Claim processor jobs in Fort Lauderdale, FL

Job Description 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.

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.

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.

IntegratedResources, Inc is a premier staffing firm recognized as one of the tri-statesmost well-respected professional specialty firms. IRI has built its reputationon excellent service and integrity since its inception in 1996. Our missioncenters on delivering only the best quality talent, the first time and everytime. We provide quality resources in four specialty areas: InformationTechnology (IT), Clinical Research, Rehabilitation Therapy and Nursing. Job Description Job Title: Claims Analyst III Duration: 3 Months Location: Doral, Florida Qualifications Responsibilities: This department handles claim provider complaints. Review of claims that have already been processed by the system. The suppliers are complaining about issues with the previously processed claims. Will be identifying root causes, necessary correction of root causes and provide feedback to providers. Will be utilizing Microsoft Excel heavily. *A minimum of 1-2 years' experience in claims processing with professionals or hospitals* Top 3 skills: Computer skills - Microsoft Excel (intermediate to advanced skills, i.e.: pivot tables, v-look ups) Attention to detail Strong written communication skills Must Haves: Claims background Knowledge of billing guidelines Knowledge of contract interpretation Knowledge of billing/coding - CPT & ICD-10 Additional Information Kind Regards, Arnab Ghatak Technical Recruiter Integrated Resources, Inc. IT Life Sciences Allied Healthcare CRO Certified MBE |GSA - Schedule 66 I GSA - Schedule 621I Gold Seal JCAHO Certified ™ for Health Care Staffing “INC 5000's FASTEST GROWING, PRIVATELY HELD COMPANIES” (8th Year in a Row)

Sign On Bonus: $1,000 Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law This position is not eligible for employment based sponsorship. Ensures accurate adjudication of claims, by translating medical policies, reimbursement policies, and clinical editing policies into effective and accurate reimbursement criteria. PRIMARY DUTIES: * Review medical record documentation in support of Evaluation and Management, CPT, HCPCS and ICD-10 code. * Reviews company specific, CMS specific, and competitor specific medical policies, reimbursement policies, and editing rules, as well as conducting clinical research, data analysis, and identification of legislative mandates to support draft development and/or revision of enterprise reimbursement policy. * Translates medical policies into reimbursement rules. * Performs CPT/HCPCS code and fee schedule updates, analyzing each new code for coverage, policy, reimbursement development, and implications for system edits. * Coordinates research and responds to system inquiries and appeals. * Conducts research of claims systems and system edits to identify adjudication issues and to audit claims adjudication for accuracy. * Perform pre-adjudication claims reviews to ensure proper coding was used. * Prepares correspondence to providers regarding coding and fee schedule updates. * Trains customer service staff on system issues. * Works with providers contracting staff when new/modified reimbursement contracts are needed. Minimum Requirements: Requires a BA/BS degree and a minimum of 2 years related experience; or any combination of education and experience, which would provide an equivalent background. Certified Professional Coder (CPC) or Registered Health Information Administrator (RHIA) certification required. Preferred Skills, Capabilities and Experience: * CEMC, RHIT, CCS, CCS-P certifications preferred. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

The Claims Analyst is responsible for analyzing, appealing, and resolving denied or underpaid medical insurance claims to ensure accurate reimbursement for healthcare services. This role requires a deep understanding of payer requirements, billing codes, and denial management processes to identify root causes and prevent future denials. JOB DUTIES: Review and research denied or underpaid claims from insurance carriers, identifying denial trends and root causes. Prepare and submit timely and accurate appeals with supporting medical documentation and payer guidelines. Communicate effectively with insurance companies to follow up on outstanding denials and appeal status. Collaborate with billing, coding, and client account teams to resolve discrepancies and ensure claim accuracy. Update claim activity notes in the system and maintain detailed documentation of actions taken. Identify patterns or systemic issues contributing to denials and report findings to leadership for process improvement. Ensure compliance with federal, state, and payer regulations (HIPAA, Medicare, Medicaid, etc.). Meet or exceed productivity and quality standards established by the RCM department. Participate in ongoing training to stay updated on payer policies, billing regulations, and denial trends. Review and research denied or underpaid claims from insurance carriers, identifying denial trends and root causes. Prepare and submit timely and accurate appeals with supporting medical documentation and payer guidelines. Communicate effectively with insurance companies to follow up on outstanding denials and appeal status. Collaborate with billing, coding, and client account teams to resolve discrepancies and ensure claim accuracy. Update claim activity notes in the system and maintain detailed documentation of actions taken. Identify patterns or systemic issues contributing to denials and report findings to leadership for process improvement. Ensure compliance with federal, state, and payer regulations (HIPAA, Medicare, Medicaid, etc.). Meet or exceed productivity and quality standards established by the RCM department. Participate in ongoing training to stay updated on payer policies, billing regulations, and denial trends. REPORTING RELATIONSHIPS: This position works under general supervision, according to established procedures; decides how and when to complete tasks, and reports major activities through periodic meetings and written reports. This position reports directly to the RCM Manager. JOB REQUIRMENTS: · High school diploma required; bachelor's degree preferred. · Minimum of 3 years of experience working with hospital claim denials. · Strong analytical and problem-solving skills. · Excellent written and verbal communication skills. · Ability to multitask while maintaining strong attention to detail. · Ability to work under pressure and meet tight deadlines. · Intermediate proficiency in Microsoft Office (Excel, Word, Outlook). · Must obtain and maintain the HBIZ Denial Recovery Specialist Certification.

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

Pinnacle Environmental Management Support is a full-service environmental claims management firm in business for over 30 years servicing the energy sector. Analyst for Environmental Claims at Pinnacle EMS is responsible for spreadsheet analysis, data entry, and accounting functions. This position provides paraprofessional work, which involves assisting clients in participation in state-administered Underground Storage Tank (UST) cleanup trust funds. These Funds are the equivalent of insurance funds. Employees work with relative independence on the preparation of claim applications as assigned. Supervision and direction are provided by a Program Manager and/or SR. Team Lead who review and evaluate work for the attainment of desired results by analysis of efficiency and accuracy. Independent judgment is required to plan, prioritize, and organize diversified workload, recommends changes in office practices or procedures. Principle Duties and Responsibilities: Prepares reimbursement applications under the supervision of a Program Manager which involves tasks such as, Data Enry into database applications, spreadsheet or work processor Preparing payment affidavits for signature Determining sequence of events relative to the UST site y reading reports Organizing and line item coding of invoices Requesting missing documents from vendors and clients Preparing accounting spreadsheets Preparing claims within prescribed and allocated budgets Account for time on a timesheet Performing quality checks on work Drafting status and submittal letters to the client and any other related work as required Qualifications/Skills and Knowledge Requirements work requires an extensive knowledge of business and excellent command of the English language Must have knowledge of a variety of software applications and platforms, such as, Office 365, monday.com, internet research and database High level of interpersonal skills to handle sensitive situations Attention to detail in data entry, word processing and proofing Education and Experience: Bachelor's Degree preferred in Environmental Science One - three years related experience We provide a competitive compensation package and a wide range of benefits; including Paid Time Off, Holiday Pay, Health Insurance, Dental and Vision Insurance, 401K, and Company Paid Life Insurance. This is a Full-Time position with a work schedule of Monday-Friday 8-4:30 E.S.T. $18.00 per hour. Commensurate based on experience Pinnacle Environmental Management Support is an Equal Employment Opportunity Employer. Keywords: claims, analyst, data, excel, programs, management, insurance, UST, remediation, petroleum, environmental, financial, accounting, administrative, coding, assistant, accounts, accounting, underground storage tanks

We are seeking a highly motivated individual to join our Company as a Claims Analyst based in Miami. The candidate will have multiple claims responsibilities such as supporting the effective management, analysis, and resolution of claims, ensuring accurate processing and timely communication between clients, reinsurers, and external providers (adjusters, engineers, surveyors, attorneys, etc.) The role involves detailed data analysis, documentation review, and coordination across departments to maintain the integrity and efficiency of the claims process across multiple lines of business. The Role Claims Administration & Reporting * Receive, register, and review incoming claim notifications. * Prepare claim summaries, bordereaux, and loss advices for reinsurers and internal use. * Monitor the progress of claims, coordinate settlements, follow up on recoveries, and reconcile balances with Accounts and Settlements team. * Ensure accurate and timely entry of claims data into the claims management system. Analysis & Processing * Perform analytical reviews of claims data to identify trends and analyze portfolio-level loss for Management review and escalation. * Identify and flag potential coverage issues, ambiguities, or emerging challenges. * Analyze policy coverage of multiple lines including but not limited to Property, Marine, Casualty, and Financial Lines in various LatAm jurisdictions and the Caribbean. * Support the preparation of claims reports and presentations for internal and external stakeholders. Liaison * Communicate with clients, reinsurers, and external providers to resolve queries and obtain required documentation. * Assist in negotiating and securing claim settlements from reinsurers. * Maintain strong professional relationships with key parties to facilitate efficient claims resolution. Compliance & Quality Assurance * Ensure adherence to internal policies, market regulations, and reinsurance contract terms. * Maintain knowledge of coverage wordings, legal and compliance requirements, and industry claim practices. * Support internal audits and compliance checks by providing documentation and responding to inquiries. * Contribute to continuous improvement initiatives within the local and regional claims team to enhance efficiency and accuracy Qualifications The Requirements Essential: * Bachelor's degree in Risk Management, Finance, Business, Economics or a related discipline. * 5-year experience in an insurance or reinsurance environment, ideally within a broker or (re)insurer claims setting. * Knowledge of multiple lines (as detailed above). Experience in Financial Lines is a plus. * Strong understanding of insurance and reinsurance structures. * Excellent analytical, numerical, and problem-solving skills. * High attention to detail with strong organizational skills. * Proficiency in MS Office (Word, Excel) is required. * Bilingual, English and Spanish required. Desirable: * Engagement or progress toward a professional insurance qualification (e.g., CPCU, Are, AIC). Key Competencies * Analytical thinking and accuracy * Client advocacy and relationship management * Initiative and attention to detail * Time management and prioritization * Collaboration and teamwork * Adaptability in a fast-paced environment Company Benefits WTW provides a competitive benefit package which includes the following (eligibility requirements apply): * Health and Welfare Benefits: Medical (including prescription coverage), Dental, Vision, Health Savings Account, Commuter Account, Health Care and Dependent Care Flexible Spending Accounts, Group Accident, Group Critical Illness, Life Insurance, AD&D, Group Legal, Identify Theft Protection, Wellbeing Program and Work/Life Resources (including Employee Assistance Program) * Leave Benefits: Paid Holidays, Annual Paid Time Off (includes paid state/local paid leave where required), Short-Term Disability, Long-Term Disability, Other Leaves (e.g., Bereavement, FMLA, ADA, Jury Duty, Military Leave, and Parental and Adoption Leave), Paid Time Off * Retirement Benefits: Contributory Pension Plan and Savings Plan (401k). All Level 38 and more senior roles may also be eligible for non-qualified Deferred Compensation and Deferred Savings Plans. Pursuant to the San Francisco Fair Chance Ordinance and Los Angeles County Fair Chance Ordinance for Employers, we will consider for employment qualified applicants with arrest and conviction records. EOE, including disability/vets

We are seeking a highly motivated individual to join our Company as a Claims Analyst based in Miami. The candidate will have multiple claims responsibilities such as supporting the effective management, analysis, and resolution of claims, ensuring accurate processing and timely communication between clients, reinsurers, and external providers (adjusters, engineers, surveyors, attorneys, etc.) The role involves detailed data analysis, documentation review, and coordination across departments to maintain the integrity and efficiency of the claims process across multiple lines of business. The Role Claims Administration & Reporting Receive, register, and review incoming claim notifications. Prepare claim summaries, bordereaux, and loss advices for reinsurers and internal use. Monitor the progress of claims, coordinate settlements, follow up on recoveries, and reconcile balances with Accounts and Settlements team. Ensure accurate and timely entry of claims data into the claims management system. Analysis & Processing Perform analytical reviews of claims data to identify trends and analyze portfolio-level loss for Management review and escalation. Identify and flag potential coverage issues, ambiguities, or emerging challenges. Analyze policy coverage of multiple lines including but not limited to Property, Marine, Casualty, and Financial Lines in various LatAm jurisdictions and the Caribbean. Support the preparation of claims reports and presentations for internal and external stakeholders. Liaison Communicate with clients, reinsurers, and external providers to resolve queries and obtain required documentation. Assist in negotiating and securing claim settlements from reinsurers. Maintain strong professional relationships with key parties to facilitate efficient claims resolution. Compliance & Quality Assurance Ensure adherence to internal policies, market regulations, and reinsurance contract terms. Maintain knowledge of coverage wordings, legal and compliance requirements, and industry claim practices. Support internal audits and compliance checks by providing documentation and responding to inquiries. Contribute to continuous improvement initiatives within the local and regional claims team to enhance efficiency and accuracy Qualifications The Requirements Essential: Bachelor's degree in Risk Management, Finance, Business, Economics or a related discipline. 5-year experience in an insurance or reinsurance environment, ideally within a broker or (re)insurer claims setting. Knowledge of multiple lines (as detailed above). Experience in Financial Lines is a plus. Strong understanding of insurance and reinsurance structures. Excellent analytical, numerical, and problem-solving skills. High attention to detail with strong organizational skills. Proficiency in MS Office (Word, Excel) is required. Bilingual, English and Spanish required. Desirable: Engagement or progress toward a professional insurance qualification (e.g., CPCU, Are, AIC). Key Competencies Analytical thinking and accuracy Client advocacy and relationship management Initiative and attention to detail Time management and prioritization Collaboration and teamwork Adaptability in a fast-paced environment Company Benefits WTW provides a competitive benefit package which includes the following (eligibility requirements apply): Health and Welfare Benefits: Medical (including prescription coverage), Dental, Vision, Health Savings Account, Commuter Account, Health Care and Dependent Care Flexible Spending Accounts, Group Accident, Group Critical Illness, Life Insurance, AD&D, Group Legal, Identify Theft Protection, Wellbeing Program and Work/Life Resources (including Employee Assistance Program) Leave Benefits: Paid Holidays, Annual Paid Time Off (includes paid state/local paid leave where required), Short-Term Disability, Long-Term Disability, Other Leaves (e.g., Bereavement, FMLA, ADA, Jury Duty, Military Leave, and Parental and Adoption Leave), Paid Time Off Retirement Benefits: Contributory Pension Plan and Savings Plan (401k). All Level 38 and more senior roles may also be eligible for non-qualified Deferred Compensation and Deferred Savings Plans. Pursuant to the San Francisco Fair Chance Ordinance and Los Angeles County Fair Chance Ordinance for Employers, we will consider for employment qualified applicants with arrest and conviction records. EOE, including disability/vets

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

Overview 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 2025-1488482

Job Description Claims Coordinator Delray Beach or Palm Beach Gardens, FL (Hybrid) $21-$26 per hour + full benefits About the Opportunity A long-established Florida insurance agency with more than 100 years in business is looking for a Claims Coordinator to join its growing team. In this role, you will support clients through every stage of the claims process, ensuring claims are handled efficiently, accurately, and with care. You will work closely with the Claims Administrator, producers, and account managers to advocate on behalf of clients and provide clear, timely communication between insureds and carriers. What You'll Do · Facilitate first notice of loss and coordinate claim setup with carriers. · Maintain claim activities and documentation in EPIC. · Respond to all client and carrier inquiries within 24 hours. · Monitor open claims to ensure timely status updates and resolutions. · Advocate for clients on claim-related issues such as coverage questions, denials, or legal notices. · Communicate with the Claims Administrator, producers, and account managers to address and resolve issues. · Notify producers and account managers of significant losses or high-value claims. · Provide detailed loss runs and reports upon request. · Maintain and update a network of trusted vendors such as restoration companies and glass repair providers. · Report any coverage concerns or omissions to the appropriate team members. · Support the claims department with additional projects as needed. What You Bring · High School Diploma or GED required. · 3 to 5 years of claims or commercial/personal lines experience. · Strong organizational and communication skills. · EPIC experience preferred. · A proactive, client-focused approach with attention to detail. What You'll Get · Hourly pay between $21 and $26, depending on experience. · 100% employer-paid Medical, Dental, and Vision insurance for employees. · 401(k) with profit sharing. · Long-term stability with an agency that has been serving clients for over a century. · Supportive, team-based culture focused on client service and professional growth. If you are organized, responsive, and passionate about helping clients navigate the claims process, this role offers an excellent opportunity to grow within a respected Florida agency.

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 2025-1488482

Full-time, non-exempt Miami, Florida Hybrid About VUMI VUMI (VIP Universal Medical Insurance Group) is an international health insurance company committed to providing premier medical insurance products and VIP healthcare services to individuals and corporations worldwide. With operational offices in Panama, Ecuador, Colombia, and across the globe, we offer unique benefits and extensive global coverage. Privately owned and backed by over 35 years of experience in the healthcare industry, VUMI employs a diverse team of 500+ professionals and is part of a leading international healthcare group. Join a top team of healthcare professionals driving innovation and excellence at one of the leading IPMI (International Private Medical Insurance) organizations in the industry. About You You are a bilingual professional fluent in both English and Spanish, with strong communication skills and a keen attention to confidentiality and time management. You bring related experience and a high school diploma or equivalent, along with the ability to quickly learn new processes and work independently with minimal supervision. You thrive in a fast-paced environment where you handle customer inquiries with accuracy and professionalism. You are proactive in investigating issues, collaborating with cross-functional teams, and providing timely updates to both customers and management. Your detail-oriented approach helps identify potential fraudulent claims, and you are comfortable supporting special projects and participating in team meetings and training. If you're a motivated self-starter who enjoys delivering exceptional customer service and contributing to an efficient claims process, you'll be a great fit for this role. POSITION SUMMARY The Claims Coordinator handles inquiries and concerns related to claims, including coverage details, benefit limits, explanation of denials, and payment status. This role is responsible for receiving, responding to, and directing phone calls and other communications from members, brokers, and providers-ensuring accurate information is provided promptly and escalating issues when necessary. ESSENTIAL FUNCTIONS Receive and handle customer inquiries from potential, current, and former members, brokers, and providers. Provide timely, accurate, and clear information in response to customer requests. Process customer requests following established departmental policies and procedures. Conduct research and investigations to resolve customer inquiries effectively. Collaborate closely with claims adjudicators and other departments to gather necessary information. Deliver timely feedback to customers through outbound calls, emails, mail, or fax. Identify potential fraudulent claims and take appropriate action in line with company protocols. Assist with client office visits as needed. Report service failures, systemic issues, and customer concerns promptly to the Claims Director or Claims Manager. Generate reports for brokers to facilitate the completion of claims and payment processes. Support the completion of special projects as assigned. Attend and actively participate in meetings and training sessions as required. Perform other duties as assigned. MINIMUM QUALIFICATIONS High school diploma or equivalent required Related experience preferred Fluent in English and Spanish Strong confidentiality and time management skills Ability to learn quickly and work independently with self-motivation BENEFITS At VUMI , the well-being of our employees is our top priority. We offer a robust benefits package that includes: Medical, Dental, and Vision Insurance 401(k) Retirement Plan Hybrid Work Model (combination of remote and in-office work) Wellness Programs, including free access to our building gym A vibrant, engaging work environment that values and supports our employees' growth, well-being, and success WORKING CONDITIONS The following job-related working conditions are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential function. WORKING CONDITIONS The following job-related working conditions are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential function. Work Environment: The role primarily operates in an in-door, climate-controlled office setting working in close proximity to others. Noise level in the work environment is low to moderate. Light level provides adequate brightness for reading, computer work, and other tasks without causing glare or strain. Physical Demands: The job primarily involves sedentary work with prolonged periods sitting at a desk. While performing the duties of this job, employees may occasionally be expected to: exert up to 10 pounds of force and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects. operate standard office equipment such as copiers, computers, telephones, printers, etc. Travel Requirements: Minimal to no travel required NOTE This job description in no way states or implies that these are the only duties to be performed by the employee(s) incumbent in this position. Employees will be required to follow any other job-related instructions and to perform any other job-related duties requested by any person authorized to give instructions or assignments. All duties and responsibilities are essential functions and requirements and are subject to possible modification to reasonably accommodate individuals with disabilities. To perform this job successfully, the incumbents will possess the skills, aptitudes, and abilities to perform each duty proficiently. Some requirements may exclude individuals who pose a direct threat or significant risk to the health or safety of themselves or others. The requirements listed in this document are the minimum levels of knowledge, skills, or abilities. This document does not create an employment contract, implied or otherwise. The Company complies with employment regulations as they apply to the location of service.

Job Details Job Family STAFF - Support Staff Grade H9 Salary $18.71 Base Rate Department Testing Reports To Director of Testing Closing Date Open Until Filled FLSA Status Non-Exempt First Review Date July 07, 2025 The Part-Time Examiner is responsible for the coordination, administration, scoring, and interpretation of a large variety of placement, admission and certification examinations. What you will be doing * Administers and troubleshoots computer based and paper based exams * Interprets and implements testing policies and procedures * Prepares logistical paperwork for the administration of tests * Keeps accurate confidential records and ensures the integrity and security of all exams * Scores and reports test results to students and faculty * Assists student with issues related to testing * Disseminates information about tests and services provided by the department * Enters and retrieves test records * Processes scores received from other institutions as per established procedures * Gathers and reports daily testing and department data * Documents incident/irregularity reports in a concise and accurate manner * Assists with student feedback and office related job tasks * Maintains the security and integrity of test materials * Operates scanner and converts confidential documents into electronic format * Performs other duties as assigned What you need to succeed * Bachelor's degree from a regionally accredited institution and one (1) year of relevant testing or student/customer service experience or; Associate's degree from a regionally accredited institution and three (3) years of relevant testing or student/customer service experience * Knowledge and understanding of College organization, goals, and objectives, and policies and procedures * Proficiency in Microsoft Office software and specific computer programs related to area of responsibility * Possess excellent communication skills (verbal and written) * Strong customer service and problem solving skills * Ability to make sound and timely decisions * Possess superior analytical skills * Ability to work a flexible schedule to include evening and weekend assignments * Ability to work well in a multi-ethnic and multi-cultural environment with students, faculty and staff Preferences * Testing and/or Assessment experience preferred Additional Requirements The final candidate is to successfully complete a background screening and reference check process. EQUAL ACCESS/EQUAL OPPORTUNITY Miami Dade College is an equal access/equal opportunity institution which does not discriminate on the basis of sex, race, color, marital status, age, religion, national origin, disability, veteran's status, ethnicity, pregnancy, sexual orientation or genetic information. To obtain more information about the College's equal access and equal opportunity policies, procedures and practices, please contact the College's Civil Rights Compliance Officer: Cindy Lau Evans, Director, Equal Opportunity Programs/ ADA Coordinator/ Title IX Coordinator, at ************** (Voice) or 711 (Relay Service). 11011 SW 104 St., Room 1102-01; Miami, FL 33176. *********************

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.

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