level 1-3 appeals (e.g., medical necessity, low pay, timely filing). Gathering and submitting medical records for appeal support. Working with utilization review (UR) or clinical teams. Familiarity with ASAM and MCG medical necessity criteria. Exposure to payment posting, authorization reviews, or credentialing. What You'll Bring: Minimum 1 year of SUD/MH billing and claims follow-up experience (required). High School Diploma or equivalent, associate or bachelor's degree (preferred). Strong understanding of insurance verification, EOBs, and RCM workflows. Familiarity with major payers: BCBS, Cigna, Aetna, UHC, Optum, TriWest. Experience overturning insurance denials is a strong plus. Proficient in CMD (CollaborateMD) and Kipu EMR (strongly preferred). Excellent written and verbal communication skills. Highly organized, detail-oriented, and capable of managing multiple priorities. Why Join Quadrant Billing Solutions? Rapid career growth in a mission-driven, niche billing company. Collaborate with clinical and billing experts who understand behavioral health. Join a tight-knit, supportive team culture. Gain opportunities for leadership advancement as the company scales.

Job Description << PHARMACY TECHNICIAN/MEDICAL PROCESSOR NEEDED FOR MEDICAL PRACTICE >> We are searching for TOP TALENT! NuLife Institute is Miami's premier medical facility for Functional, Integrative Medicine and Age Management. It is the only facility of its kind to provide personalized non-surgical age reversing treatment plans custom-tailored to your body, using your very own Internal Blueprint™. We are searching for a driven and customer service oriented Medical Processor/Pharmacy Technician to process medication treatment programs to help drive our patient retention and practice operations success. This person plays a critical role in ensuring that patients receive the correct medications safely and efficiently, making their skills and attention to detail indispensable to any team. This role will may become a hybrid role in the future with working from locations and home once candidate is able to work autonomous. Daily Responsibilities and Required Skills Daily Responsibilities: Reviewing incoming Patient Program Orders: Reviewing and crossing checking doctor's orders line up with medication to be sold and dispensed. Reviewing and taking payment. Medication Preparation and Dispensing: Accurately measure, count, and label medications as prescribed in compliance with state and federal regulations. Prescription Processing: Receive and verify prescriptions from patients within patient programs and/or our healthcare provider notes. Input prescription information into the pharmacy system. Pharmacy Interaction: Review Invoices Direct connection with pharmacies for orders, pricing and ongoing issues. Inventory Management: Maintain stock levels and organize inventory. Check for expired medications and dispose of them appropriately. Compliance and Record-Keeping: Ensure all prescriptions meet regulatory standards. Ensure compliance with State and Federal regulations and company policies and procedures that ensure the safety, security and privacy of the staff and its customers. Individual provides support and guidance to staff in processing medical programs efficiently and effectively. Requirements Required Skills: Math Skills: Proficiency in basic arithmetic for measuring, weighing, and calculating dosages. Ability to interpret and calculate proportions for compounding medications. Attention to Detail: Double-checking prescriptions to prevent errors. Ensuring labels, dosages, and patient information are accurate. Organization: Keeping the workspace tidy and medications properly sorted. Managing multiple tasks efficiently in a fast-paced environment. Communication: Effectively interacting with staff and healthcare providers. Promoting excellent customer service to ensure patient satisfaction from team members, including troubleshooting challenges, and if necessary, developing processes to circumvent possible recurrences. Explaining instructions clearly and professionally. Technical Proficiency: Ability to adapt to new online systems. Problem-Solving: Resolving issues or prescription discrepancies quickly. Addressing customer inquiries and concerns empathetically. Compliance Awareness: Understanding of federal and state regulations regarding controlled substances and prescription medications. Adherence to HIPAA and patient privacy laws. QUALIFICATIONS/REQUIREMENTS General Computer knowledge and Experience (Word, Excel) Prior Experience with Electronic Medical Records (EMR) or CRM System (ie. Salesforce) Strong organizational skills are imperative Ability to be self-directed and a self-starter Highly strategic, creative and process oriented thinker Proven ability to resolve conflicts and discrepancies Excellent customer service and communication skills. Experience working with prescriptions, healthcare, or customer-facing roles (preferred) Proficient in understanding and mastering workflow and system processes Knowledge of HIPAA OSHA, and other federal, state, and local regulations Knowledge of maintaining medical supply inventory for medical office Ability to communicate professionally with Medical Team, Administrative Team, distributors/supplies, Pharmacy Representatives, patients and guests Benefits Retirement Plan 401(k) [Matching] Health Insurance Medical Dental Vision (PTO) Paid Time Off

ESSENTIAL DUTIES & RESPONSIBILITIES To perform this job, an individual must perform each essential function satisfactorily, with or without a reasonable accommodation; including, but not limited to: Serve as a liaison between the plan, claims, providers, and various departments to effectively identify and resolve claims issues. Collaborate with various business units to resolve claims issues to ensure prompt and accurate claims adjudication. Review, research, solve and process assigned work. This would include navigating multiple computer systems and platforms (e.g. Verify pricing, prior authorizations, applicable benefits) Audit check run and send claims for corrections. Ensure that the proper benefits are applied to each claim by using the appropriate tools, processes, and procedures (e.g. Claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents/ certificates tool) Independently complete on a daily basis all documentation and communicate the status of claims as needed adhering to all reporting requirements. Communicate through correspondence with members and providers regarding claim payment or required information, using clear, simple language to ensure understanding. Meet and maintain the performance goals established for the position in the areas of quality, production, and attendance. Performs other duties as assigned. QUALIFICATIONS & EDUCATION High school diploma / GED (or higher) OR 5+ years of equivalent working experience. Knowledge of Medical Terminology, coding, and diagnosis coding is helpful. Excellent verbal and written communication skills. Commitment to excellence and high standards. Strong organizational, problem-solving, and analytical skills. Able to manage priorities and workflow. Demonstrates a high level of professionalism in dealing with confidential and sensitive issues. Ability to work effectively, independently and in a team environment. Ability to deal effectively with a variety of individuals. Fluency in Spanish and English required. Proficiency in computer software (i.e. Microsoft Word, Excel, Power-Point, and Outlook) and the ability to learn new and complex computer system applications (including comfort using short-cut keys/demands). WORKING CONDITIONS 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. The noise level in the work environment is usually moderate. Interacts with health plan members, staff, visitors, government agencies, etc., under a variety of conditions and circumstances. This work requires the following physical activities: climbing, bending, stooping, kneeling, reaching, sitting, standing, walking, lifting, finger dexterity, grasping, repetitive motions, talking, hearing and visual acuity. The work is performed indoors. All full-time employees are required to complete forty (40) hours per week as scheduled, including weekends and holidays as needed. The work schedule is approximate, and hours/days may change based on company needs.

Effectively and accurately applies policy conditions of coverage, processing guidelines and cost containment knowledge into the adjudication of global health claims and comprehensive cases. ESSENTIAL JOB DUTIES AND RESPONSIBILITIES: Processes all types of global health insurance claims Conduct claims analysis reviewing in detail claim documentation, medical reports and supporting documentation to decide compensability Examine with accuracy policy and member information, plan conditions of coverage and processing guidelines against claim documentation to determine benefit application Conduct post claim underwriting reviews to identify possible pre-existing condition Utilize anti-fraud policies to mitigate fraud possibility for submitted claims Review benefit letter / medical authorizations for cost and benefit application Evaluate claim compensability based on procedures performed, treatment intensity and diagnosis Validate benefit accumulators, patient responsibility, duplicate claim prevention and provider discount Assign ICD-10 codes along with valid procedure codes when necessary Apply Usual, Customary and Reasonable pricing guidelines to determine acceptable claim cost Maintain acceptable productivity and turnaround times for all assignments Maintain high work accuracy and quality scores Support team with versatile assignments related to department needs Qualifications DESIRED MINIMUM QUALIFICATIONS: Proficiency in Microsoft product suite (i.e. Microsoft Office, Word, Excel, etc.) Strong analytical, problem solving and negotiating skills Ability to adapt quickly in fast paced environment Detail oriented with exceptional organizational and communication skills Complete Fluency in English, Spanish (Portuguese a plus) Proven ability to work independently and meet determined deadlines Ability to navigate and enter data utilizing multiple systems and screens Education and Experience: Associates Degree or commensurate work experience Billing/Coding Certification preferred Minimum of 3 years experience in Health Insurance Industry

Advance Your Career in Insurance Claims with Allied Universal Compliance and Investigation Services. Allied Universal Compliance and Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators, and surveillance investigators. Our team is committed to innovation and excellence, making a significant impact in the insurance industry. If you're ready to grow with the best, explore a career with us and make a difference. Job Description Allied Universal is hiring a Claims Investigator. Claim Investigators validate the facts of loss for Insurance claims through scene Investigations, claimant and witness Interviews, document retrieval and data Interpretation. Florida applicants must either hold a C Private Investigators' License OR Independently complete the 40-hour course necessary to successfully apply for a CC Private Investigator's license (apprenticeship) before applying. Must possess a valid driver's license with at least one year of driving experience RESPONSIBILITIES: Investigate insurance claims for a variety of coverage to include workers' compensation, general liability, property and casualty and disability Gather information independently and in collaboration with clients and case managers through various methods such as data collection, interviews, research, and scene investigations Follow guidance from the handling insurance adjuster to perform field tasks essential to the investigation Develop and document information on any investigation in a professional and expert manner by writing clear, concise, and grammatically correct reports, memos, and letters Run appropriate database indices if necessary and verify the accuracy of results found QUALIFICATIONS (MUST HAVE): Must possess one or more of the following: Bachelor's degree in Criminal Justice Associate's degree in Criminal Justice with a minimum of four (4) years of demonstrated experience conducting complex insurance investigations or adjusting complex claims High school diploma with a minimum of six (6) years of demonstrated experience conducting complex insurance investigations or adjusting complex claims Ability to be properly licensed as a Private Investigator as required by the states in which you work Post offer, must be able to successfully complete the Allied Universal Investigations training/orientation course Minimum of two (2) years of demonstrated experience conducting insurance claims investigations or adjusting complex claims Working knowledge and understanding of anti-fraud laws, insurance regulations, and compliance rules and standards in their home state and within their designated region of the country Special Investigative Unit (SIU) Compliance knowledge Ability to type 40+ words per minute with minimum error Flexibility to work varied and irregular hours and days including weekends and holidays Proficient in utilizing laptop computers and cell phones PREFERRED QUALIFICATIONS (NICE TO HAVE): Military experience Law enforcement Insurance administration experience One or more of the following professional industry certifications Certified Fraud Investigator (CFE) Certified Insurance Fraud Investigator (CIFI) Fraud Claim Law Associate (FCLA) Fraud Claim Law Specialist (FCLS) Certified Protection Professional (CPP) Associate in Claims (AIC) Chartered Property Casualty Underwriter (CPCU) BENEFITS: Medical, dental, vision, basic life, AD&D, and disability insurance Enrollment in our company's 401(k)plan, subject to eligibility requirements Seven paid holidays annually, sick days available where required by law Vacation time offered at an initial accrual rate of 3.08 hours biweekly for full time positions. Unused vacation is only paid out where required by law. Closing Allied Universal is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race/ethnicity, age, color, religion, sex, sexual orientation, gender identity, national origin, genetic information, disability, protected veteran status or relationship/association with a protected veteran, or any other basis or characteristic protected by law. For more information: *********** If you have difficulty using the online system and require an alternate method to apply or require an accommodation, please contact our local Human Resources department. To find an office near you, please visit: ***********/offices. Requisition ID 2026-1524280

Founded in 2003, Kanner & Pintaluga is a NLJ500 and Mid-Market Pro 50 law firm that has recovered over $1 billion for property damage and personal injury clients nationwide. With nearly 100 lawyers and more than 30 offices throughout the Central and Southeastern United States, our primary goal is to achieve the most favorable outcome for our clients, who have the absolute right to receive the maximum compensation for their damages. POSITION SUMMARY: The Claims Processor is responsible for handling insurance claims, obtaining and verifying information, corresponding with insurance agents and beneficiaries, and promptly sending Letters of Representation for the case to begin its process. ESSENTIAL JOB FUNCTIONS: Open claims with insurance companies. Handle incoming and outgoing calls as well as faxes. Perform general data entry tasks. Verify the information for accuracy. Perform other related duties as assigned. EXPERIENCE/REQUIREMENTS: Full-time, 8:00 am to 5:00 pm, M-F. High school/GED diploma required. Strong customer service skills and experience. Proficient with Microsoft Office programs (Word, Excel, and Outlook). Ability to manage a heavy workload in a fast-paced environment. Ability to communicate with clients and co-workers effectively and efficiently. Possess excellent organizational skills and the ability to multitask and prioritize workload. FIRM BENEFITS The Firm offers a competitive benefits package for our full-time employees and their families. Here is a summary of our benefits (the list is not all-inclusive): Competitive Wage Paid Time Off, Holiday, Bereavement, and Sick Time 401K Retirement Savings Plan with Firm match Group Medical/Dental/Vision Plans Employer-Covered Supplemental Benefits Voluntary Supplemental Benefits Annual Performance Reviews Equal Opportunity Statement Kanner & Pintaluga is an Equal Opportunity Employer. Kanner & Pintaluga retains the right to change, assign, or reassign duties and responsibilities to this position at any time - in its sole discretion. Employment is at will. E-Verify This employer participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S. If E-Verify cannot confirm that you are authorized to work, this employer is required to give you written instructions and an opportunity to contact Department of Homeland Security (DHS) or Social Security Administration (SSA) so you can begin to resolve the issue before the employer can take any action against you, including terminating your employment. Employers can only use E-Verify once you have accepted a job offer and completed the I-9 Form.

The Claims Examiner III ensures that claims are processed according to department standards and assists the Claims manager in maintaining the workflow and processes, in order to achieve set goals. Key Responsibilities: Review and release professional and institutional claims Process Member Reimbursement claims Coordinates with the Assistant Director the weekly/monthly workflow issues and set goals for the department Assists the Assistant Director on generating reports to track productivity and pending items Collaborate in the application of policies and procedures of the department Collaborate with the Assistant Director to ensure the team is meeting production and quality metrics Communicate effectible to the department staff the strategy to improve performance and meet stablished goals Maintain a positive environment that support staff well-being and foster an atmosphere that builds teamwork Ensure that the team utilizes the system capabilities to its maximum potential Performs other duties as necessary Qualifications: High School Diploma or GED 3+ years as Medical Claims Examiner Experience in contract interpretation Knowledge of CMS guidelines and regulations Ability to work Windows and other computer applications Ability to work well with others Note: This description indicates, in general terms, the type and level of work performed and responsibilities held by the team member(s). Duties described are not to be interpreted as being all-inclusive or specific to any individual team member. No Third Party Agencies or Submissions Will Be Accepted. Our company is committed to creating a diverse environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. DFWP Opportunities posted here do not create any implied or express employment contract between you and our company / our clients and can be changed at our discretion and / or the discretion of our clients. Any and all information may change without notice. We reserve the right to solely determine applicant suitability. By your submission you agree to all terms herein.

Job Description We are seeking a Claims Examiner to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations. About the Role: The Claims Examiner plays a critical role in the health care and social assistance industry by thoroughly reviewing and evaluating insurance claims to ensure accuracy, compliance, and appropriateness of payments. This position involves analyzing medical documentation, policy details, and billing information to determine the validity of claims and identify any discrepancies or potential fraud. The Examiner collaborates with healthcare providers, insurance agents, and internal teams to resolve claim issues and facilitate timely reimbursement. By maintaining up-to-date knowledge of healthcare regulations and insurance policies, the Examiner helps protect the organization from financial loss and supports the delivery of fair and efficient claims processing. Ultimately, this role contributes to the integrity and sustainability of the healthcare insurance system by ensuring claims are processed accurately and ethically. Minimum Qualifications: High school diploma or GED Minimum of 2 years experience in claims examination, medical billing, or healthcare insurance processing. Strong understanding of medical terminology, insurance policies, and healthcare billing codes (e.g., ICD-10, CPT). Proficiency with claims management software and Microsoft Office suite. Preferred Qualifications: Associate's degree or Bachelor's degree in health administration, healthcare management, or a related discipline. Certification such as Certified Professional Coder (CPC) or Certified Claims Professional (CCP). Experience working within the health care and social assistance industry or with government healthcare programs. Familiarity with regulatory frameworks such as HIPAA and the Affordable Care Act. Responsibilities: Review and analyze health insurance claims for completeness, accuracy, and compliance with policy terms and regulatory requirements. Verify medical codes, treatment documentation, and billing information to ensure services are properly covered and billed. Investigate and resolve claim discrepancies by communicating with providers, members, and internal departments. Identify and escalate potential fraudulent claims or billing errors to compliance or legal teams. Maintain detailed records of claim evaluations and stay current with healthcare laws and industry standards to support audits and improve processing workflows.

ModMed is hiring a driven Patient Claim Specialist who will play a pivotal role in shaping a positive patient experience within our passionate, high-performing Revenue Cycle Management team. As a critical team member, you will support patients receiving care from ModMed BOOST service providers and doctors, ensuring their account needs are met excellently. This direct interaction with our customers' patients makes you an integral part of ModMed's business. It opens the door to an exhilarating career path for individuals driven by a passion for healthcare and exceptional customer service within a fast-paced Healthcare IT company that is genuinely Modernizing Medicine! Your Role: * Serve as primary contact for all inbound and outbound patient calls regarding patient balance inquiries, claims processing, insurance updates, and payment collections * Initiate outbound calls to patients of RCM clients to understand and address any account/payment issues, such as demographic and insurance updates * Input and update patient account information and document calls into the Practice Management system * Special Projects: Other duties as required to support and enhance our customer/patient-facing activities Skills & Requirements: * High School Diploma or GED required * Availability to work 9:30-5:30pm PST or 11:30am to 8:30 pm EST * Minimum of 1-2 years of previous healthcare administration or related experience required * Basic understanding of medical billing claims submission process and working with insurance carriers required (e.g., Medicare, private HMOs, PPOs) * Manage/ field 60+ inbound calls per day * Bilingual is a requirement (Spanish & English) * Proficient knowledge of business software applications such as Excel, Word, and PowerPoint * Strong communication and interpersonal skills with an emphasis on the ability to work effectively over the telephone * Ability and openness to learn new things * Ability to work effectively within a team in order to create a positive environment * Ability to remain calm in a demanding call center environment * Professional demeanor required * Ability to effectively manage time and competing priorities #LI-SM2

ESSENTIAL DUTIES & RESPONSIBILITIES To perform this job, an individual must perform each essential function satisfactorily, with or without a reasonable accommodation; including, but not limited to: Serve as a liaison between the plan, claims, providers, and various departments to effectively identify and resolve claims issues. Collaborate with various business units to resolve claims issues to ensure prompt and accurate claims adjudication. Review, research, solve and process assigned work. This would include navigating multiple computer systems and platforms (e.g. Verify pricing, prior authorizations, applicable benefits) Audit check run and send claims for corrections. Ensure that the proper benefits are applied to each claim by using the appropriate tools, processes, and procedures (e.g. Claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents/ certificates tool) Independently complete on a daily basis all documentation and communicate the status of claims as needed adhering to all reporting requirements. Communicate through correspondence with members and providers regarding claim payment or required information, using clear, simple language to ensure understanding. Meet and maintain the performance goals established for the position in the areas of quality, production, and attendance. Performs other duties as assigned. QUALIFICATIONS & EDUCATION High school diploma / GED (or higher) OR 5+ years of equivalent working experience. Knowledge of Medical Terminology, coding, and diagnosis coding is helpful. Excellent verbal and written communication skills. Commitment to excellence and high standards. Strong organizational, problem-solving, and analytical skills. Able to manage priorities and workflow. Demonstrates a high level of professionalism in dealing with confidential and sensitive issues. Ability to work effectively, independently and in a team environment. Ability to deal effectively with a variety of individuals. Fluency in Spanish and English required. Proficiency in computer software (i.e. Microsoft Word, Excel, Power-Point, and Outlook) and the ability to learn new and complex computer system applications (including comfort using short-cut keys/demands). WORKING CONDITIONS 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. The noise level in the work environment is usually moderate. Interacts with health plan members, staff, visitors, government agencies, etc., under a variety of conditions and circumstances. This work requires the following physical activities: climbing, bending, stooping, kneeling, reaching, sitting, standing, walking, lifting, finger dexterity, grasping, repetitive motions, talking, hearing and visual acuity. The work is performed indoors. All full-time employees are required to complete forty (40) hours per week as scheduled, including weekends and holidays as needed. The work schedule is approximate, and hours/days may change based on company needs.

Job Description << PHARMACY TECHNICIAN/MEDICAL PROCESSOR NEEDED FOR MEDICAL PRACTICE >> We are searching for TOP TALENT! NuLife Institute is Miami's premier medical facility for Functional, Integrative Medicine and Age Management. It is the only facility of its kind to provide personalized non-surgical age reversing treatment plans custom-tailored to your body, using your very own Internal Blueprint™. We are searching for a driven and customer service oriented Medical Processor/Pharmacy Technician to process medication treatment programs to help drive our patient retention and practice operations success. This person plays a critical role in ensuring that patients receive the correct medications safely and efficiently, making their skills and attention to detail indispensable to any team. This role will be a hybrid role in the future with working from locations and home once candidate is able to work autonomous. Daily Responsibilities and Required Skills Daily Responsibilities: Reviewing incoming Patient Program Orders: Reviewing and crossing checking doctor's orders line up with medication to be sold and dispensed. Reviewing and taking payment. Medication Preparation and Dispensing: Accurately measure, count, and label medications as prescribed in compliance with state and federal regulations. Prescription Processing: Receive and verify prescriptions from patients within patient programs and/or our healthcare provider notes. Input prescription information into the pharmacy system. Pharmacy Interaction: Review Invoices Direct connection with pharmacies for orders, pricing and ongoing issues. Inventory Management: Maintain stock levels and organize inventory. Check for expired medications and dispose of them appropriately. Compliance and Record-Keeping: Ensure all prescriptions meet regulatory standards. Ensure compliance with State and Federal regulations and company policies and procedures that ensure the safety, security and privacy of the staff and its customers. Individual provides support and guidance to staff in processing medical programs efficiently and effectively. Requirements Required Skills: Math Skills: Proficiency in basic arithmetic for measuring, weighing, and calculating dosages. Ability to interpret and calculate proportions for compounding medications. Attention to Detail: Double-checking prescriptions to prevent errors. Ensuring labels, dosages, and patient information are accurate. Organization: Keeping the workspace tidy and medications properly sorted. Managing multiple tasks efficiently in a fast-paced environment. Communication: Effectively interacting with staff and healthcare providers. Promoting excellent customer service to ensure patient satisfaction from team members, including troubleshooting challenges, and if necessary, developing processes to circumvent possible recurrences. Explaining instructions clearly and professionally. Technical Proficiency: Ability to adapt to new online systems. Problem-Solving: Resolving issues or prescription discrepancies quickly. Addressing customer inquiries and concerns empathetically. Compliance Awareness: Understanding of federal and state regulations regarding controlled substances and prescription medications. Adherence to HIPAA and patient privacy laws. QUALIFICATIONS/REQUIREMENTS General Computer knowledge and Experience (Word, Excel) Prior Experience with Electronic Medical Records (EMR) or CRM System (ie. Salesforce) Strong organizational skills are imperative Ability to be self-directed and a self-starter Highly strategic, creative and process oriented thinker Proven ability to resolve conflicts and discrepancies Excellent customer service and communication skills. Experience working with prescriptions, healthcare, or customer-facing roles (preferred) Proficient in understanding and mastering workflow and system processes Knowledge of HIPAA OSHA, and other federal, state, and local regulations Knowledge of maintaining medical supply inventory for medical office Ability to communicate professionally with Medical Team, Administrative Team, distributors/supplies, Pharmacy Representatives, patients and guests Benefits Retirement Plan 401(k) [Matching] Health Insurance Medical Dental Vision (PTO) Paid Time Off

Job Description << PHARMACY TECHNICIAN/MEDICAL PROCESSOR NEEDED FOR MEDICAL PRACTICE >> We are searching for TOP TALENT! NuLife Institute is Miami's premier medical facility for Functional, Integrative Medicine and Age Management. It is the only facility of its kind to provide personalized non-surgical age reversing treatment plans custom-tailored to your body, using your very own Internal Blueprint™. We are searching for a driven and customer service oriented Medical Processor/Pharmacy Technician to process medication treatment programs to help drive our patient retention and practice operations success. This person plays a critical role in ensuring that patients receive the correct medications safely and efficiently, making their skills and attention to detail indispensable to any team. This role will may become a hybrid role in the future with working from locations and home once candidate is able to work autonomous. Daily Responsibilities and Required Skills Daily Responsibilities: Reviewing incoming Patient Program Orders: Reviewing and crossing checking doctor's orders line up with medication to be sold and dispensed. Reviewing and taking payment. Medication Preparation and Dispensing: Accurately measure, count, and label medications as prescribed in compliance with state and federal regulations. Prescription Processing: Receive and verify prescriptions from patients within patient programs and/or our healthcare provider notes. Input prescription information into the pharmacy system. Pharmacy Interaction: Review Invoices Direct connection with pharmacies for orders, pricing and ongoing issues. Inventory Management: Maintain stock levels and organize inventory. Check for expired medications and dispose of them appropriately. Compliance and Record-Keeping: Ensure all prescriptions meet regulatory standards. Ensure compliance with State and Federal regulations and company policies and procedures that ensure the safety, security and privacy of the staff and its customers. Individual provides support and guidance to staff in processing medical programs efficiently and effectively. Requirements Required Skills: Math Skills: Proficiency in basic arithmetic for measuring, weighing, and calculating dosages. Ability to interpret and calculate proportions for compounding medications. Attention to Detail: Double-checking prescriptions to prevent errors. Ensuring labels, dosages, and patient information are accurate. Organization: Keeping the workspace tidy and medications properly sorted. Managing multiple tasks efficiently in a fast-paced environment. Communication: Effectively interacting with staff and healthcare providers. Promoting excellent customer service to ensure patient satisfaction from team members, including troubleshooting challenges, and if necessary, developing processes to circumvent possible recurrences. Explaining instructions clearly and professionally. Technical Proficiency: Ability to adapt to new online systems. Problem-Solving: Resolving issues or prescription discrepancies quickly. Addressing customer inquiries and concerns empathetically. Compliance Awareness: Understanding of federal and state regulations regarding controlled substances and prescription medications. Adherence to HIPAA and patient privacy laws. QUALIFICATIONS/REQUIREMENTS General Computer knowledge and Experience (Word, Excel) Prior Experience with Electronic Medical Records (EMR) or CRM System (ie. Salesforce) Strong organizational skills are imperative Ability to be self-directed and a self-starter Highly strategic, creative and process oriented thinker Proven ability to resolve conflicts and discrepancies Excellent customer service and communication skills. Experience working with prescriptions, healthcare, or customer-facing roles (preferred) Proficient in understanding and mastering workflow and system processes Knowledge of HIPAA OSHA, and other federal, state, and local regulations Knowledge of maintaining medical supply inventory for medical office Ability to communicate professionally with Medical Team, Administrative Team, distributors/supplies, Pharmacy Representatives, patients and guests Benefits Retirement Plan 401(k) [Matching] Health Insurance Medical Dental Vision (PTO) Paid Time Off