Claim processor jobs in Metairie, LA - 98 jobs

Responsibilities & Duties:Claims Processing and Assessment: Evaluate incoming claims to determine eligibility, coverage, and validity. Conduct thorough investigations, including reviewing medical records and other relevant documentation. Analyze policy provisions and contractual agreements to assess claim validity. Utilize claims management systems to document findings and process claims efficiently. Communication and Customer Service: Communicate effectively with policyholders, beneficiaries, and healthcare providers regarding claim status and requirements. Provide timely responses to inquiries and maintain professional and empathetic communication throughout the claims process. Address customer concerns and escalate complex issues to senior claims personnel or management as needed. Compliance and Documentation: Ensure compliance with company policies, procedures, and regulatory requirements. Maintain accurate records and documentation related to claims activities. Follow established guidelines for claims adjudication and payment authorization. Quality Assurance and Improvement: Identify opportunities for process improvement and efficiency within the claims department. Participate in quality assurance initiatives to uphold service standards and improve claim handling practices. Collaborate with team members and management to implement best practices and enhance overall departmental performance. Reporting and Analysis: Generate reports and provide data analysis on claims trends, processing times, and outcomes. Contribute to the development of management reports and presentations regarding claims operations.

Job Title: Claims Analyst-Federal Construction ***Work Location: Panama City, FL (Tyndall AFB) *** Salary: Based on experience and will be discussed with manager in interview REQUIREMENT- Must be a US Citizen and must pass a federal background review and drug screen Responsibilities/Duties: Analyze contract terms, project schedules, and scope to identify potential claims or disputes. Prepare, evaluate, and document construction claims including Requests for Equitable Adjustment (REAs), time extensions, and cost impacts. Review subcontractor claims and coordinate analysis with project and legal teams. Maintain organized documentation related to claims, including correspondence, daily reports, meeting minutes, schedules, and cost records. Work closely with project managers, estimators, and schedulers to gather and validate data. Support negotiations and settlement of claims with clients and subcontractors. Provide recommendations for claim avoidance and risk mitigation. Ensure all claims comply with applicable contract clauses and federal regulations (FAR, DFARS, etc.). Assist in drafting position papers, presentations, and reports to support claim resolution or litigation support. Education/Experience: Bachelor's degree in Construction Management, Engineering, Business, or related field. Minimum of 5 years of experience in construction claims analysis, preferably in federal or military construction projects. Experience on U.S. Army Corps of Engineers (USACE) or NAVFAC projects. Certification in construction claims or contract management (e.g., CCP, PMP, AACE certifications). Working knowledge of construction law and dispute resolution processes. Strong understanding of federal contracting regulations and procedures (FAR, DFARS). Familiarity with scheduling techniques and tools (e.g., Primavera P6, Microsoft Project). Experience analyzing cost impacts and time delays using industry-standard methodologies. Excellent written and verbal communication skills. Highly organized with strong attention to detail. Ability to work independently and collaboratively with project teams. Proficient in Microsoft Office Suite (Excel, Word, Outlook). Benefits: Competitive salary based on experience. Comprehensive health, dental, and vision insurance. Retirement savings plan with company match. Paid time off and holidays. Professional development and career advancement opportunities. A supportive and collaborative work environment. Equal Opportunity Employer (U.S.) all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, sexual orientation, gender identity, or any other characteristic protected by law. Accura uses E-Verify in its hiring practices to achieve a lawful workplace. *******************

Are you looking for a great team environment? Southern Farm Bureau Casualty Insurance Company is currently seeking a Flood Examiner. Southern Farm Bureau is a great company and an excellent place to work. The Company offers a family-oriented work environment and a rich benefit package including paid time off, company matched 401(k), pension/retirement, medical, dental, vision, group life, accidental death and dismemberment, employee assistance program, a continued education program, and a hybrid home/office work schedule. This position is located in Ridgeland, MS. The Flood Examiner will review and pay flood claims and ICC claims. Update and run reports, answer incoming claim calls and perform other related work as required or delegated by Flood Claim Supervisor. Essential Functions • Review and process claim files for payment within designated authority level. • Review, evaluate, and process ICC claims for payment • Answer incoming claim inquiries, help verify coverage, and provide customer service to agency force, insureds and claim personnel • Assist Flood Claim Supervisor setting up annual Flood Claim Coordinator's meeting. • Assist with auditing flood claim operations. Additional Responsibilities • Other duties and responsibilities as assigned • Regular and predictable attendance is required.

About the Role PuroClean of Shreveport is seeking a high-character individual to join our team as a Loss Claims Specialist. This is more than a job-it's a leadership role designed for someone who can take full ownership of a project from start to finish and align with our mission of providing empathetic, efficient, and professional restoration services to our community. As a Loss Claims Specialist, you will serve in a project manager capacity, overseeing the execution of all services related to water damage, mold, biohazard, contents handling, and reconstruction. This role demands strong organizational skills, technical knowledge, and a commitment to both customer care and team collaboration. Why Join Us * Profit Sharing Position - your success is our success * Annual Draw of $50,000 + laptop + software subscriptions * Be part of a purpose-driven company that values integrity, excellence, and service * Opportunities for growth and advancement in a fast-paced industry What You'll Need * A personal vehicle and reliable transportation * A working phone * A desire to learn and align with our SOPs and company goals * Willingness to take ownership and be accountable for job outcomes * Ability to manage multiple claims and ensure timely completion of each project What You'll Do * Manage restoration projects from intake through completion * Coordinate and execute all mitigation and reconstruction services: * Water Damage * Mold Remediation * Biohazard Cleanup * Contents Pack-Out and Cleaning * Reconstruction/Build-Back * Estimate, invoice, and track jobs using software including: * Xactimate * Estimate * Time and Materials platforms * Learn and apply our internal SOPs with consistency and accuracy * Meet or exceed quarterly performance goals Preferred (but not required): * Prior construction or restoration experience * Familiarity with insurance claims processes or property loss mitigation Who We're Looking For We're looking for someone with more than just technical skills. We value character, accountability, and alignment with our company vision. If you take pride in your work, can lead by example, and are looking to grow in an environment that rewards dedication and results-you may be exactly who we're looking for.

The Oncology Claims Analyst 1 will coordinate coding audits and educational functions for FMOLHS and the Oncology Service Line. This individual will be responsible for drug authorizations, managing and working the edit and denial coding work queues for inpatient, outpatient clinic, and hospital based infusion departments and will provide coding and reimbursement feedback for education opportunities identified to the Service Line and FMOLHS. Prepares and presents coding education to providers and works in collaboration with various hospital and FMOLHS departments as a liaison related to NCCN, ASCO, and FDA guidelines. Must be familiar with reviewing documentation to assign appropriate CPT/HCPCS and ICD-10-CM-PCS diagnosis codes, understand current professional coder workflows, reviews principal, secondary diagnoses and procedures for hospital and physician (professional) services for inpatient, outpatient, and infusion records based on knowledge of coding systems. Additionally serves as business/reimbursement specialist for oncology drug regimens for both the Service Line and FMOLHS. * Coding/Program Management * Reviews and audits codes (CPT, ICD 10, HCPC, Level II, and modifier coding, etc.) and is expert on prior authorization using FDA, National Comprehensive Cancer Network (NCCN), and American Society of Clinical Oncology (ASCO) for specialty practices like inpatient chemotherapy hospitalizations, outpatient oncology visits, hospital based outpatient infusion centers for both oncology and non-oncology patients. * Is consultant/expert for FMOLHS business office and external agencies in clarification of coding regarding reimbursement infusion issues, especially new FDA and new clinical pathways of National Comprehensive Cancer Network (NCCN). Manages data gathering and chart auditing as necessary for FMOLHS Revenue Cycle, LPG, and Oncology Service Line. * Works closely and consistently with major pharmaceutical companies on new drug treatment guidelines/pathways, drug replacement programs, and Southern Oncology Association of Practices (SOAP) to determine business best practices and clinical education opportunities for physicians/providers. Reports findings consistently to Director of Pharmacy and VP of Oncology Service Line. * Advises the executive team on best practices for drug purchase opportunities to ensure potential profitability is maximized while working with FMOLHS contract director to verify profitability of managed care contracts related to drug margins. * Works with various national oncology specific institutions, like MD Anderson, Bone Marrow transplant centers, etc. alongside physicians/payers directly whether clinical pathways/treatment regimens fall within proper coding/maximum reimbursement of clinical trials, off label, NCCN guideline, etc. to manage proper clean claims and decrease likelihood of claim denial. * Works directly with business, administrative team, and physicians/providers to perform at least monthly education on chart audits, new treatment pathways, governmental payer requirements, and others. * Coding/Program Management * Reviews and audits codes (CPT, ICD 10, HCPC, Level II, and modifier coding, etc.) and is expert on prior authorization using FDA, National Comprehensive Cancer Network (NCCN), and American Society of Clinical Oncology (ASCO) for specialty practices like inpatient chemotherapy hospitalizations, outpatient oncology visits, hospital based outpatient infusion centers for both oncology and non-oncology patients. * Is consultant/expert for FMOLHS business office and external agencies in clarification of coding regarding reimbursement infusion issues, especially new FDA and new clinical pathways of National Comprehensive Cancer Network (NCCN). Manages data gathering and chart auditing as necessary for FMOLHS Revenue Cycle, LPG, and Oncology Service Line. * Works closely and consistently with major pharmaceutical companies on new drug treatment guidelines/pathways, drug replacement programs, and Southern Oncology Association of Practices (SOAP) to determine business best practices and clinical education opportunities for physicians/providers. Reports findings consistently to Director of Pharmacy and VP of Oncology Service Line. * Advises the executive team on best practices for drug purchase opportunities to ensure potential profitability is maximized while working with FMOLHS contract director to verify profitability of managed care contracts related to drug margins. * Works with various national oncology specific institutions, like MD Anderson, Bone Marrow transplant centers, etc. alongside physicians/payers directly whether clinical pathways/treatment regimens fall within proper coding/maximum reimbursement of clinical trials, off label, NCCN guideline, etc. to manage proper clean claims and decrease likelihood of claim denial. * Works directly with business, administrative team, and physicians/providers to perform at least monthly education on chart audits, new treatment pathways, governmental payer requirements, and others. * Analysis and Collaboration * Proactively researches and understands payer issues. Troubleshoots and resolves issues that impact revenue. Works collectively with FMOLHS denial management team to audit Medicare, Medicaid, and Insurance claims for accurate coding, charging, and modifier usage as requested by the FMOLHS. Considered expert for high dollar drug appeals across FMOLHS. * Considered expert for the Physician Group, Revenue Management Department, Pharmacy, and other financial departments in clarification of coding regarding reimbursement issues to resolve claim edits and assure clean claim submission. Monitors and evaluates compliance with documentation standards to identify trends, issues, risk areas, and opportunities for performance improvement. * Continually analyzes reports/margin analyzers to communicate business performance to the administrative team, revenue cycle team, physician practice managers, and physicians to determine efficacy and suggests opportunities for improvement. * Acts as a liaison for Professional Billing and FMOLHS Central Billing Office Management assisting in any special requests/research for information/proper documentation to aid in billing processes especially high dollar denials/write offs/analysis. * Experience: 3 years of medical revenue cycle experience * Education: High School Diploma

About Us: Struction Solutions is an innovative Independent Adjusting, Building Consultant, and Disaster Recovery Firm, known for our commitment to delivering innovative and tailored solutions to our clientele. Our team of professionals work tirelessly to ensure accuracy, efficiency, and customer satisfaction. As we continue to grow and expand, we're seeking talented individuals who share our dedication to excellence and are eager to make a meaningful impact in our industry. Position Details: Resolves insurance claims involving marine casualties. Their role includes investigating, evaluating, and negotiating claims to determine the extent of the insurance company's liability. This role requires a thorough understanding of maritime laws, insurance policies, and handling procedures. Investigation: They conduct thorough investigations of marine incidents, such as collisions, groundings, sinkings, fires, or cargo damage. This includes gathering evidence, interviewing witnesses, and inspecting vessels and cargo. Assessment: They assess the extent of the damage and determine the cause of the incident. This may involve working with marine surveyors, engineers, and other experts to evaluate the condition of the vessel and cargo. Documentation: They collect and review relevant documents, such as ship logs, maintenance records, cargo manifests, and insurance policies, to support the claim. Evaluation: They evaluate the claim to determine whether it is covered under the insurance policy and to what extent. This involves interpreting policy terms and conditions, as well as applicable laws and regulations. Negotiation: They negotiate settlements with claimants, which can include shipowners, charterers, cargo owners, and other affected parties. The goal is to reach a fair and equitable resolution while minimizing the financial impact on the insurance company. Reporting: They prepare detailed reports and recommendations for the insurance company, documenting their findings, the extent of the damage, and the proposed settlement. Liaison: They act as a liaison between the insurance company and other parties involved in the claim, such as legal representatives, regulatory authorities, and other stakeholders. Compliance: They ensure that all claims are handled in compliance with relevant laws, regulations, and industry standards. Risk Management: They may also be involved in risk management activities, helping to identify and mitigate potential risks to reduce the likelihood of future claims. Qualifications: Proven experience in insurance claims adjustment, preferably in marine insurance. Strong knowledge of maritime laws and regulations. Excellent analytical, negotiation, and communication skills. Ability to manage multiple claims efficiently under tight deadlines. Proficiency in claim management software and Microsoft Office Suite. Location: New Orleans, LA area Marine casualty claim adjustment specialists need a strong understanding of maritime law, insurance principles, and the technical aspects of marine operations. They also require excellent analytical, communication, and negotiation skills. Join us at Struction Solutions, and let's redefine the future of the Independent Adjusting industry together! View all jobs at this company

Claim Clerk ) Schedule: Monday-Friday, 7:30 a.m. - 4:00 p.m. (37.5 hours per week) Salary Range:$12.00 - $15.50 per hour Build Your Career With Purpose at CCMSI At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success. We don't just process claims-we support people. As the largest privately-owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work , and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day. Job Summary The Claim Clerk provides administrative support to both Liability and Workers' Compensation adjusters, ensuring accurate documentation and timely processing of claim-related tasks. This role requires strong attention to detail, organizational skills, and the ability to manage multiple priorities in a fast-paced environment. You'll work closely with a team of four and play a critical role in maintaining compliance and efficiency within the claims process. Responsibilities When we hire claim clerks, we look for detail-oriented professionals who take pride in accuracy, organization, and supporting a team that delivers exceptional service. In this role, you'll help keep claims moving by managing documentation, deadlines, and communication with precision. What You'll Do Match mail for assigned accounts and file claim-related documents Follow up on bills and assist with claim file maintenance Set up designated claim files and complete all setup instructions as requested Summarize correspondence and medical records in claim log notes and file appropriately Provide administrative support to claim staff on client-specific teams Back up the receptionist as needed Retrieve closed files and maintain storage organization Photocopy claim documents and return provider calls as directed Ensure compliance with service commitments established by the team Qualifications Required: High school diploma or equivalent Proficiency in Microsoft Word, data entry, and typing skills Strong attention to detail and organizational abilities Nice to Have: Experience with Microsoft Excel Knowledge of medical terminology Bilingual (Spanish) proficiency - highly valued for communicating with claimants, employers, or vendors, but not required. Why You'll Love Working Here 4 weeks (Paid time off that accrues throughout the year in accordance with company policy) + 10 paid holidays in your first year Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP) Career growth: Internal training and advancement opportunities Culture: A supportive, team-based work environment How We Measure Success At CCMSI, great claim clerks stand out through accuracy, efficiency, and teamwork. We measure success by: Quality administrative support - organized filing, accurate documentation, and dependable assistance to adjusters Compliance & audit performance - adherence to client-specific and corporate standards for recordkeeping and data integrity Timeliness & accuracy - prompt handling of mail, bills, and claim file updates with attention to detail Team collaboration - proactive communication and responsiveness to adjuster and client needs Professional judgment - maintaining confidentiality and prioritizing tasks effectively Cultural alignment - understanding that every claim represents a real person and supporting the process with care This is where we shine, and we hire clerks who want to shine with us. Compensation & Compliance The posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay. CCMSI offers comprehensive benefits including medical, dental, vision, life, and disability insurance. Paid time off accrues throughout the year in accordance with company policy, with paid holidays and eligibility for retirement programs in accordance with plan documents. Visa Sponsorship: CCMSI does not provide visa sponsorship for this position. ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process. Equal Opportunity Employer: CCMSI complies with all applicable employment laws, including pay transparency and fair chance hiring regulations. Background checks, if required for the role, are conducted only after a conditional offer and in accordance with applicable fair chance hiring laws. Our Core Values At CCMSI, we believe in doing what's right-for our clients, our coworkers, and ourselves. We look for team members who: Lead with transparency We build trust by being open and listening intently in every interaction. Perform with integrity We choose the right path, even when it is hard. Chase excellence We set the bar high and measure our success. What gets measured gets done. Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own. Win together Our greatest victories come when our clients succeed. We don't just work together-we grow together. If that sounds like your kind of workplace, we'd love to meet you. #ClaimsCareers #InsuranceJobs #JacksonMSJobs #AdminSupport #CareerGrowth #EmployeeOwned #GreatPlaceToWorkCertified #NowHiring #ClericalJobs #TeamSupport #CCMSICareers #LI-InOffice #IND456 We can recommend jobs specifically for you! Click here to get started.

The Claims Specialist is responsible for handling damage claims and property loss claims, to help resolve them efficiently and fairly. Successful Candidates MUST have prior experience with automotive insurance claims or experience working with insurance in a body shop or similar vehicle repair facility to be considered for this role. Job Type: Full Time On-Site or Hybrid at our office in Natchez, MS - This is not a fully remote position. Duties and Responsibilities: Investigating and analyzing details of damage claims and property loss claims to determine the level of liability. Reviewing and evaluating damage claims and property loss claims for accuracy and completeness. Interacting with service providers, clients, and claimants to gather more information about damage claims and property loss claims. Documenting all claim related activities and maintaining claim files for review and auditing purposes. Following all company policies and procedures and complying with all legal requirements Maintaining a high level of customer service by answering questions and providing information to all parties involved in the claims process. Requirements: Experience in the Collateral Recovery industry required, preferably in a Claims related role. Excellent written and verbal communications skills. Excellent listening, negotiation and problem-solving skills. Attention to detail and high level of accuracy. Must be proficient in Microsoft Office or Google Suite. Benefits: · Medical, Dental and Vision Insurance · Paid Time Off · Paid Holidays

The Oncology Claims Analyst 1 will coordinate coding audits and educational functions for FMOLHS and the Oncology Service Line. This individual will be responsible for drug authorizations, managing and working the edit and denial coding work queues for inpatient, outpatient clinic, and hospital based infusion departments and will provide coding and reimbursement feedback for education opportunities identified to the Service Line and FMOLHS. Prepares and presents coding education to providers and works in collaboration with various hospital and FMOLHS departments as a liaison related to NCCN, ASCO, and FDA guidelines. Must be familiar with reviewing documentation to assign appropriate CPT/HCPCS and ICD-10-CM-PCS diagnosis codes, understand current professional coder workflows, reviews principal, secondary diagnoses and procedures for hospital and physician (professional) services for inpatient, outpatient, and infusion records based on knowledge of coding systems. Additionally serves as business/reimbursement specialist for oncology drug regimens for both the Service Line and FMOLHS. Experience: 3 years of medical revenue cycle experience Education: High School Diploma Coding/Program Management Reviews and audits codes (CPT, ICD 10, HCPC, Level II, and modifier coding, etc.) and is expert on prior authorization using FDA, National Comprehensive Cancer Network (NCCN), and American Society of Clinical Oncology (ASCO) for specialty practices like inpatient chemotherapy hospitalizations, outpatient oncology visits, hospital based outpatient infusion centers for both oncology and non-oncology patients. Is consultant/expert for FMOLHS business office and external agencies in clarification of coding regarding reimbursement infusion issues, especially new FDA and new clinical pathways of National Comprehensive Cancer Network (NCCN). Manages data gathering and chart auditing as necessary for FMOLHS Revenue Cycle, LPG, and Oncology Service Line. Works closely and consistently with major pharmaceutical companies on new drug treatment guidelines/pathways, drug replacement programs, and Southern Oncology Association of Practices (SOAP) to determine business best practices and clinical education opportunities for physicians/providers. Reports findings consistently to Director of Pharmacy and VP of Oncology Service Line. Advises the executive team on best practices for drug purchase opportunities to ensure potential profitability is maximized while working with FMOLHS contract director to verify profitability of managed care contracts related to drug margins. Works with various national oncology specific institutions, like MD Anderson, Bone Marrow transplant centers, etc. alongside physicians/payers directly whether clinical pathways/treatment regimens fall within proper coding/maximum reimbursement of clinical trials, off label, NCCN guideline, etc. to manage proper clean claims and decrease likelihood of claim denial. Works directly with business, administrative team, and physicians/providers to perform at least monthly education on chart audits, new treatment pathways, governmental payer requirements, and others. Coding/Program Management Reviews and audits codes (CPT, ICD 10, HCPC, Level II, and modifier coding, etc.) and is expert on prior authorization using FDA, National Comprehensive Cancer Network (NCCN), and American Society of Clinical Oncology (ASCO) for specialty practices like inpatient chemotherapy hospitalizations, outpatient oncology visits, hospital based outpatient infusion centers for both oncology and non-oncology patients. Is consultant/expert for FMOLHS business office and external agencies in clarification of coding regarding reimbursement infusion issues, especially new FDA and new clinical pathways of National Comprehensive Cancer Network (NCCN). Manages data gathering and chart auditing as necessary for FMOLHS Revenue Cycle, LPG, and Oncology Service Line. Works closely and consistently with major pharmaceutical companies on new drug treatment guidelines/pathways, drug replacement programs, and Southern Oncology Association of Practices (SOAP) to determine business best practices and clinical education opportunities for physicians/providers. Reports findings consistently to Director of Pharmacy and VP of Oncology Service Line. Advises the executive team on best practices for drug purchase opportunities to ensure potential profitability is maximized while working with FMOLHS contract director to verify profitability of managed care contracts related to drug margins. Works with various national oncology specific institutions, like MD Anderson, Bone Marrow transplant centers, etc. alongside physicians/payers directly whether clinical pathways/treatment regimens fall within proper coding/maximum reimbursement of clinical trials, off label, NCCN guideline, etc. to manage proper clean claims and decrease likelihood of claim denial. Works directly with business, administrative team, and physicians/providers to perform at least monthly education on chart audits, new treatment pathways, governmental payer requirements, and others. Analysis and Collaboration Proactively researches and understands payer issues. Troubleshoots and resolves issues that impact revenue. Works collectively with FMOLHS denial management team to audit Medicare, Medicaid, and Insurance claims for accurate coding, charging, and modifier usage as requested by the FMOLHS. Considered expert for high dollar drug appeals across FMOLHS. Considered expert for the Physician Group, Revenue Management Department, Pharmacy, and other financial departments in clarification of coding regarding reimbursement issues to resolve claim edits and assure clean claim submission. Monitors and evaluates compliance with documentation standards to identify trends, issues, risk areas, and opportunities for performance improvement. Continually analyzes reports/margin analyzers to communicate business performance to the administrative team, revenue cycle team, physician practice managers, and physicians to determine efficacy and suggests opportunities for improvement. Acts as a liaison for Professional Billing and FMOLHS Central Billing Office Management assisting in any special requests/research for information/proper documentation to aid in billing processes especially high dollar denials/write offs/analysis.

The Oncology Claims Analyst 1 will coordinate coding audits and educational functions for FMOLHS and the Oncology Service Line. This individual will be responsible for drug authorizations, managing and working the edit and denial coding work queues for inpatient, outpatient clinic, and hospital based infusion departments and will provide coding and reimbursement feedback for education opportunities identified to the Service Line and FMOLHS. Prepares and presents coding education to providers and works in collaboration with various hospital and FMOLHS departments as a liaison related to NCCN, ASCO, and FDA guidelines. Must be familiar with reviewing documentation to assign appropriate CPT/HCPCS and ICD-10-CM-PCS diagnosis codes, understand current professional coder workflows, reviews principal, secondary diagnoses and procedures for hospital and physician (professional) services for inpatient, outpatient, and infusion records based on knowledge of coding systems. Additionally serves as business/reimbursement specialist for oncology drug regimens for both the Service Line and FMOLHS. Experience: 3 years of medical revenue cycle experience Education: High School Diploma Coding/Program Management Reviews and audits codes (CPT, ICD 10, HCPC, Level II, and modifier coding, etc.) and is expert on prior authorization using FDA, National Comprehensive Cancer Network (NCCN), and American Society of Clinical Oncology (ASCO) for specialty practices like inpatient chemotherapy hospitalizations, outpatient oncology visits, hospital based outpatient infusion centers for both oncology and non-oncology patients. Is consultant/expert for FMOLHS business office and external agencies in clarification of coding regarding reimbursement infusion issues, especially new FDA and new clinical pathways of National Comprehensive Cancer Network (NCCN). Manages data gathering and chart auditing as necessary for FMOLHS Revenue Cycle, LPG, and Oncology Service Line. Works closely and consistently with major pharmaceutical companies on new drug treatment guidelines/pathways, drug replacement programs, and Southern Oncology Association of Practices (SOAP) to determine business best practices and clinical education opportunities for physicians/providers. Reports findings consistently to Director of Pharmacy and VP of Oncology Service Line. Advises the executive team on best practices for drug purchase opportunities to ensure potential profitability is maximized while working with FMOLHS contract director to verify profitability of managed care contracts related to drug margins. Works with various national oncology specific institutions, like MD Anderson, Bone Marrow transplant centers, etc. alongside physicians/payers directly whether clinical pathways/treatment regimens fall within proper coding/maximum reimbursement of clinical trials, off label, NCCN guideline, etc. to manage proper clean claims and decrease likelihood of claim denial. Works directly with business, administrative team, and physicians/providers to perform at least monthly education on chart audits, new treatment pathways, governmental payer requirements, and others. Coding/Program Management Reviews and audits codes (CPT, ICD 10, HCPC, Level II, and modifier coding, etc.) and is expert on prior authorization using FDA, National Comprehensive Cancer Network (NCCN), and American Society of Clinical Oncology (ASCO) for specialty practices like inpatient chemotherapy hospitalizations, outpatient oncology visits, hospital based outpatient infusion centers for both oncology and non-oncology patients. Is consultant/expert for FMOLHS business office and external agencies in clarification of coding regarding reimbursement infusion issues, especially new FDA and new clinical pathways of National Comprehensive Cancer Network (NCCN). Manages data gathering and chart auditing as necessary for FMOLHS Revenue Cycle, LPG, and Oncology Service Line. Works closely and consistently with major pharmaceutical companies on new drug treatment guidelines/pathways, drug replacement programs, and Southern Oncology Association of Practices (SOAP) to determine business best practices and clinical education opportunities for physicians/providers. Reports findings consistently to Director of Pharmacy and VP of Oncology Service Line. Advises the executive team on best practices for drug purchase opportunities to ensure potential profitability is maximized while working with FMOLHS contract director to verify profitability of managed care contracts related to drug margins. Works with various national oncology specific institutions, like MD Anderson, Bone Marrow transplant centers, etc. alongside physicians/payers directly whether clinical pathways/treatment regimens fall within proper coding/maximum reimbursement of clinical trials, off label, NCCN guideline, etc. to manage proper clean claims and decrease likelihood of claim denial. Works directly with business, administrative team, and physicians/providers to perform at least monthly education on chart audits, new treatment pathways, governmental payer requirements, and others. Analysis and Collaboration Proactively researches and understands payer issues. Troubleshoots and resolves issues that impact revenue. Works collectively with FMOLHS denial management team to audit Medicare, Medicaid, and Insurance claims for accurate coding, charging, and modifier usage as requested by the FMOLHS. Considered expert for high dollar drug appeals across FMOLHS. Considered expert for the Physician Group, Revenue Management Department, Pharmacy, and other financial departments in clarification of coding regarding reimbursement issues to resolve claim edits and assure clean claim submission. Monitors and evaluates compliance with documentation standards to identify trends, issues, risk areas, and opportunities for performance improvement. Continually analyzes reports/margin analyzers to communicate business performance to the administrative team, revenue cycle team, physician practice managers, and physicians to determine efficacy and suggests opportunities for improvement. Acts as a liaison for Professional Billing and FMOLHS Central Billing Office Management assisting in any special requests/research for information/proper documentation to aid in billing processes especially high dollar denials/write offs/analysis.

The Oncology Claims Analyst 1 will coordinate coding audits and educational functions for FMOLHS and the Oncology Service Line. This individual will be responsible for drug authorizations, managing and working the edit and denial coding work queues for inpatient, outpatient clinic, and hospital based infusion departments and will provide coding and reimbursement feedback for education opportunities identified to the Service Line and FMOLHS. Prepares and presents coding education to providers and works in collaboration with various hospital and FMOLHS departments as a liaison related to NCCN, ASCO, and FDA guidelines. Must be familiar with reviewing documentation to assign appropriate CPT/HCPCS and ICD-10-CM-PCS diagnosis codes, understand current professional coder workflows, reviews principal, secondary diagnoses and procedures for hospital and physician (professional) services for inpatient, outpatient, and infusion records based on knowledge of coding systems. Additionally serves as business/reimbursement specialist for oncology drug regimens for both the Service Line and FMOLHS. Responsibilities * Coding/Program Management * Reviews and audits codes (CPT, ICD 10, HCPC, Level II, and modifier coding, etc.) and is expert on prior authorization using FDA, National Comprehensive Cancer Network (NCCN), and American Society of Clinical Oncology (ASCO) for specialty practices like inpatient chemotherapy hospitalizations, outpatient oncology visits, hospital based outpatient infusion centers for both oncology and non-oncology patients. * Is consultant/expert for FMOLHS business office and external agencies in clarification of coding regarding reimbursement infusion issues, especially new FDA and new clinical pathways of National Comprehensive Cancer Network (NCCN). Manages data gathering and chart auditing as necessary for FMOLHS Revenue Cycle, LPG, and Oncology Service Line. * Works closely and consistently with major pharmaceutical companies on new drug treatment guidelines/pathways, drug replacement programs, and Southern Oncology Association of Practices (SOAP) to determine business best practices and clinical education opportunities for physicians/providers. Reports findings consistently to Director of Pharmacy and VP of Oncology Service Line. * Advises the executive team on best practices for drug purchase opportunities to ensure potential profitability is maximized while working with FMOLHS contract director to verify profitability of managed care contracts related to drug margins. * Works with various national oncology specific institutions, like MD Anderson, Bone Marrow transplant centers, etc. alongside physicians/payers directly whether clinical pathways/treatment regimens fall within proper coding/maximum reimbursement of clinical trials, off label, NCCN guideline, etc. to manage proper clean claims and decrease likelihood of claim denial. * Works directly with business, administrative team, and physicians/providers to perform at least monthly education on chart audits, new treatment pathways, governmental payer requirements, and others. * Coding/Program Management * Reviews and audits codes (CPT, ICD 10, HCPC, Level II, and modifier coding, etc.) and is expert on prior authorization using FDA, National Comprehensive Cancer Network (NCCN), and American Society of Clinical Oncology (ASCO) for specialty practices like inpatient chemotherapy hospitalizations, outpatient oncology visits, hospital based outpatient infusion centers for both oncology and non-oncology patients. * Is consultant/expert for FMOLHS business office and external agencies in clarification of coding regarding reimbursement infusion issues, especially new FDA and new clinical pathways of National Comprehensive Cancer Network (NCCN). Manages data gathering and chart auditing as necessary for FMOLHS Revenue Cycle, LPG, and Oncology Service Line. * Works closely and consistently with major pharmaceutical companies on new drug treatment guidelines/pathways, drug replacement programs, and Southern Oncology Association of Practices (SOAP) to determine business best practices and clinical education opportunities for physicians/providers. Reports findings consistently to Director of Pharmacy and VP of Oncology Service Line. * Advises the executive team on best practices for drug purchase opportunities to ensure potential profitability is maximized while working with FMOLHS contract director to verify profitability of managed care contracts related to drug margins. * Works with various national oncology specific institutions, like MD Anderson, Bone Marrow transplant centers, etc. alongside physicians/payers directly whether clinical pathways/treatment regimens fall within proper coding/maximum reimbursement of clinical trials, off label, NCCN guideline, etc. to manage proper clean claims and decrease likelihood of claim denial. * Works directly with business, administrative team, and physicians/providers to perform at least monthly education on chart audits, new treatment pathways, governmental payer requirements, and others. * Analysis and Collaboration * Proactively researches and understands payer issues. Troubleshoots and resolves issues that impact revenue. Works collectively with FMOLHS denial management team to audit Medicare, Medicaid, and Insurance claims for accurate coding, charging, and modifier usage as requested by the FMOLHS. Considered expert for high dollar drug appeals across FMOLHS. * Considered expert for the Physician Group, Revenue Management Department, Pharmacy, and other financial departments in clarification of coding regarding reimbursement issues to resolve claim edits and assure clean claim submission. Monitors and evaluates compliance with documentation standards to identify trends, issues, risk areas, and opportunities for performance improvement. * Continually analyzes reports/margin analyzers to communicate business performance to the administrative team, revenue cycle team, physician practice managers, and physicians to determine efficacy and suggests opportunities for improvement. * Acts as a liaison for Professional Billing and FMOLHS Central Billing Office Management assisting in any special requests/research for information/proper documentation to aid in billing processes especially high dollar denials/write offs/analysis. Qualifications * Experience: 3 years of medical revenue cycle experience * Education: High School Diploma

At SCP Health, what you do matters As part of the SCP Health team, you have an opportunity to make a difference. At our core, we work to bring hospitals and healers together in the pursuit of clinical effectiveness. With a portfolio of over 8 million patients, 7500 providers, 30 states, and 400 healthcare facilities, SCP Health is a leader in clinical practice management spanning the entire continuum of care, including emergency medicine, hospital medicine, wellness, telemedicine, intensive care, and ambulatory care. Why you will love working here: - Strong track record of providing excellent work/life balance. - Comprehensive benefits package and competitive compensation. - Commitment to fostering an inclusive culture of belonging and empowerment through our core values - collaboration, courage, agility, and respect. CORE VALUES In alignment with the core values of SCP-Health, this role will demonstrate the organization's four core values: Agility, the Accounting Specialist drives the direction of the department based on ever changing internal and external trends ensuring that organizational performance objectives are achieved. Respect, the Accounting Specialist creates an environment that fosters respect for all employees to assure courtesy, professionalism, and dignity are exhibited through all interactions with t Courage, the Accounting Specialist supports policies, metrics, and work standards, to ensure our teams consistently demonstrate a willingness to do what is needed to make a difference for our team. Collaboration, the Accounting Specialist will coordinate across the department as needed to assist and ensure a “One-Team” approach. JOB DESCRIPTION: Responsibilities: Prepare weekly reports on open/closed claims, reconciliation status, and outstanding risks. Reconcile accrued liability account until all claims are resolved. Assist with auditing files before processing. Maintain documentation to support compliance requirements. Identify recurring issues and recommend process improvements. Work directly with IDREs and payors to resolve discrepancies and document outcomes. Participation in month-end closing procedures and schedule preparation. Knowledge, Skills, and Abilities: Expert in Microsoft Office and Microsoft Excel High level of accountability, accuracy, and efficiency, especially when multitasking Analytical, collaborative, and trustworthy Ethical, thorough, and attentive with excellent verbal and written communication skills Maintain quality standards while working in a high-volume, fast-paced environment Must be able to set priorities and demonstrate sound judgment in handling problems Must be extremely well organized and demonstrate great time management skills Must be a team player and work well with others Must be able to work under moderate stress and pressure while maintaining a professional attitude Must be able to communicate effectively with professionals EDUCATION (Required and/or Preferred): High school diploma or general education degree (GED) required Bachelor's degree in Accounting, Finance, Business, or related field preferred (or equivalent experience). FIELD OF STUDY: Accounting/Finance/Business/Reimbursement WORK EXPERIENCE/QUALIFICATIONS: 2+ years of experience in claims, revenue cycle, accounting, or healthcare reimbursement Strong knowledge of Excel (pivot tables, advanced formulas, reconciliations) Basic understanding of accounting principles WORK ENVIRONMENT AND PHYSICAL DEMANDS: Professional setting Continuous sitting Continuous oral & written communication and listening skills Continuous computer use Occasional bending, kneeling, lifting, pulling & pushing up to 10 pounds Job requires a high level of mental awareness PRIMARY LOCATION: SCP Corporate - Lafayette Office #LI-PM1

We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross. Residency in or relocation to Louisiana is preferred for all positions. **POSITION PURPOSE** Duties may include the following responsibilities or functions required to support the claims unit. Accurate processing of claims edits, determining primacy for the Coordination of Benefits (COB), adjusting previously paid claims and initiating procedures to recover funds on overpaid claims. Analyzing, investigating, and resolving problem cases; executing recovery processes; and completing special projects. Accountable for complying with all laws and regulations that are associated with duties and responsibilities. **NATURE AND SCOPE** + This role does not manage people + This role reports to this job: SUPERVISOR, CLAIMS OPERATIONS + Necessary Contacts: In order to effectively fulfill this position, the Claims Specialist II must be in contact with personnel in other Units:Various internal departments and staff including, but not limited to, Provider Services, Legal, Internal Audit, IT, other Benefits Operations Management and staff, Enrollment and Billing, Administrative Services, and District Offices.Various external entities including, but not limited to, Providers, Members, Lawyers, Groups, Commissioner of Insurance, other insurance companies, and other Plans. **QUALIFICATIONS** **Education** + High School Diploma or equivalent required **Work Experience** + 2 years in medical claims processing required + Coordination of Benefits (COB) processing experience preferred **Skills and Abilities** + Strong analytical ability, that includes strong logical, systemic, and investigates thinking. + Strong oral and written communication skills and human relations skills are necessary. + Working knowledge of relevant PC software. + Ability to prioritize multiple streams of work effectively. **Licenses and Certifications** + None Required **ACCOUNTABILITIES AND ESSENTIAL FUNCTIONS** + Reviews, researches, and makes necessary updates to claims that may include the following: recalculation of benefits to previously processed claims, the processing of claims edits, or initiation of refund requests, according to contractual benefits or provider reimbursement rules, ultimately providing a high degree of customer satisfaction. + Achieves and maintains a clear understanding of all systems, applications, and procedures necessary to identify denial codes, edits, and processing codes pertaining to all claims (including our coordination with additional coverage plans) in order to process both coordinated and non-coordinated claims correctly. Requesting of medical records may be required. + Communicates, both orally and in writing, with internal and external contacts in order to provide necessary and accurate information for the establishment of sound claim records. This may include, but is not limited to, the coordination of benefits (COB), medical record requests, etc. + Review quality audits for correction or routing within 48 hours of receipt following departmental and corporate guidelines to ensure accuracy of claims processing and customer satisfaction. + Researches, investigates, and determines the correct order of benefits for payment to be made by the applicable plans and makes necessary corrections to COB records. Communicates to appropriate department(s) when Medicare has determined primacy incorrectly and ensures a letter is generated to notify Medicare. Failure to report discrepancy could result in a daily fine up to $1,000.00. + Analyzes, investigates, resolves problem cases (to include COB records, adjusting previously processed claims and requesting refund of overpaid claims). Reviews all previously processed claims to ensure consistency in payments to maximize recovery of overpayments following corporate and departmental guidelines to ensure financial stability. + Executes procedures to recover funds from providers, subscribers, or beneficiaries where overpayments have occurred to ensure accuracy of claims processing and financial stability. + Steps in and assists in any other capacity as deemed necessary (i.e., training, implementations, and documentation). + May complete special projects as assigned by Management due to internal audit findings, multiple provider status changes, and system errors following corporate and departmental guidelines to ensure financial stability and customer satisfaction. **Additional Accountabilities and Essential Functions** _The Physical Demands described here are representative of those that must be met by an employee to successfully perform the Accountabilities and Essential Functions of the job. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions_ + Perform other job-related duties as assigned, within your scope of responsibilities. + Job duties are performed in a normal and clean office environment with normal noise levels. + Work is predominately done while standing or sitting. + The ability to comprehend, document, calculate, visualize, and analyze are required. **An Equal Opportunity Employer** **All BCBSLA EMPLOYEES please apply through Workday Careers.** PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME, FIREFOX, SAFARI) **Additional Information** Please be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive, only those most qualified will be contacted. To monitor the status of your application, please visit the "My Applications" section in the Candidate Home section of your Workday account. If you are an individual with a disability and require a reasonable accommodation to complete an application, please contact ********************* for assistance. In support of our mission to improve the health and lives of Louisianians, Blue Cross encourages the good health of its employees and visitors. We want to ensure that our employees have a work environment that will optimize personal health and well-being. Due to the acknowledged hazards from exposure to environmental tobacco smoke, and in order to promote good health, our company properties are smoke and tobacco free. _Blue Cross and Blue Shield of Louisiana performs background and pre-employment drug screening after an offer has been extended and prior to hire for all positions. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner._ _Additionally, Blue Cross and Blue Shield of Louisiana is a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results._ **JOB CATEGORY:** **Insurance**

Job Category: Accounting Job Type: Full-Time Facility Type: Corporate Shift Type (Clinical Positions): Day Shift At AMG we offer our employees much more than just a job in the healthcare industry. We offer unique career opportunities for people who are called to make a difference in the lives of others and desire to be part of a team that contributes to making a difference each day for our patients. We invite you to join our team and share your gifts and talents. In addition to market-competitive pay rates and benefits in the Lafayette market, you will have the opportunity to work for an Employee Stock Ownership Plan (ESOP), as AMG is an employee-owned company! AMG, Integrated Healthcare Management (AMG Corporate) is seeking a Hospital Billing & Claims Appeal Specialist in Lafayette, Louisiana. This position is crossed trained and is responsible for patient account billing, including monthly statement mail out, and electronic billing submissions. Also responsible for fiscal year end cost reporting. Also providing support for the Billing Specialists and the corporate office team in relation to managing incorrect contracted payments with managed care payors to seek resolution and file necessary appeals. The position will be responsible for assisting the billing specialist with obtaining necessary documentation, writing appeals and following up with appeals as requested by the billing team. The candidate must possess strong communication skills, excellent customer services skills, and be able to work collaboratively with a team. This position requires a strong Hospital Billing and Claim Appeals background with experience in the Post-Acute setting and interpretation of payor contracts for appropriate appeal rights. This is not a remote position. Join our dynamic team and enjoy a career where you can make a difference with AMG Integrated Healthcare Management! Apply Now Job Requirements * Position located in Lafayette, Louisiana. * Strong knowledge of MS Word and Excel. * Requires a strong Claim Appeals background with experience in the Post-Acute setting. * Requires interpretation of payor contracts for appropriate appeal rights. * Minimum of 2-3 years hospital billing/collections/accounting experience in health care related field. * A strong background in Long Term Acute Care (LTAC). * Must be able to diplomatically articulate communications, interpret and explain complex information, and comprehend written, verbal and electronic communication. * Strong problem-solving skills with effective time management. * Strong organizational skills to maintain awareness of appeal timelines. * Self-starter with strong analytical skills and attention to detai About Us AMG is a hospital system committed to our patients, our people, and to the pursuit of healing. As a Top-5 Post-Acute hospital system, we're known for excellence, integrity, community, and compassion. Our mission is to return patients to their optimal level of well-being in the least restrictive medical environment. We accomplish this through a multi-disciplined approach that includes aggressive clinical and therapeutic interventions, as well as family involvement. Our high staff to patient ratio ensures individualized attention. Our nurses, therapists, and physicians work with each patient to obtain the best possible outcomes. Acadiana Management Group, LLC is an equal opportunity employer.

Thank you for your interest in The University of New Orleans. Once you start the application process, you will not be able to save your work, so you should collect all required information before you begin. The required information is listed below in the job posting. You must complete all required portions of the application and attach the required documents in order to be considered for employment. Department OPH-Bureau of Emergency Medical ServicesJob SummaryJob Description Serves on a psychomotor exam team as an examiner, professional partner, patient, or other role as needed for the Office of Public Health (OPH) Bureau of Emergency Services (BEMS). Responsible for conducting unbiased examination activities for all candidates. Participates in the examination process by acting in any one of three defined positions as follows: Skill Examiner - provides specific and consistent instructions to each candidate. Records, totals and documents all performances as required on skill evaluation forms and submit to the National Registry Representative and/or Exam Coordinator. EMT Assistant - serves as the trained partner for all candidates testing. Simulated Patient - effectively acts out the role of an actual patient in a similar hospital situation; assists the skill examiner when reviewing a candidate's performance, and verifies completion of a procedure or treatment. Arrives at the examination site at the time indicated on the communication received from the Exam Coordinator to meet with the National Registry Representative and/or Exam Coordinator and receive assignments. Thoroughly reads the specific essay for the assigned skill before the actual evaluation begins, and role-play if necessary. Checks all equipment, props, and moulage before and during the examination. Assures professional conduct of all personnel involved with the particular skill throughout the examination. Maintains the security and integrity of all examination material. Maintains confidentiality of candidates and their performance results. Fairly and accurately completes all skill evaluation forms. Spotlights common areas of weakness to the National Registry Representative and/or Exam Coordinator. Other tasks as assigned. QUALIFICATIONS REQUIRED: Bachelor's degree, or Associate's degree plus 3 years of professional experience, or 6 years of professional work experience. Minimum 2 years professional experience in the Emergency Medical Services (EMS) profession. National certification from the National Registry of EMTs. Licensed Louisiana EMS Clinician. Excellent analytical and critical thinking skills; effective organizational and time management skills. Great attention to detail and follow up. Ability to manage projects, assignments, and competing priorities. Proficient in the use of Zoom, Teams, and Microsoft Office, including but not limited to Outlook, Word, and Excel. DESIRED: Advanced degree. Minimum 6 years professional experience in the Emergency Medical Technician (EMT) profession. Minimum 2 years performing administrative functions within an office environment or health care field. Minimum 1 year professional experience working as an EMS examiner. Additional relevant industry certifications or training. Required Attachments Please upload the following documents in the Resume/Cover Letter section. Detailed resume listing relevant qualifications and experience; Cover Letter indicating why you are a good fit for the position and University of Louisiana Systems; Names and contact information of three references; Applications that do not include the required uploaded documents may not be considered. Posting Close DateThis position will remain open until filled. Note to Applicant: Applicants should fully describe their qualifications and experience with specific reference to each of the minimum and preferred qualifications in their cover letter. The search committee will use this information during the initial review of application materials. References will be contacted at the appropriate phase of the recruitment process. This position may require a criminal background check to be conducted on the candidate(s) selected for hire. As part of the hiring process, applicants for positions at the University of New Orleans may be required to demonstrate the ability to perform job-related tasks. The University of New Orleans is an Affirmative Action and Equal Employment Opportunity employer. We do not discriminate on the basis of race, gender, color, religion, national origin, disability, sexual orientation, gender identity, protected Veteran status, age if 40 or older, or any other characteristic protected by federal, state, or local law.

Integral part of helping Louisiana thrive through efficient and consistent handling of injured workers claims. Investigating assigned claims through completion. Provides unparalleled customer experience for all our stakeholders. Major Areas of Accountability General Participates in a formal training program to develop the knowledge and skills to handle insurance claims involving work-related accidents. Is responsible for the well-being of hundreds of Louisiana employees who are injured. Examine claims forms and other records to determine insurance coverage. Interview or correspond with our policyholders, claimants, witnesses, physicians, or other relevant parties to complete investigation. Investigate facts of loss to determine extent of injury. Review and understand police reports, medical treatment records, medical bills, and other insurance documents during the duration of the claim. Adjust reserves or provide reserve recommendations to establish the value of the claim consistent with corporate policies. Negotiate claim settlement opportunities. Confer with legal counsel on claims involving litigation. Takes initiative and manages personal claim caseload in accordance with processes and procedures with a focus on individual, team and departmental goals. Seeks opportunities for improvement and continued learning Maintains required LA Workers' Compensation Adjuster License. Performs other job duties as needed by the department Personality/Working Style Strong character Alignment with company values, mission, and vision Trustworthy and honest Decisive Curious and persistent Passion for innovation Willingness to learn Adaptive to changing (tolerance for ambiguity) Desire to collaborate to achieve corporate goals Strong communicator Effective communication skills Empathetic listener and open-minded Commitment to accountability Education and Experience Education Required: Bachelor's degree and a minimum of 2 years handling of workers' compensation claims, or 4 years of experience as an insurance claims adjuster. OR High School Diploma/GED with 2 years handling of workers' compensation claims and 4 years of experience as an insurance claims adjuster. Active Louisiana Workers' Compensation Adjuster License required prior to start or obtained within seven (7) business days after start date. Skills Required: Communication, computer literate, math, judgement and problem-solving skills.

Do you enjoy processing loan applications? Does working with customer credit, underwriters and line partners bring satisfaction in your work life? If so, apply with us! We're looking for a great person to support the goals and our Centralized Lending Commercial team which includes credit support for underwriting and portfolio management functions. Underwriting Support: * Demonstrates an understanding of applicable credit products and requirements. * Determine appropriate underwriting channel based on transaction size, collateral, and total to be approved. * Triage loan applications for missing financial information based on requirements. * Request and follow up with appropriate financial documents for new money and renewal requests. * Determine the appropriate underwriting channel along with the required documentation and manage the collection of required documentation. Research & Documentation: * Research imaged files to determine outstanding and required documentation required to underwrite loan. * Identify missing guarantor and/or co-borrowers within submitted loan application. * Screen loan applications for requests submitted in wrong channels. * Ensure recognition of several different types of financial documentation. Evaluate submitted information for completeness and accuracy as needed. * Verify borrower related debt and deposit information is correct and aligns with the origination. * Be versed in the recognition of a complete financial statement and have the ability to determine if the information is usable to the underwriter. Administrative: * Image supporting documents into loan origination system while following accuracy standards. * Upload financial data into the underwriting system. * Ability to compose and track written communication to customer and line partners. * Daily written and verbal communication with financial center personnel, management, and underwriters. Required: * Education: High School diploma or GED required; Ideal candidate will have a degree (Associate or Bachelor) preferred. * Prior experience in credit underwriting support, or role closely aligned with credit, loans and effectively supporting loan functions. * Communication: Above average written and oral communication skills including the ability to compose emails and communicate via telephone conversations to internal customers that properly represent First Horizon Bank and communicate the intent of the current loan application. Ability to use critical thinking to complete job responsibilities. Ability to make decisions independently based on training and written procedures and processes. * Technical knowledge: Basic knowledge of consumer and/or commercial loan documentation and products. Knowledge of internet research methods. Thorough knowledge of basic internet search engines. Good working knowledge of Microsoft Office, especially Microsoft Outlook is required. * nCinco knowledge preferred but not required. * HMDA (Home Mortgage Disclosure Act) knowledge preferred but not required About Us First Horizon Corporation is a leading regional financial services company, dedicated to helping our clients, communities and associates unlock their full potential with capital and counsel. Headquartered in Memphis, TN, the banking subsidiary First Horizon Bank operates in 12 states across the southern U.S. The Company and its subsidiaries offer commercial, private banking, consumer, small business, wealth and trust management, retail brokerage, capital markets, fixed income, and mortgage banking services. First Horizon has been recognized as one of the nation's best employers by Fortune and Forbes magazines and a Top 10 Most Reputable U.S. Bank. More information is available at ********************* Benefit Highlights * Medical with wellness incentives, dental, and vision * HSA with company match * Maternity and parental leave * Tuition reimbursement * Mentor program * 401(k) with 6% match * More -- FirstHorizon.com/First-Horizon-National-Corporation/Careers/Our-Benefits Follow Us Facebook X formerly Twitter LinkedIn Instagram YouTube

Pre-Billing / Claims Processing Specialist (On-Site - Houma, LA) The Pre-Billing / Claims Processing Specialist is responsible for preparing, reviewing, and submitting clean, accurate claims to insurance companies for payment. This role is critical to minimizing denials and ensuring timely reimbursement. Key Responsibilities Review charges, patient demographics, diagnosis codes, and insurance information for accuracy Process and submit insurance claims using CollaborateMD Ensure claims meet payer and regulatory requirements prior to submission Identify and correct errors before claims are released Collaborate with AR and Billing Admin teams to resolve pre-billing issues Maintain timely claim submission and productivity standards Address claim rejections related to data entry or formatting errors Why Work at PGL Play a key role in a high-impact function where clean claims drive financial success Gain hands-on experience with CollaborateMD and laboratory billing workflows Work in a structured environment that prioritizes accuracy, training, and process consistency Be part of a growing organization that values career development and internal growth opportunities Work Location This position is on-site in Houma, Louisiana This is not a remote position Qualifications & Skills Experience in medical billing or claims processing preferred Knowledge of CPT, ICD-10, and insurance guidelines Strong attention to detail and organizational skills Ability to manage volume while maintaining accuracy

The Booking/Funding Processor I - Commercial will be responsible for all special attention loans, renewals, lines of credit, revolving and indirect tickets, maintenance, and upload of loans. RENASANT BANK IS AN EQUAL OPPORTUNITY EMPLOYER Responsibilities * Enter lines of credit, revolving and indirect loans * Set up commitments for loans tied to lines of credit and update as needed * Make necessary changes, adjustments corrections, etc., to all loan types * Separate new loans from special attention loans * Make and verify loan tickets before going to proof * Post special payments on computer * Post advances to line of credit on computer * Adjust gross income on renewed loans daily * Place holds on accounts securing loans * Perform other work as needed * Set up all tickets on all documents that require tracking * Edit loans against editing guidelines * Perform other related duties as assigned Qualifications * High school diploma or equivalent required * Good basic computer and data entry skills * General loan document knowledge * Good mathematics, accounting, and balancing skills Physical Demands The physical demands described 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 frequently required to stand or sit; kneel, stoop, or squat; use hands or fingers to handle or feel objects, tools or controls; reach with hands and arms, and talk or hear. The employee is occasionally required to walk. The employee must occasionally lift and /or move up to 25 pounds. Specific vision abilities required by this job include close vision, peripheral vision, depth perception and the ability to focus. Work Environment The Bank's professional working environment requires employees to communicate effectively, both verbally and in writing. Employees must demonstrate strong interpersonal skills when working closely with internal business partners and external clients. Employees may be exposed to confidential and propriety information within the working environment, therefore, must uphold confidentiality at all times. Due to the possibility of being exposed to high risk situations (i.e. robbery), detailed instructions and procedures are required to be followed at all times to safeguard the Bank's employees, customers, and assets. The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities, or requirements. The principal duties and responsibilities enumerated are all essential job functions except for those that begin with the word "May". This is intended to describe the normal level of work required by the person performing the work. The principle duties outlined are the essential responsibilities and duties. Other duties may be assigned as needs arise. Job requirements and/or processes may be modified to reasonably accommodate persons with a disability as required by law. This description is not intended as a contract and is subject to change. Any written contractual agreements supersede this job description.