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Claim processor jobs in Rhode Island

- 15 jobs
  • Claims Follow Up Rep

    Brown University Health 4.6company rating

    Claim processor job in Providence, RI

    SUMMARY: Under general supervision of the Follow-up Supervisor, performs all duties necessary to follow up on outstanding claims and correct all denied claims for a large physician multi-specialty practice. Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include: Instill Trust and Value Differences Patient and Community Focus and Collaborate RESPONSIBILITIES: Review all denied claims, correct them in the system and send correctedppealed claims asbr / written correspondence, fax or via electronic submission. Identify and analyze denials and enact corrective measures as needed to effectivelybr / communicate and resolve payer errors. Continually maintain knowledge of payer specific updates via payer's listservs, providerbr / updates, webinars, meetings and websites. Understand and maintain compliance with HIPAA guidelines when handling patient information Contact internal departments to acquire missing or erroneous information on a claimbr / resulting in adjudication delays or denials. Report to supervisor identification of denial trends resulting in revenue delays. Answers telephone inquiries from 3rd party payers; refer all unusual requests tobr / supervisor. Retrieve appropriate medical records documentation based on third party requests. Refer all accounts to supervisor for additional review if the account cannot be resolvedbr / according to normal procedures. Work with management to improve processes, increase accuracy, create efficiencies andbr / achieve the overall goals of the department. Maintain quality assurance, safety, environmental and infection control in accordancebr / with established policies, procedures, and objectives of the system andbr / affiliates. Perform other related duties as required. MINIMUM QUALIFICATIONS: BASIC KNOWLEDGE: Equivalent to a high school graduate. Knowledge of 3rd party billing to include ICD, CPT, HCPCS and 1500 claim forms. Demonstrated skills in critical thinking, diplomacy and relationship-building. Highly developed communication skills, successfully demonstrated in effectively working with a wide variety of people in both individual and team settings. Demonstrated problem-solving and inductive reasoning skills which manifest themselves in creative solutions for operational inefficiencies. EXPERIENCE: One to three years of relevant experience in professional billing preferred. Experience with Epic a plus. INDEPENDENT ACTION: Incumbent generally establishes own work plan based on pre-determined priorities and standard procedures to ensure timely completion of assigned work. Problems needing clarification are reviewed with supervisor prior to taking action. SUPERVISORY RESPONSIBILITY: None Pay Range: $19.58-$32.31 EEO Statement: Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment. Location: Corporate Headquarters - 15 LaSalle Square Providence, Rhode Island 02903 Work Type: Mon-Fri 7:30-4 Work Shift: Day Daily Hours: 8 hours Driving Required: No
    $19.6-32.3 hourly 1d ago
  • Phleb/Processor

    Prime Healthcare 4.7company rating

    Claim processor job in Woonsocket, RI

    At Landmark Medical Center, our dedicated team of professionals is committed to our core values of quality, compassion, and community. As a member of Prime Healthcare, Landmark Medical Center is actively seeking new members to join its award-winning team! Landmark Medical Center is a 214-bed acute care hospital in Woonsocket, RI. The hospital has been “A”rated for patient safety by The Leapfrog Group and has received numerous Healthgrades awards for patient safety excellence, heart care, and orthopedics. Originally known as the "Woonsocket Hospital," Landmark Medical Center has been serving the communities of northern Rhode Island and southern Massachusetts since 1873. Learn more at ************************ Responsibilities The Phlebotomy Technician I primarily perform skin puncture or venipuncture on patients of all ages for the purpose of obtaining a blood specimen for analysis in the clinical laboratory and is under the supervision of Laboratory Director / Manager / Supervisor. The PT I; 1) performs computer data entry, filing, telephone communication and other clerical duties, 2) possesses adequate knowledge of the terminology of tests ordered in the laboratory, 3) demonstrates good communication skills and telephone etiquette in greeting patients and other visitors in a polite and friendly manner, 4) demonstrates proper phlebotomy technique and the use of equipment in collecting specimens from newborns to geriatric patients, 5) processes microbiology, immunology, hematology, coagulation, urinalysis, chemistry and blood bank specimens, 6) processes specimens for referral to reference laboratories, 7) stocks and orders routine supplies, 8) maintains the cleanliness of storage areas, trays, centrifuges, refrigerators, freezers and work areas, 9) processes or load specimens on automated laboratory instrumentation in accordance with established policy and procedures, 10) May be assist to Pick up samples at hospital/ OR, assist lab specialty in sorting out samples for analysis and put away samples, assist pathology, inventory, replenish supplies, order supplies, mail pick up/ delivery, faxing, answering phone, product deliveries, etc.. 11) other tasks or responsibilities may be assigned by the department manager/director. Qualifications EDUCATION, EXPERIENCE, TRAINING 1. High School Diploma, or equivalent, required 2. Current BCLS (AHA) certificate upon hire and maintain current. 3. Minimum 1 year clinical laboratory experience preferred #LI-DQ1 Employment Status Per Diem Shift Variable Equal Employment Opportunity Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: ******************************************************************************************** Options Apply for this job online Email this job to a friend Refer Sorry the Share function is not working properly at this moment. Please refresh the page and try again later. Share on your newsfeed
    $32k-37k yearly est. Auto-Apply 60d+ ago
  • Claims Examiner

    Heritage Insurance 4.2company rating

    Claim processor job in Johnston, RI

    Investigates, evaluates, reserves, negotiates and settles assigned claims in accordance with Best Practices. Provides quality claim handling and superior customer service on assigned claims, while engaging in indemnity and expense management. Promptly manages claims by completing essential functions including contacts, investigation, damages development, evaluation, reserving, and disposition. Responsibilities: * Provides voice to voice contact within 24 hours of first report. * Conducts timely coverage analysis and communication with insured based on application of policy information, facts or allegations of each case. Consults with Unit Manager on use of Claim Coverage Counsel. * Investigates each claim through prompt contact with appropriate parties such as policyholders, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent of liability, damages, and contribution potential. Records necessary statements. * Identifies resources for specific activities required to properly investigate claims such as Subro, Fire or Fraud investigators and to other experts. Requests through Unit Manager and coordinates the results of their efforts and findings. * Verifies the nature and extent of injury or property damage by obtaining and reviewing appropriate records and damages documentation. * Maintains effective diary management system to ensure that all claims are handled timely. Evaluates liability and damages exposure, and establishes proper indemnity and expense reserves, at required time intervals. * Utilizes evaluation documentation tools in accordance with department guidelines. * Responsible for prompt, cost effective, and proper disposition of all claims within delegated authority. * Negotiate disposition of claims with insured's and claimants or their legal representatives. Recognizes and implements alternate means of resolution. * Maintains and document claim file activities in accordance with established procedures. * Attends depositions and mediations and all other legal proceedings, as needed. * Protects organization's value by keeping information confidential. * Maintains compliance with Claim Department's Best Practices. * Provides quality customer service and ensures file quality * Supports workload surges and/or Catastrophe operations as needed to include working significant overtime during designated CATs. * Communicates with co-workers, management, clients, vendors, and others in a courteous and professional manner. * Participates in special projects as assigned. * Some overnight travel maybe required. * Maintains the integrity of the company and products offered by complying with federal and state regulations as well as company policies and procedures. Qualifications: * Associate's Degree required; Bachelor's Degree preferred. A combination of education and significant directly related experience may be considered in lieu of degree. * Adjuster Licensure required. * One to three years of experience processing claims; property and casualty segment preferred. * Experience with Xactware products preferred. * Demonstrated ability to research, conduct proactive investigations and negotiate successful resolutions. * Proficiency with Microsoft Office products required; internet research tools preferred. * Demonstrated customer service focus / superior customer service skills. * Excellent communication skills and ability to interact on a professional level with internal and external personnel * Results driven with strong problem solving and analytical skills. * Ability to work independently in a fast paced environment; meets deadlines, and manages changing priorities effectively. * Detail-oriented and exceptionally organized * Collaborative partner; ability to contribute to a positive work environment. General Information: All employees must pass a pre-employment background check. Other checks may be needed based on position: driving history, credit report, etc. The preceding has been designed to indicate the general nature of work performed; the level of knowledge and skills typically required; and usual working conditions of this position. It is not designed to contain, or be interpreted as, a comprehensive listing of all requirements or responsibilities that may be required by employees in this job. Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time. Heritage Insurance Holdings, Inc. is an Equal Opportunity Employer. We will not discriminate unlawfully against qualified applicants or employees with respect to any term or condition of employment based on race, color, national origin, ancestry, sex, sexual orientation, age, religion, physical or mental disability, marital status, place of birth, military service status, or other basis protected by law.
    $41k-59k yearly est. 21d ago
  • Welcome Center Representative at Greater Providence YMCA

    Mana Ger 4.4company rating

    Claim processor job in Providence, RI

    Job Description Provide membership information and service, promote and sell programs and memberships, participate in administrative support functions, while working in a fast-paced environment. Reports To: Job type: Part-time Member Services Coordinator/Director Essential Duties & Responsibilities: Include the following. Other duties may be assigned · Provide information regarding membership and program offerings by staying abreast of program brochure information and special events as well as facility schedules, being prepared to provide personalized direction to other services. · Work in a fast-paced environment and deal with the public in a professional manner · Aggressively promote and sell membership. · Process all membership, camp, program, and child care registrations. · Process membership ID's and issue to members. · Answer all telephone calls within 3 rings in a professional manner and in accordance with branch procedures. · May assist with or provide facility tours · Greet members by name in a friendly manner while exhibiting the YMCA character values of caring, honesty, respect and responsibility. · Retain membership confidentiality in financial and personal matters handling every situation in a professional manner. · Maintain composure in adverse situation regarding members, with the ultimate goal being win/win situation. · Reconcile end of shift money received through the sale of membership, merchandise, camp, program, and child care registrations. · Provide administrative support such as typing, data entry, photocopying, and faxing. · Maintain good public relations with members and direct serious matters to your supervisor. · Work in harmony and cooperation with staff, volunteers, and members of the YMCA to develop team spirit and family atmosphere. · Attend staff/team meetings and events. · Arrive on time and prepared for scheduled shift. Obtain substitute coverage when unable to work scheduled shift. · Assist with insuring a risk free environment, i.e. caution people regarding unsafe practices and conditions. Report accidents and injuries and complete incident reports. YMCA of Greater Providence Team Standards: 1. Know our mission and be able to tell our story. The mission of the YMCA of Greater Providence is to build healthy spirit, mind and body for all, through programs, services and relationships that are based on our core values of caring, honesty, respect and responsibility. 2. Honor your colleagues by being on time, present and fully engaged at all times. 3. If you disagree, propose a solution. 4. Be accountable for results. 5. A commitment to valuing and acting as one YMCA as evidenced by referring to ourselves as employees of the YMCA of Greater Providence. 6. Display leadership that requires not only skill, but energy, passion, optimism and creativity. 7. Build open and honest communication. Face to face, or voice to voice, is the preferred method of communication with email for information sharing only. 8. Deliver exceptional service that is of high value. Build a positive staff team. Be friendly. Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and/or Experience: High School Diploma preferred. No specific experience required. Reasoning Ability: Ability to anticipate, identify and address members needs to ensure safety and enjoyment. To accurately complete all required paperwork. To professionally handle and or get help to resolve conflict. The ability to follow instructions as given and/or directed by supervisor. Certifications / Training: CPR and First Aid Certifications - within 1st 30 days of employment and must keep up to date throughout employment. OSHA Training, Child Care Prevention, Listen First - Within 1st 90 days of employment It is the Employees responsibility to maintain all certifications and renew in a timely manner in accordance with Certifying Organization. Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to stand; walk; sit; use hands to finger, handle, or feel; reach with hands; balance, stoop, kneel or crouch; and talk or hear. The employee must occasionally lift and/or move up to 100 pounds. Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The position has exposure to Blood borne Pathogens and the incumbent will be educated and prepared to do so. The noise level in the work environment is usually moderate.
    $25k-31k yearly est. 23d ago
  • Vault Processor

    Brink's 4.0company rating

    Claim processor job in Smithfield, RI

    The Brink's Company (NYSE:BCO) is a leading global provider of cash and valuables management, digital retail solutions, and ATM managed services. Our customers include financial institutions, retailers, government agencies, mints, jewelers, and other commercial operations. Our network of operations in 52 countries serves customers in more than 100 countries. We believe in building partnerships that secure commerce and doing that requires fostering an engaged culture that values people with diverse backgrounds, ideas, and perspectives. We build a sense of belonging, so all employees feel respected, safe, and valued, and we provide equal opportunity to participate and grow. Job Description Who We Are: Brink's U.S., a division of Brink's Incorporated, is the trusted leader in armored transportation, currency processing, ATM services, and secure logistics for banks, retailers, and government clients. We take pride in offering our employees meaningful career growth and advancement opportunities. As a Vault Processor, you'll handle, secure, and process large volumes of cash and valuables within Brink's vaults. This position plays a key role in maintaining the flow of currency between financial institutions and commercial clients, with a strong emphasis on accuracy, security, and team collaboration. Key Responsibilities: + Securely manage vault operations and protect assets + Prepare, verify, and process cash shipments and deposits + Record and report all transactions with accuracy + Enter liability and inventory data into tracking systems + Monitor machinery and workflows + Follow all safety and security procedures Minimum Qualifications: + At least 21 years old + Able to lift up to 50 lbs + Proficient in data entry + Able to obtain a firearms permit and guard card Preferred Qualifications: + Experience with vault operations or cash handling + Military background + Familiarity with ATM servicing, deposit processing, or account reconciliation Benefits & Perks: + Access to benefits after 30 days of employment! Medical, Dental, Vision, 401K, Paid Holidays & Vacation Hours (For Full Time positions). Link to our benefits: brinksbenefits.com (********************************************************************************************* + Uniforms and protective gear provided + Opportunities for internal growth in a team-first culture Brink's is an equal opportunity employer and is committed to providing a workplace free of discrimination and harassment. We consider all qualified applicants for employment without regard to race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, or any other protected characteristic under applicable law. We believe in fostering an inclusive environment where everyone feels respected, valued, and empowered to succeed. What's Next? Thank you for considering applying for a job at Brink's. To be considered for this position, you must complete the entire application process, which includes answering all prescreening questions and providing your eSignature. Upon completion of the application process, you will receive an email confirming that we have received your application. We will review all candidates and notify you of your status should we deem you fit for a job. Thank you again for your interest in a career at Brink's. For more information about future career opportunities, join our talent network, like our Facebook page or Follow us on X. Brink's is an equal opportunity/affirmative action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, marital status, protected veteran status, sexual orientation, gender identity, genetic information, or history or any other characteristic protected by law. Brink's is also committed to providing a drug-free workplace. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state, or local protected class. Build a Career with Purpose at Brink's For over 165 years, Brink's has been a trusted global leader in secure logistics and cash and valuables management solutions. Today, we continue to evolve-powered by technology, driven by purpose, and united by values. With a legacy built on trust and a future driven by innovation, Brink's partners for customer success, empowering businesses across the globe to operate with confidence and peace of mind. At Brink's, we operate in more than 100 countries, across cultures and languages, yet we're one team-committed to protecting what matters most. Our people are at the heart of everything we do. We foster a culture of collaboration, innovation, and continuous learning, where every team member is empowered to grow, take ownership, and make an impact. No matter which business area or country you are located, Brink's offers a place to build a meaningful career. Here, you'll find opportunities to develop your skills, contribute to global solutions, and be part of something bigger. We believe in doing what's right, working together, and striving for excellence. If you're looking for a career that combines purpose with performance, Brink's is the place for you. Brink's is proud to be an equal opportunity employer. If you need reasonable accommodations/adjustments during the hiring process, please let your recruiter know we're here to support you every step of the way. See the "Terms and Conditions for Brink's" at: Terms of Use - Brink's US (*********************************** See the "Brink's California Consumer Privacy Notice" at: Brink's California Consumer Privacy Act Notice - Brink's US (********************************************************************
    $28k-34k yearly est. 37d ago
  • Claims Representative (IAP) - Workers Compensation Training Program

    Sedgwick 4.4company rating

    Claim processor job in Providence, RI

    By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work Fortune Best Workplaces in Financial Services & Insurance Claims Representative (IAP) - Workers Compensation Training Program Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career? + A stable and consistent work environment in an office setting. + A training program to learn how to help employees and customers from some of the world's most reputable brands. + An assigned mentor and manager who will guide you on your career journey. + Career development and promotional growth opportunities through increasing responsibilities. + A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs. **PRIMARY PURPOSE OF THE ROLE:** To be oriented and trained as new industry professional with the ability to analyze workers compensation claims and determine benefits due. **ARE YOU AN IDEAL CANDIDATE?** We are seeking enthusiastic individuals for an entry-level trainee position. This role begins with a comprehensive 6-week classroom-based professional training program designed to equip you with the foundational skills needed for a successful career in claims adjusting. Over the course of a few years, you'll have the opportunity to grow and advance within the field. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Attendance and completion of designated classroom claims professional training program. + Performs on-the-job training activities including: + Adjusting lost-time workers compensation claims under close supervision. May be assigned medical only claims. + Adjusting low and mid-level liability and/or physical damage claims under close supervision. + Processing disability claims of minimal disability duration under close supervision. + Documenting claims files and properly coding claim activity. + Communicating claim action/processing with claimant and client. + Supporting other claims examiners and claims supervisors with larger or more complex claims as assigned. + Participates in rotational assignments to provide temporary support for office needs. **QUALIFICATIONS** Bachelor's or Associate's degree from an accredited college or university preferred. **EXPERIENCE** Prior education, experience, or knowledge of: - Customer Service - Data Entry - Medical Terminology (preferred) - Computer Recordkeeping programs (preferred) - Prior claims experience (preferred) Additional helpful experience: - State license if required (SIP, Property and Liability, Disability, etc.) - WCCA/WCCP or similar designations - For internal colleagues, completion of the Sedgwick Claims Progression Program **TAKING CARE OF YOU** + Entry-level colleagues are offered a world class training program with a comprehensive curriculum + An assigned mentor and manager that will support and guide you on your career journey + Career development and promotional growth opportunities + A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more _As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is 25.65/hr. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. #claims #claimsexaminer #entrylevel #remote #LI-Remote_ Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**
    $30k-40k yearly est. 8d ago
  • Specimen Processor

    Sonic Healthcare USA 4.4company rating

    Claim processor job in East Providence, RI

    We're not just a workplace - we're a Great Place to Work certified employer! Proudly certified as a Great Place to Work, we are dedicated to creating a supportive and inclusive environment. At Sonic Healthcare USA, we emphasize teamwork and innovation. Check out our job openings and advance your career with a company that values its team members! Job Description East Side Clinical Laboratory, a leader in the medical laboratory industry, is seeking a Specimen Processor to join our Specimen Processing Team because we are growing! LOCATION: 10 Risho Ave, East Providence, RI 02914 HOURS: 3:00pm - 11:30pm; Monday to Friday with Saturday rotations when needed FULL TIME: Benefits Eligible In this role you will: Verifies and matches information on requisitions and drawn specimens, received from the road phlebotomy, branch laboratory, physician's offices and courier departments. Enters accurately data for each patient relevant to the type of testing performed. Verifies patient name, address, method of payment and enters into computer system when necessary. Must adhere to departmental procedures regarding consistency and accuracy of information entered into the computer system. Adheres accession label to all specimens and requisitions for tracking and test reporting. Spins related blood specimens in centrifuge before forwarding to the appropriate department. Ensures that adequate amount of blood is drawn to perform all tests requested. May be required to aliquot blood specimens; process other blood fluids for distribution to departments and reference labs. Is responsible for verification of branch lab specimens received in the main laboratory. Ensures that an adequate amount of specimen is delivered to the appropriate department. Troubleshoots when specimen provided is insufficient and/or incorrect. Rechecks co-worker's data entry/requisitions/specimens handling for accuracy and quality control. Receive and processes stat work, which requires high priority attention. Troubleshoots problematic areas and notifies department supervisor. Any changes to original patient testing file must be reported to the appropriate technical supervisor. Maintains and files forms for all reference laboratory send outs for all East Side Clinical Laboratory locations. Follows up with the reference laboratory for missing reports. Knowledgeable in third-party financial billing procedures. If necessary, contacts proper individuals to obtain financial information. Results entry to reference lab reports (senior members). Required to work Saturday or weekend rotation as specified by departmental schedule. Performs other related duties as assigned. Extended hours may be required. All you need is: High School Diploma/GED required. Associate's Degree in related field preferred. Knowledge of third party billing, general laboratory procedures and basic computer and excellent typing skills. Must possess excellent communication and organizational skills. Ability to work in an organized manner. East Side Clinical Laboratory is an Equal Opportunity and Affirmative Action Employer. “All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of race, color, religion, sex, sexual orientation, national origin, age, disability or protected veteran status. East Side Clinical Laboratories takes affirmative action in support of its policy to advance in employment individuals who are minorities, women, protected veterans, and individuals with disabilities.” Scheduled Weekly Hours: 40 Work Shift: 2nd Shift (United States of America) Job Category: Laboratory Operations Company: East Side Clinical Laboratory, Inc. Sonic Healthcare USA is an equal opportunity employer that celebrates diversity and is committed to an inclusive workplace for all employees. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, age, national origin, disability, genetics, veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.
    $27k-35k yearly est. Auto-Apply 60d+ ago
  • Claims Follow Up Rep

    Brown University Health 4.6company rating

    Claim processor job in Providence, RI

    SUMMARY: Under general supervision of the Follow-up Supervisor, performs all duties necessary to follow up on outstanding claims and correct all denied claims for a large physician multi-specialty practice. Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include: Instill Trust and Value Differences Patient and Community Focus and Collaborate RESPONSIBILITIES: Review all denied claims, correct them in the system and send correctedppealed claims asbr / written correspondence, fax or via electronic submission. Identify and analyze denials and enact corrective measures as needed to effectivelybr / communicate and resolve payer errors. Continually maintain knowledge of payer specific updates via payer's listservs, providerbr / updates, webinars, meetings and websites. Understand and maintain compliance with HIPAA guidelines when handling patient information Contact internal departments to acquire missing or erroneous information on a claimbr / resulting in adjudication delays or denials. Report to supervisor identification of denial trends resulting in revenue delays. Answers telephone inquiries from 3rd party payers; refer all unusual requests tobr / supervisor. Retrieve appropriate medical records documentation based on third party requests. Refer all accounts to supervisor for additional review if the account cannot be resolvedbr / according to normal procedures. Work with management to improve processes, increase accuracy, create efficiencies andbr / achieve the overall goals of the department. Maintain quality assurance, safety, environmental and infection control in accordancebr / with established policies, procedures, and objectives of the system andbr / affiliates. Perform other related duties as required. MINIMUM QUALIFICATIONS: BASIC KNOWLEDGE: Equivalent to a high school graduate. Knowledge of 3rd party billing to include ICD, CPT, HCPCS and 1500 claim forms. Demonstrated skills in critical thinking, diplomacy and relationship-building. Highly developed communication skills, successfully demonstrated in effectively working with a wide variety of people in both individual and team settings. Demonstrated problem-solving and inductive reasoning skills which manifest themselves in creative solutions for operational inefficiencies. EXPERIENCE: One to three years of relevant experience in professional billing preferred. Experience with Epic a plus. INDEPENDENT ACTION: Incumbent generally establishes own work plan based on pre-determined priorities and standard procedures to ensure timely completion of assigned work. Problems needing clarification are reviewed with supervisor prior to taking action. SUPERVISORY RESPONSIBILITY: None Pay Range: $19.58-$32.31 EEO Statement: Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment. Location: Corporate Headquarters - 15 LaSalle Square Providence, Rhode Island 02903 Work Type: Monday-Friday 7:30-4 Work Shift: Day Daily Hours: 8 hours Driving Required: No
    $19.6-32.3 hourly 5d ago
  • Apparel processor 7-12pm

    Marshalls of Ma

    Claim processor job in East Providence, RI

    Marshalls At TJX Companies, every day brings new opportunities for growth, exploration, and achievement. You'll be part of our vibrant team that embraces diversity, fosters collaboration, and prioritizes your development. Whether you're working in our four global Home Offices, Distribution Centers or Retail Stores-TJ Maxx, Marshalls, Homegoods, Homesense, Sierra, Winners, and TK Maxx, you'll find abundant opportunities to learn, thrive, and make an impact. Come join our TJX family-a Fortune 100 company and the world's leading off-price retailer. Job Description: Opportunity: Grow Your Career Responsible for delivering a highly satisfied customer experience proven by engaging and interacting with all customers, embodying customer experience principles and philosophy, and maintaining a clean and organized store environment. Adheres to all operational, merchandise, and loss prevention standards. May be cross-trained to work in multiple areas of the store in order to support the needs of the business. Role models established customer experience practices with internal and external customers Supports and embodies a positive store culture through honesty, integrity, and respect Accurately rings customer purchases/returns and counts change back to customer according to established operating procedures Promotes credit and loyalty programs Maintains and upholds merchandising philosophy and follows established merchandising procedures and standards Accurately processes and prepares merchandise for the sales floor following company procedures and standards Initiates and participates in store recovery as needed throughout the day Maintains all organizational, cleanliness, and recovery standards for the sales floor and participates in the maintenance/cleanliness of the entire store Provides and accepts recognition and constructive feedback Adheres to all labor laws, policies, and procedures Supports and participates in store shrink reduction goals and programs Participates in safety awareness and maintains a safe environment Other duties as assigned Who We're Looking For: You. Possesses excellent customer service skills Able to work a flexible schedule to support business needs Possesses strong communication and organizational skills with attention to detail Capable of multi-tasking Able to respond appropriately to changes in direction or unexpected situations Capable of lifting heavy objects with or without reasonable accommodation Works effectively with peers and supervisors Retail customer experience preferred Benefits include: Associate discount; EAP; smoking cessation; bereavement; 401(k) Associate contributions; child care & cell phone discounts; pet & legal insurance; credit union; referral bonuses. Those who meet service or hours requirements are also eligible for: 401(k) match; medical/dental/vision; HSA; health care FSA; life insurance; short/long term disability; paid parental leave; paid holidays/vacation/sick; auto/home insurance discounts; scholarship program; adoption assistance. All benefits are provided in accordance with and subject to the terms of the applicable plan or program and may change from time to time. Contact your TJX representative for more information. In addition to our open door policy and supportive work environment, we also strive to provide a competitive salary and benefits package. TJX considers all applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, marital or military status, or based on any individual's status in any group or class protected by applicable federal, state, or local law. TJX also provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. Applicants with arrest or conviction records will be considered for employment. Address: 1925 Pawtucket Avenue Location: USA Marshalls Store 0163 East Providence RIThis position has a starting pay range of $15.00 to $15.50 per hour. Actual starting pay is determined by a number of factors, including relevant skills, qualifications, and experience.
    $15-15.5 hourly 60d ago
  • Claims Follow Up Rep

    Brown University Health 4.6company rating

    Claim processor job in Providence, RI

    SUMMARY: Under general supervision of the Claims Administration Follow-up Supervisor, perform all clerical duties necessary to properly process patient bills to customers taking appropriate follow-up steps to obtain timely reimbursement of each 3rd party claim and ensure the financial stability of the Hospital. Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include: Instill Trust and Value Differences Patient and Community Focus and Collaborate RESPONSIBILITIES: Consistently applies the corporate values of respect, honesty and fairness and the constant pursuit of excellence in improving the health status of the people of the region through the provision of customer-friendly, geographically accessible and high-value services within the environment of a comprehensive integrated academic health system. Responsible for knowing and acting in accordance with the principles of the Brown University Health Corporate Compliance Program and Code of Conduct. Review claim forms for all required data fields depending on the specific 3rd party requirements. Review patient account for demographic accuracy. Process all necessary system adjustments or changes as needed, such as adding/deleting insurance information, insurance priority changes, balance transfers, demographic changes, contractual allowances, and any other routine patient accounting adjustments not requiring supervisory approval ensuring accurate financial data. Analyze all assigned claims received from various sources to ensure accurate and timely reimbursement based on the individual payer's contracts or Federal reimbursement methods. Contact insurer via online systems, call centers, written correspondence, fax or appropriate electronic or paper billing of claims to secure payment. Maintains an understanding of the most current contract language in order to consistently ensure reimbursement in accordance with contract language. Continually maintains knowledge of payer specific updates via payer's listservs, provider updates, webinars, meetings and websites. Review payer's settlements for correct reimbursement and proceed with contact to insurer if claim is not adjudicated correctly based on working knowledge of the various payer's policies and each individual related contract. Identifies and analyzes denials and payment variances and enacts corrective measures as needed to effectively communicate and resolve payer errors. Understands and maintains compliance with HIPAA guidelines when handling patient information Initiate adjustments to payer's as appropriate after analyzing under or over payments based on contract, Federal regulation, late charge corrections or inappropriate denials. Submits appeals to payers as appropriate to recover denied revenue Contact internal departments to acquire missing or erroneous information on a claim resulting in adjudication delays or denials. Run reports as necessary to quantify various variances on patient accounts related to identified issues within the payers or as the result of known charging errors or procedural breakdown. Reports to supervisor identification of trends resulting in under/over payments, inappropriate denials or charging/billing discrepancies. Answer telephone inquiries from 3rd parties and interdepartmental calls. Refer all unusual requests to supervisor. Retrieve appropriate medical records documentation based on third party requests. Initiate the accurate and timely processing of all secondary and tertiary claims as needed according to specific 3rd party regulations. Process all incoming mail and follow up on all rejections received according to specific 3rd party regulations. Refer all accounts to supervisor for additional review if the account cannot be resolved according to normal patient accounting procedures. Works with supervisor, management and the patient accounting staff to improve processes, increase accuracy, create efficiencies and achieve the overall goals of the department. Maintain quality assurance, safety, environmental and infection control in accordance with established policies, procedures, and objectives of the system and affiliates. Perform other related duties as required. WORK LOCATIONS/EXPECTIONS: After orientation at the Corporate facilities, work is performed based on the following options approved by management and with adherence to a signed telecommuting work agreement and Patient Financial Services Remote Access Policy and Procedure. Full time schedule worked in office Full time schedule worked in a dedicated space in the home Part time schedule in office and in a dedicated space within the home Schedules must be approved in advance by management who will allow for flexibility that does not interfere with the ability to accomplish all job functions within the said schedule. Staff are required to participate in scheduled meetings and be available to management throughout their scheduled hours. Staff must be signed into Microsoft Teams during their entire shift and communicate with Supervisor as directed. MINIMUM QUALIFICATIONS: BASIC KNOWLEDGE: Equivalent to a high school graduate Knowledge of 3rd party billing to include ICD, CPT, HCPCS, UB and HCFA 1505 claim form Demonstrated skills in critical thinking, diplomacy and relationship-building Highly developed communication skills, successfully demonstrated in effectively working with a wide variety of people in both individual and team settings Demonstrated problem-solving and inductive reasoning skills which manifest themselves in creative solutions for operational inefficiencies. EXPERIENCE: One to three years of relevant experience in medical collections or professional/hospital billing preferred INDEPENDENT ACTION: Incumbent generally establishes own work plan based on pre-determined priorities and standard procedures to ensure timely completion of assigned work. Problems needing clarification are reviewed with supervisor prior to taking action. SUPERVISORY RESPONSIBILITY: None Pay Range: $19.58-$32.31 EEO Statement: Brown University Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, ethnicity, sexual orientation, ancestry, genetics, gender identity or expression, disability, protected veteran, or marital status. Brown University Health is a VEVRAA Federal Contractor. Location: Corporate Headquarters - 167 Point Street Providence, Rhode Island 02903 Work Type: M-F 7am-330pm Work Shift: Day Daily Hours: 8 hours Driving Required: No
    $19.6-32.3 hourly 19d ago
  • Home Equity Processor

    Citizens Financial Group 4.3company rating

    Claim processor job in Johnston, RI

    As a part of our team, you're made ready for a fulfilling career with exciting new challenges and opportunities to stretch yourself! When you are in this role, you will review submitted documentation to ensure compliance with bank requirements. Additionally, you will follow-up and review routine documentation requirements with customers, loan officers, branches, and other financial institutions. Furthermore, you will complete reviews within department standards and enter clear, concise comments, edit information and document application status on appropriate loan systems. Lastly, you will communicate professionally in oral and written format with internal and external customers regarding status requests, missing information, explanation of required documentation and/ or closing information. Most importantly, at Citizens, we're more than a bank and here you'll experience new things, create new opportunities, think beyond your role and make an impact! Primary responsibilities include Review loan application documentation. Interact with customers, work with both loan officers and branch colleagues to obtain required documents from customers, order and review property titles, appraisals, flood certifications, and income documents to ensure accuracy and completeness. Make welcome calls on new files, follow the department's call cadence throughout the process to ensure customer's are communicated direct and well informed of all aspects of their line in process. Ensure that documentation exists in the system of record of their call cadence contacts, results of the contact so that they and any colleague who reviews the file is aware of the file status. Act as main point of contact with customer during the processing of their loan application, review submitted documentation to ensure compliance with bank requirements. Follow-up and review routine documentation (paystubs/tax returns/W2's/trust documents/homeowners insurance/flood etc. requirements with customers, loan officer, branches, and other financial institutions) Knowledge of loan processing and related vendor reports and must be familiar with state and federal regulations. Complete review within department standards. Enter clear, concise comments, edit information and documents applications status on appropriate loan systems. Communicate professionally in oral and written format with internal and external customer regarding status requests, missing information, explanation of required documentations and/or closing information. Participate in daily huddles. Must have excellent oral communications skills. Qualifications, Education, Certifications and/or Other Professional Credentials 2+ years of either mortgage or home equity processing experience Knowledge of DTI and LTV ratios with ability to decipher loan documentation and related reports and/or websites Ability to calculate DTI and LTV ratios for alternative borrowing scenarios Able to read and understand different types of title reports and research title issues Able to read and explain to customers the content of appraisal reports Able to read and understand homeowners and flood insurance documents Able to complete flood packages Solid understanding of income documentation, including complicated tax returns Able to maintain a pipeline and meet customer touch point SLAs Experience in oral and written communication with internal and external customers Thorough understanding of Regulatory, State and Company guidelines, policies and procedures. High School Graduate or Equivalent Proficient PC skills Hours & Work Schedule Hours per Week: Monday-Friday Work Schedule: Johnston, RI - 4 days a week in office
    $31k-35k yearly est. Auto-Apply 60d+ ago
  • Vault Processor

    Brink's 4.0company rating

    Claim processor job in Smithfield, RI

    The Brink's Company (NYSE:BCO) is a leading global provider of cash and valuables management, digital retail solutions, and ATM managed services. Our customers include financial institutions, retailers, government agencies, mints, jewelers, and other commercial operations. Our network of operations in 52 countries serves customers in more than 100 countries. We believe in building partnerships that secure commerce and doing that requires fostering an engaged culture that values people with diverse backgrounds, ideas, and perspectives. We build a sense of belonging, so all employees feel respected, safe, and valued, and we provide equal opportunity to participate and grow. Job Description Who We Are: Brink's U.S., a division of Brink's Incorporated, is the trusted leader in armored transportation, currency processing, ATM services, and secure logistics for banks, retailers, and government clients. We take pride in offering our employees meaningful career growth and advancement opportunities. As a Vault Processor, you'll handle, secure, and process large volumes of cash and valuables within Brink's vaults. This position plays a key role in maintaining the flow of currency between financial institutions and commercial clients, with a strong emphasis on accuracy, security, and team collaboration. Key Responsibilities: Securely manage vault operations and protect assets Prepare, verify, and process cash shipments and deposits Record and report all transactions with accuracy Enter liability and inventory data into tracking systems Monitor machinery and workflows Follow all safety and security procedures Minimum Qualifications: At least 21 years old Able to lift up to 50 lbs Proficient in data entry Able to obtain a firearms permit and guard card Preferred Qualifications: Experience with vault operations or cash handling Military background Familiarity with ATM servicing, deposit processing, or account reconciliation Benefits & Perks: Access to benefits after 30 days of employment! Medical, Dental, Vision, 401K, Paid Holidays & Vacation Hours (For Full Time positions). Link to our benefits: brinksbenefits.com Uniforms and protective gear provided Opportunities for internal growth in a team-first culture Brink's is an equal opportunity employer and is committed to providing a workplace free of discrimination and harassment. We consider all qualified applicants for employment without regard to race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, or any other protected characteristic under applicable law. We believe in fostering an inclusive environment where everyone feels respected, valued, and empowered to succeed. What's Next? Thank you for considering applying for a job at Brink's. To be considered for this position, you must complete the entire application process, which includes answering all prescreening questions and providing your eSignature. Upon completion of the application process, you will receive an email confirming that we have received your application. We will review all candidates and notify you of your status should we deem you fit for a job. Thank you again for your interest in a career at Brink's. For more information about future career opportunities, join our talent network, like our Facebook page or Follow us on X. Brink's is an equal opportunity/affirmative action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, marital status, protected veteran status, sexual orientation, gender identity, genetic information, or history or any other characteristic protected by law. Brink's is also committed to providing a drug-free workplace. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state, or local protected class.
    $28k-34k yearly est. Auto-Apply 38d ago
  • Claims Follow Up Rep TC

    Brown University Health 4.6company rating

    Claim processor job in Providence, RI

    SUMMARY: Under general supervision of the Claims Administration Follow-up Supervisor, perform all clerical duties necessary to properly process patient bills to customers taking appropriate follow-up steps to obtain timely reimbursement of each 3rd party claim and ensure the financial stability of the Hospital. Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include: Instill Trust and Value Differences Patient and Community Focus and Collaborate RESPONSIBILITIES: Consistently applies the corporate values of respect, honesty and fairness and the constant pursuit of excellence in improving the health status of the people of the region through the provision of customer-friendly, geographically accessible and high-value services within the environment of a comprehensive integrated academic health system. Responsible for knowing and acting in accordance with the principles of the Brown University Health Corporate Compliance Program and Code of Conduct. Review claim forms for all required data fields depending on the specific 3rd party requirements. Review patient account for demographic accuracy. Process all necessary system adjustments or changes as needed, such as adding/deleting insurance information, insurance priority changes, balance transfers, demographic changes, contractual allowances, and any other routine patient accounting adjustments not requiring supervisory approval ensuring accurate financial data. Analyze all assigned claims received from various sources to ensure accurate and timely reimbursement based on the individual payer's contracts or Federal reimbursement methods. Contact insurer via online systems, call centers, written correspondence, fax or appropriate electronic or paper billing of claims to secure payment. Maintains an understanding of the most current contract language in order to consistently ensure reimbursement in accordance with contract language. Continually maintains knowledge of payer specific updates via payer's listservs, provider updates, webinars, meetings and websites. Review payer's settlements for correct reimbursement and proceed with contact to insurer if claim is not adjudicated correctly based on working knowledge of the various payer's policies and each individual related contract. Identifies and analyzes denials and payment variances and enacts corrective measures as needed to effectively communicate and resolve payer errors. Understands and maintains compliance with HIPAA guidelines when handling patient information Initiate adjustments to payer's as appropriate after analyzing under or over payments based on contract, Federal regulation, late charge corrections or inappropriate denials. Submits appeals to payers as appropriate to recover denied revenue Contact internal departments to acquire missing or erroneous information on a claim resulting in adjudication delays or denials. Run reports as necessary to quantify various variances on patient accounts related to identified issues within the payers or as the result of known charging errors or procedural breakdown. Reports to supervisor identification of trends resulting in under/over payments, inappropriate denials or charging/billing discrepancies. Answer telephone inquiries from 3rd parties and interdepartmental calls. Refer all unusual requests to supervisor. Retrieve appropriate medical records documentation based on third party requests. Initiate the accurate and timely processing of all secondary and tertiary claims as needed according to specific 3rd party regulations. Process all incoming mail and follow up on all rejections received according to specific 3rd party regulations. Refer all accounts to supervisor for additional review if the account cannot be resolved according to normal patient accounting procedures. Works with supervisor, management and the patient accounting staff to improve processes, increase accuracy, create efficiencies and achieve the overall goals of the department. Maintain quality assurance, safety, environmental and infection control in accordance with established policies, procedures, and objectives of the system and affiliates. Perform other related duties as required. WORK LOCATIONS/EXPECTIONS: After orientation at the Corporate facilities, work is performed based on the following options approved by management and with adherence to a signed telecommuting work agreement and Patient Financial Services Remote Access Policy and Procedure.. Full time schedule worked in office Full time schedule worked in a dedicated space in the home Part time schedule in office and in a dedicated space within the home Schedules must be approved in advance by management who will allow for flexibility that does not interfere with the ability to accomplish all job functions within the said schedule. Staff are required to participate in scheduled meetings and be available to management throughout their scheduled hours. Staff must be signed into Microsoft Teams during their entire shift and communicate with Supervisor as directed. MINIMUM QUALIFICATIONS: BASIC KNOWLEDGE: Equivalent to a high school graduate Knowledge of 3rd party billing to include ICD, CPT, HCPCS, UB and HCFA 1505 claim form Demonstrated skills in critical thinking, diplomacy and relationship-building Highly developed communication skills, successfully demonstrated in effectively working with a wide variety of people in both individual and team settings Demonstrated problem-solving and inductive reasoning skills which manifest themselves in creative solutions for operational inefficiencies. EXPERIENCE: One to three years of relevant experience in medical collections or professional/hospital billing preferred INDEPENDENT ACTION: Incumbent generally establishes own work plan based on pre-determined priorities and standard procedures to ensure timely completion of assigned work. Problems needing clarification are reviewed with supervisor prior to taking action. SUPERVISORY RESPONSIBILITY: None Pay Range: $19.58-$32.31 EEO Statement: Brown University Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, ethnicity, sexual orientation, ancestry, genetics, gender identity or expression, disability, protected veteran, or marital status. Brown University Health is a VEVRAA Federal Contractor. Location: Corporate Headquarters - 167 Point Street Providence, Rhode Island 02903 Work Type: 8-Hour Shift: Monday-Friday, 7:00am-3:30pm Work Shift: Day Daily Hours: 8 hours Driving Required: No
    $19.6-32.3 hourly 25d ago
  • Specimen Processor (Part Time - 2nd shift) East Providence, RI

    Sonic Healthcare USA 4.4company rating

    Claim processor job in East Providence, RI

    We're not just a workplace - we're a Great Place to Work certified employer! Proudly certified as a Great Place to Work, we are dedicated to creating a supportive and inclusive environment. At Sonic Healthcare USA, we emphasize teamwork and innovation. Check out our job openings and advance your career with a company that values its team members! LOCATION: E Providence, RI DAYS: Monday - Friday with Saturday rotation HOURS: 6:00pm-11:30pm PART TIME: 20 hours In this role you will: Verifies and matches information on requisitions and drawn specimens, received from the road phlebotomy, branch laboratory, physician's offices and courier departments. Enters accurately data for each patient relevant to the type of testing performed. Verifies patient name, address, method of payment and enters into computer system when necessary. Must adhere to departmental procedures regarding consistency and accuracy of information entered into the computer system. * Adheres accession label to all specimens and requisitions for tracking and test reporting. Spins related blood specimens in centrifuge before forwarding to the appropriate department. Ensures that adequate amount of blood is drawn to perform all tests requested. May be required to aliquot blood specimens; process other blood fluids for distribution to departments and reference labs. * Is responsible for verification of branch lab specimens received in the main laboratory. Ensures that an adequate amount of specimen is delivered to the appropriate department. Troubleshoots when specimen provided is insufficient and/or incorrect. Rechecks co-worker's data entry/requisitions/specimens handling for accuracy and quality control. Receive and processes stat work, which requires high priority attention. * Troubleshoots problematic areas and notifies department supervisor. Any changes to original patient testing file must be reported to the appropriate technical supervisor. Maintains and files forms for all reference laboratory send outs for all East Side Clinical Laboratory locations. Knowledgeable in third-party financial billing procedures. If necessary, contacts proper individuals to obtain financial information. Results entry to reference lab reports (senior members). If trained as a phlebotomist, may be required to assist with phlebotomy duties in the main laboratory, if necessary. Required to work Saturday or weekend rotation as specified by departmental schedule. Performs other related duties as assigned. Extended hours may be required. Work in a fast paced environment. All you need is: High School Diploma/GED required. Associate's Degree in related field preferred. Knowledge of third party billing, general laboratory procedures and basic computer and excellent typing skills. Must possess excellent communication and organizational skills. Ability to work in an organized manner. Physical Demands: Extensive sitting, phone and computer use. Capable of standing continuously for up to 2 hours. Extend and reach with hands and arms and use hands and fingers. Occasionally required to climb, balance, bend, stoop, kneel or crouch. May be required to lift, move and carry up to 15-20 pounds. Hearing acuity sufficient to effectively communicate with customers and employees via telephone and in person. Ability to communicate verbally on phone and in person. Fluency in the English language. Scheduled Weekly Hours: 25 Work Shift: 2nd Shift (United States of America) Job Category: Laboratory Operations Company: East Side Clinical Laboratory, Inc. Sonic Healthcare USA is an equal opportunity employer that celebrates diversity and is committed to an inclusive workplace for all employees. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, age, national origin, disability, genetics, veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.
    $27k-35k yearly est. Auto-Apply 60d+ ago
  • Claims Follow Up Rep TC

    Brown University Health 4.6company rating

    Claim processor job in Providence, RI

    SUMMARY: Under general supervision of the Claims Administration Follow-up Supervisor, perform all clerical duties necessary to properly process patient bills to customers taking appropriate follow-up steps to obtain timely reimbursement of each 3rd party claim and ensure the financial stability of the Hospital. Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include: Instill Trust and Value Differences Patient and Community Focus and Collaborate RESPONSIBILITIES: Consistently applies the corporate values of respect, honesty and fairness and the constant pursuit of excellence in improving the health status of the people of the region through the provision of customer-friendly, geographically accessible and high-value services within the environment of a comprehensive integrated academic health system. Responsible for knowing and acting in accordance with the principles of the Brown University Health Corporate Compliance Program and Code of Conduct. Review claim forms for all required data fields depending on the specific 3rd party requirements. Review patient account for demographic accuracy. Process all necessary system adjustments or changes as needed, such as adding/deleting insurance information, insurance priority changes, balance transfers, demographic changes, contractual allowances, and any other routine patient accounting adjustments not requiring supervisory approval ensuring accurate financial data. Analyze all assigned claims received from various sources to ensure accurate and timely reimbursement based on the individual payer's contracts or Federal reimbursement methods. Contact insurer via online systems, call centers, written correspondence, fax or appropriate electronic or paper billing of claims to secure payment. Maintains an understanding of the most current contract language in order to consistently ensure reimbursement in accordance with contract language. Continually maintains knowledge of payer specific updates via payer's listservs, provider updates, webinars, meetings and websites. Review payer's settlements for correct reimbursement and proceed with contact to insurer if claim is not adjudicated correctly based on working knowledge of the various payer's policies and each individual related contract. Identifies and analyzes denials and payment variances and enacts corrective measures as needed to effectively communicate and resolve payer errors. Understands and maintains compliance with HIPAA guidelines when handling patient information Initiate adjustments to payer's as appropriate after analyzing under or over payments based on contract, Federal regulation, late charge corrections or inappropriate denials. Submits appeals to payers as appropriate to recover denied revenue Contact internal departments to acquire missing or erroneous information on a claim resulting in adjudication delays or denials. Run reports as necessary to quantify various variances on patient accounts related to identified issues within the payers or as the result of known charging errors or procedural breakdown. Reports to supervisor identification of trends resulting in under/over payments, inappropriate denials or charging/billing discrepancies. Answer telephone inquiries from 3rd parties and interdepartmental calls. Refer all unusual requests to supervisor. Retrieve appropriate medical records documentation based on third party requests. Initiate the accurate and timely processing of all secondary and tertiary claims as needed according to specific 3rd party regulations. Process all incoming mail and follow up on all rejections received according to specific 3rd party regulations. Refer all accounts to supervisor for additional review if the account cannot be resolved according to normal patient accounting procedures. Works with supervisor, management and the patient accounting staff to improve processes, increase accuracy, create efficiencies and achieve the overall goals of the department. Maintain quality assurance, safety, environmental and infection control in accordance with established policies, procedures, and objectives of the system and affiliates. Perform other related duties as required. WORK LOCATIONS/EXPECTIONS: After orientation at the Corporate facilities, work is performed based on the following options approved by management and with adherence to a signed telecommuting work agreement and Patient Financial Services Remote Access Policy and Procedure.. Full time schedule worked in office Full time schedule worked in a dedicated space in the home Part time schedule in office and in a dedicated space within the home Schedules must be approved in advance by management who will allow for flexibility that does not interfere with the ability to accomplish all job functions within the said schedule. Staff are required to participate in scheduled meetings and be available to management throughout their scheduled hours. Staff must be signed into Microsoft Teams during their entire shift and communicate with Supervisor as directed. MINIMUM QUALIFICATIONS: BASIC KNOWLEDGE: Equivalent to a high school graduate Knowledge of 3rd party billing to include ICD, CPT, HCPCS, UB and HCFA 1505 claim form Demonstrated skills in critical thinking, diplomacy and relationship-building Highly developed communication skills, successfully demonstrated in effectively working with a wide variety of people in both individual and team settings Demonstrated problem-solving and inductive reasoning skills which manifest themselves in creative solutions for operational inefficiencies. EXPERIENCE: One to three years of relevant experience in medical collections or professional/hospital billing preferred INDEPENDENT ACTION: Incumbent generally establishes own work plan based on pre-determined priorities and standard procedures to ensure timely completion of assigned work. Problems needing clarification are reviewed with supervisor prior to taking action. SUPERVISORY RESPONSIBILITY: None Pay Range: $19.58-$32.31 EEO Statement: Brown University Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, ethnicity, sexual orientation, ancestry, genetics, gender identity or expression, disability, protected veteran, or marital status. Brown University Health is a VEVRAA Federal Contractor. Location: Corporate Headquarters - 167 Point Street Providence, Rhode Island 02903 Work Type: Monday-Friday 7am-330pm Work Shift: Day Daily Hours: 8 hours Driving Required: No
    $19.6-32.3 hourly 37d ago

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