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Insurance Analytics Specialist (Actuary)- Tec...
Lockton Companies 4.5
San Francisco, CA jobs
Insurance Analytics Specialist (Actuary)- Technology Ris... San Francisco, California, United States of America Insurance Analytics Specialist (Actuary)- Technology Ris... San Francisco, California, United States of America At Lockton, we're passionate about helping our people achieve their ultimate potential. Our people are curious, action-oriented and always striving to make ourselves and those around us better. We're active listeners working to ensure understanding and problem solvers developing innovative solutions. If you can see yourself delivering excellent service to clients, giving back to our communities and being a part of our caring culture, you belong here. About the Position Lockton is a global professional services firm with 6,500 Associates who advise clients on protecting their people, property and reputations. Lockton has grown to become the world's largest privately held, independent insurance broker by helping clients achieve their business objectives. To see the latest insights from Lockton's experts, check Lockton Market Update . A few of the reasons Associates love working at Lockton include: Opportunities for growth and advancement, including paid training and professional development 12-week paid parental leave A huge emphasis on community involvement Frequent athletic and wellness events Incredibly generous rewards; US Associates receive a Rolex for their 10 year anniversary! We seek an experienced Insurance Analytics Specialist/Actuary to join our team. In this role, you will be part of an engaging and dynamic brokering team building insurance products that uses creative analytics solutions to advocate for our clients. You will also serve as the daily liaison between our account team and our internal analytics partners, ensuring data completeness and quality, as well as managing workflow and work quality. The ideal candidate will have a strong foundation in insurance analytics, a solid understanding of fundamental insurance concepts, and the ability to transform complex data into actionable insights. Key Responsibilities Advanced Analytics for Bespoke Analysis • Perform sophisticated analytical research on specialized insurance topics, including innovative initiatives in autonomy and actuarial research • Design and implement analytical models to evaluate risk factors, pricing implications, and coverage considerations for specialized insurance scenarios • Translate complex insurance data into meaningful insights that drive strategic decision-making • Develop data visualization tools to communicate analytical findings to stakeholders at various levels effectively • Research industry trends and emerging risks to provide proactive recommendations on underwriting approaches • Support internal analytics initiatives by applying statistical techniques to uncover patterns and relationships within insurance data Data Review and Workload Management with our internal Analytics partners • Serve as the primary liaison between our team and internal analytics partners, anticipating their data requirements and questions • Conduct comprehensive data validation checks to ensure completeness and accuracy • Identify and resolve data discrepancies or missing elements independently • Develop and implement standardized data preparation procedures to ensure efficient workload management, streamline the review process, and minimize delays Qualifications Required Qualifications • Bachelor's degree in Analytics, Statistics, Actuarial Science, Finance, Economics, Insurance, or related field • At least 4-6 years of experience in insurance analytics, data analysis, or a related role within the insurance industry • Demonstrated understanding of fundamental insurance concepts, including supply/demand dynamics, loss components, and their interrelationships • Proficiency in data analysis tools such as Excel, SQL, and Python • Experience with data quality assurance processes and validation methodologies • Strong analytical skills with the ability to interpret complex datasets and identify meaningful patterns Preferred Qualifications • Insurance industry certifications such as ACAS, CPCU, or ARM • Experience working with claims data, policy information, and underwriting systems • Background in predictive modeling or machine learning applications in insurance • Knowledge of the forefront of technology innovations and related insurance implications • Experience with data visualization tools like Tableau or Power BI Skills and Competencies • Exceptional attention to detail and commitment to data accuracy and integrity • Strong critical thinking and problem-solving abilities to address complex analytical challenges • Collaborate effectively across internal teams and external partners by understanding diverse stakeholder priorities and delivering solutions that align technical requirements with organizational objectives • Excellent communication skills to adapt communication approaches and translate technical findings into business insights • Self-motivation and the ability to work independently while managing multiple priorities • Collaborative mindset with the ability to work effectively with cross-functional teams • Advanced knowledge of insurance industry terminology, products, and regulatory considerations Working Conditions This full-time position primarily operates in an office environment. The role may require occasional travel to meet with partners or attend industry events. Some flexibility in work scheduling may be necessary to meet project deadlines. Equal Opportunity Statement Lockton Companies is proud to provide everyone anequal opportunity to grow and advance. We are committed to an inclusive culture and environment where our people, clients and communities are treated with respect and dignity. At Lockton, supporting diversity, equity and inclusion is ingrained in our values, and we believe that we are at our best when we fully embrace everyone. We strive to cultivate a caring culture that learnsfrom, celebrates and thrives because of ourbreadth of differences. As such, we recognize that recruiting, developing and retaining people with diverse backgrounds and experiences is vital and enabling our people to thrive personally and professionally is critical to our long-term success. About Lockton Lockton is the largest privately held independent insurance brokerage in the world. Since 1966, our independence has allowed us to serve our clients, take care of our people and give back to our communities. As such, our 12,500+ Associates doing business in over 140 countries are empowered to do what's right every day. At Lockton, we believe in the power of all people. You belong at Lockton. How We Will Support You At Lockton, we empower you to be true to yourself in all that you do. Your success is our success, and we provide opportunities to help you grow and create a rewarding career path, however you envision it. We are ready to meet you where you are today, and as your needs change over time. In addition to industry-leading health insurance, we offer additional options to support your overall health and wellbeing. Any Employment Agency, person or entity that submits an unsolicited resume to this site does so with the understanding that the applicant's resume will become the property of Lockton Companies, Inc. Lockton Companies will have the right to hire that applicant at its discretion and without any fee owed to the submitting Employment Agency, person or entity. Employment Agencies, who have fee Agreements with Lockton Companies must submit applicants to the designated Lockton Companies Employment Coordinator to be eligible for placement fees. Manage Consent Preferences Always Active #J-18808-Ljbffr
$39k-47k yearly est. 5d ago

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Insurance Specialist
Bankers Life 4.5
Nashville, TN jobs
Bankers Life , one of the most respected brands in the Financial Services industry, is seeking ambitious individuals to grow our team of Insurance Professionals. We offer award-winning training, access to mentors, and a workday that can be built around your lifestyle and an opportunity to advance your career within a leadership role. As an Insurance Professional, you will: Build a client base by growing relationships with your network and providing guidance Gain expertise through sponsored coursework and proprietary agent development training Guide clients through important financial decisions using the latest software and our expansive product portfolio Own your career by utilizing company sponsored leadership development programs to increase your potential for advancement to our mid or upper-level management roles Build manage, and lead teams of Insurance Professionals What makes a great Insurance Professional? Strong relationship building and communication skills Self-motivation to network and prospect for new clients, while demonstrating strong time management skills A competitive and entrepreneurial spirit to achieve success both for yourself and others The ability to present complicated concepts effectively What we offer: Highly competitive commission structure designed to grow with you Passive income opportunities and bonus programs Fully paid study programs for insurance licensing, SIE, Series 6, Series 63, CFP Award-winning training - Bankers Life has been named as a Training Apex Award Winner for the twelfth consecutive year Flexible in-office schedules once you complete your agent training Progressive advancement opportunities Retirement savings program and more Bankers Life , a subsidiary of CNO Financial, is a Fortune 500 company with a strong commitment to diversity and inclusion. We value an inclusive and belonging environment where everyone's different viewpoints bring new successes! Please visit our career site to learn more about our mission: ********************************
$31k-41k yearly est. 2d ago
Payment Integrity Associate - Itemized Bill Review
Oscar Health 4.6
Atlanta, GA jobs
Hi, we're Oscar. We're hiring an Associate, Itemized Bill Review to join our Payment Integrity team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves-one that behaves like a doctor in the family. About the role: The Associate, Payment Integrity, Itemized Bill Review (IBR) will be responsible for executing internal payment integrity solutions requiring billing and coding expertise with and continual improvement and development of the solutions. You will ensure claims are paid accurately and timely with the highest quality. This is accomplished by leveraging a deep understanding of Oscar's claim infrastructure, workflows, workflow tooling, platform logic, data models, etc., to work cross-functionally to understand and translate friction from stakeholders into actionable opportunities for improvement. You will report into the Manager, Payment Integrity (Pre-Pay). Work Location: This is a remote position, open to candidates who reside in: Atlanta, Georgia; Chicago, Illinois; Dallas, Texas; Louisville, Kentucky; Minneapolis, Minnesota; Philadelphia, Pennsylvania; Salt Lake City, Utah. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. #LI-Remote Pay Transparency: The base pay for this role is: $82,717 - $108,566 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses. Responsibilities: Perform line-by-line review of high-dollar facility itemized bills and corresponding claim forms (e.g., UB-04s) Proactively identify and document potential billing errors, including duplicate billing of items, services, or procedures as improper unbundling of services (e.g., separating components that should be billed together) and charges for non-covered or non-rendered services Compare billed charges against both payor-specific contracts and industry guidelines to confirm appropriate billing practices. Apply working knowledge of national coding systems (e.g., CPT, HCPCS, ICD-10, MS-DRGs) to validate the accuracy of codes used for services billed. Review claims eligible under specific reimbursement scenarios: a percentage of charges or those exceeding stop-loss levels, ensuring the claim exceeds the minimum dollar threshold set by the payor Prepare clear, concise, and professional documentation of all findings, including savings identified, policy violations, and recommended claim adjustments Contribute to the refinement of internal audit processes and tools to enhance efficiency and accuracy in identifying claim inaccuracies Serve as a subject matter expert for internal and external stakeholders regarding complex billing issues, coding guidelines, and payor policies Provide subject matter expertise and in-depth understanding of Payment Integrity internal claims processing edits, external vendor edits and Oscar reimbursement policies Identify claims payment issues from data mining, process monitoring, etc., provide scoping and action steps needed to remediate the issue Respond to internal and external inquiries and disputes regarding policies and edits. Document industry standard coding rules and provide recommendations on reimbursement policy language and scope Ideate payment integrity opportunities based on a deep knowledge of industry standard coding rules. Translate into business requirements; submit to and collaborate with internal partners to effectuate change Provide training and education to team members when necessary Perpetuate a culture of transparency and collaboration by keeping stakeholders well informed of progress, status changes, blockers, completion, etc.; field questions as appropriate Support Oscar run state objectives by providing speedy research, root cause analysis, training, etc. whenever issues are escalated and assigned by leadership Compliance with all applicable laws and regulations Other duties as assigned Requirements: A bachelor's degree or 4+ years of commensurate experience 2+ years of bill / coding audit experience with a focus on hospital or facility billing (UB-04) 4+ years experience in medical coding Medical coding certification through AAPC (CPC, COC) or AHIMA (CCS, RHIT, RHIA) Experience with reimbursement methodologies, provider contract concepts and common claims processing/resolution practices Bonus points: 3+ years of experience working with large data sets using excel or a database language Knowledge management, training, or content development in operational settings Process Improvement or Lean Six Sigma training Experience using SQL This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here. At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives. Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts. Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known. California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our .
$33k-41k yearly est. Auto-Apply 10d ago
Billing Specialist
Morgan White Group 3.6
Ridgeland, MS jobs
Job Essential Duties and Responsibilities: To perform the job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Reviews and maintains invoices and records to ensure accuracy. Maintains all customer payment records. Has knowledge of commonly used concepts, practices, and procedures within the insurance field. Relies on instructions and pre-established guidelines to perform the job function. Perform other duties as assigned by the Department Manager.
$38k-46k yearly est. 5d ago
Billing & Collection Specialist
CNA Financial Corp 4.6
Lake Mary, FL jobs
You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential. Under technical direction assigns cases and provides technical expertise to legal collection staff including guidance and setting collection strategies for the most complex accounts with the highest financial exposures. JOB DESCRIPTION: Essential Duties & Responsibilities Performs a combination of duties in accordance with departmental guidelines: * Serves as technical expert to the legal collections staff providing guidance on collection strategies and evaluations. * Evaluates most complex cases and establishes collection strategies. * Assigns cases to collection agencies and/or attorneys as required. * Responsible for trial preparation, witness preparation, mediation, negotiation and settlement of collection actions. * Evaluates case exposures, cost benefit analysis, and determines best practices or strategy to resolve matter including negotiated settlement, write-off, revision, and premium re-audits. * Initiates action to resolve matter in manner that is in the best interest of CNA including using assigned write-off authority and settlement authority. * Maintains detailed file activity documentation through closure of collection efforts. * Ensures accounts are reconciled between collection central and source ledger processing systems. * Trains and mentors collection and accounting staff in the legal collections area. Reporting Relationship Manager or above Skills, Knowledge and Abilities * In-depth knowledge of legal collections methods, systems and related interfaces and claims systems and claims reports. * Strong understanding of accounting principles and procedures and cash flow concepts, collateral arrangements, and finance agreements. * Strong understanding of the insurance industry and property casualty products for large commercial clients. * Excellent communication, negotiating and influencing skills needed to deal effectively with high profile individuals often regarding sensitive collection issues. * Ability to mentor others and foster teamwork. * Strong analytical and problem-solving skills. * Knowledge of computer applications, including Microsoft Office Suite and other business related software. Education and Experience * College degree or equivalent experience. * Typically a minimum of seven years related experience in collections #LI-Hybrid #LI-DM1 In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut, Illinois, Maryland, Massachusetts, New York and Washington, the national base pay range for this job level is $54,000 to $103,000 annually. Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees - and their family members - achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA's benefits, please visit cnabenefits.com. CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact ***************************.
$32k-37k yearly est. Auto-Apply 21d ago
Sr. E&S Agency Billing Rep (Bala Cynwyd, PA or Naperville, IL)
Philadelphia Insurance Companies 4.8
Naperville, IL jobs
Marketing Statement: Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries. We have been in operation since 1962 and are nationally recognized as a member of Ward's Top 50 and rated A++ by A.M.Best. We are looking for a Sr. E&S Agency Billing Representative to join our team in either our Bala Cynwyd, PA or Naperville, IL offices! Summary: Establish and maintain service relationship with assigned high-priority agents to facilitate successful and timely premium collection of receivables. Advise, verify and approve work items of team members as a Subject Matter Expert. A typical day will include the following: * Support team and report daily operations to Supervisor * Relationships with High Priority Agents * Manage Service Escalations * Conduct Assessments * Mentor and Train Team * Collect receivables to Prevent Past Due Status Qualifications: * High School Diploma * Minimum of 3 years of Accounts Receivable experience * Customer Service experience * Intermediate excel skills * Strong written and verbal communication skills EEO Statement: Tokio Marine Group of Companies (including, but not limited to the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an Equal Opportunity Employer. In order to remain competitive we must attract, develop, motivate, and retain the most qualified employees regardless of age, color, race, religion, gender, disability, national or ethnic origin, family circumstances, life experiences, marital status, military status, sexual orientation and/or any other status protected by law. Benefits: We offer a comprehensive benefit package, which includes tuition reimbursement and a generous 401K match. Our rich history of outstanding results and growth allow us to focus our business plan on continued growth, new products, people development and internal career opportunities. If you enjoy working in a fast paced work environment with growth potential please apply online. Additional information on Volunteer Benefits, Paid Vacation, Medical Benefits, Educational Incentives, Family Friendly Benefits and Investment Incentives can be found at ***************************************** Share: mail Apply Now
$38k-44k yearly est. 3d ago
Medical Billing Specialist |Full-Time|
Heritage Health 3.9
Coeur dAlene, ID jobs
Heritage Health is seeking a full-time (1.0 FTE) Billing Specialist to join our team in Coeur d'Alene, Idaho. Heritage Health is seeking a detail-oriented and proactive Billing Specialist to join our team. This role is essential to ensuring the accuracy and efficiency of our billing operations, supporting patient care through timely and precise financial processes. Why You Should Join our Dynamic Healthcare Team: Passionate Purpose: We're committed to enhancing lives, every day. Unmatched Support: We are committed to a fun and supportive team environment. Balanced Lifestyle: No weekends or holidays, ensuring a healthy work-life balance. Collaborative Care: Work with a dedicated team to provide the best patient outcomes in the right settings. Exceptional Rewards: Competitive pay, and benefits Benefits: Health Insurance: 100% employer-paid employee coverage for medical, dental, and vision plans for full-time employees. Life Insurance: Employer-paid for 1x annual salary (optional coverage available for additional cost). Disability Insurance: Short-term disability insurance based on age & salary. 100% employer-paid long-term disability insurance. Retirement: 403 (b) plan: Heritage Health matches up to 4% of employee contributions. Paid Time Off Benefits: 120 hours Paid Time Off (PTO) in your first year, 56 hours Extended Illness Bank (EIB) in your first year, 8 paid holidays for full-time employees, amounts are pro-rated for part-time employees who are .5 FTE or higher. Employee Assistance Program (EAP): Enjoy free telehealth visits for healthcare, counseling, and health and wellness coaching for all employees and their immediate household members. Schedule: Monday through Friday As a Billing Specialist, you will be responsible for managing patient accounts, processing claims, resolving denials, and supporting eligibility services. You'll work closely with internal teams and external payers to maintain smooth revenue cycle operations and contribute to our mission of delivering high-quality, accessible healthcare. Requirements High school graduate or equivalent Two (2) years' experience of medical billing or any equivalent combination of experience, training and/or education. Your Essential Duties: Knowledge of working AR (Account Receivable). Handle coding-related inquiries and denials, research, appeal, and provide solution recommendations. Manage held or rejected claims in a timely manner. Timely follow-up on insurance claim denials, exceptions or exclusions. Timely charge acceptance/processing and appending necessary modifiers. Verify the completeness and accuracy of all claims prior to submission. Knowledge of insurance company and patient payments posting for accuracy. Review credit balances and take action in a timely fashion. Utilize monthly aging accounts receivable reports to follow up on unpaid claims aged over 30 days. Respond to inquiries from insurance companies, patients and providers With working knowledge of Payer Websites. Timely communication to the Billing Supervisor regarding trends with payors/front desk and other issues that are potentially disruptive to cash flow. Heritage Health staff have an active role in our Patient Centered Medical Home model of care. This role is designated as part of the Heritage Health PCMH Care Team. Regular and predictable attendance is an essential function of this position. Performs miscellaneous job-related duties as assigned. Your Success Factors: Working knowledge of CPT and ICD10 codes and medical terminology. Up to date with health information technologies and applications. Skill in establishing and maintaining effective working relationships with other employees, patients, organizations and the public. Ability to read and interpret insurance explanation of benefits. Ability to communicate effectively in writing, over the phone, and in person. Proficient in Microsoft Office including Outlook, Word and Excel. Be service-oriented with the ability to pay attention to details in a fast-paced environment. Job Overview: Working Conditions: Work is normally performed in a typical interior, office work environment in an administrative building. Work may be demanding and chaotic at times. May be exposed to patient population that will present a variety of contagious diseases, physical injuries and emotional states of mind. Physical/Mental Requirements: Prolonged periods of sitting, and working on a computer. May lift up to 15 pounds at times. Must be able to access and navigate various departments of a given location. Must be able to complete tasks in a noisy or stressful environment. Must be able to adhere to process protocol. Safety: Heritage Health enforces a safety culture whereby all employees have the responsibility for continuously developing and maintaining a safe working environment. Each employee is responsible for completing all training requirements, participating in emergency response tasks as requested, and serving on safety committees and teams as requested. In addition, employees must accept the responsibility for maintaining the safety of themselves and others by adhering to all written and verbal instructions, promptly reporting and/or correcting all hazards or unsafe conditions and providing feedback to supervisors and management on all safety issues Salary Description $20.82 -29.64
$32k-39k yearly est. 12d ago
Central Billing Associate
Lockton 4.5
Kansas City, MO jobs
The Billing Associate will be responsible for invoicing agency bill premiums as required by the Commercial Insurance Division. * Invoice all premiums as directed by the Commercial Insurance division. * Confirm correct coding in the Nexsure system to avoid production errors. * Discuss potential problems with the Billing Supervisor or Accounting Manager. * Forward appropriate documents to Accounting Department. * Forward appropriate documents to Surplus Lines Department. * Act as the liaison between Lockton associates and contract markets to research and resolve discrepancies * Assist with other work-related duties and special projects as assigned. * Protect the confidentiality of all information.
$32k-38k yearly est. 19d ago
Billing & Collection Specialist
CNA Holding Corporation 4.7
Chicago, IL jobs
You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential. Under technical direction assigns cases and provides technical expertise to legal collection staff including guidance and setting collection strategies for the most complex accounts with the highest financial exposures. JOB DESCRIPTION: Essential Duties & Responsibilities Performs a combination of duties in accordance with departmental guidelines: Serves as technical expert to the legal collections staff providing guidance on collection strategies and evaluations. Evaluates most complex cases and establishes collection strategies. Assigns cases to collection agencies and/or attorneys as required. Responsible for trial preparation, witness preparation, mediation, negotiation and settlement of collection actions. Evaluates case exposures, cost benefit analysis, and determines best practices or strategy to resolve matter including negotiated settlement, write-off, revision, and premium re-audits. Initiates action to resolve matter in manner that is in the best interest of CNA including using assigned write-off authority and settlement authority. Maintains detailed file activity documentation through closure of collection efforts. Ensures accounts are reconciled between collection central and source ledger processing systems. Trains and mentors collection and accounting staff in the legal collections area. Reporting Relationship Manager or above Skills, Knowledge and Abilities In-depth knowledge of legal collections methods, systems and related interfaces and claims systems and claims reports. Strong understanding of accounting principles and procedures and cash flow concepts, collateral arrangements, and finance agreements. Strong understanding of the insurance industry and property casualty products for large commercial clients. Excellent communication, negotiating and influencing skills needed to deal effectively with high profile individuals often regarding sensitive collection issues. Ability to mentor others and foster teamwork. Strong analytical and problem-solving skills. Knowledge of computer applications, including Microsoft Office Suite and other business related software. Education and Experience College degree or equivalent experience. Typically a minimum of seven years related experience in collections #LI-Hybrid #LI-DM1 In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut, Illinois , Maryland, Massachusetts , New York and Washington, the national base pay range for this job level is $54,000 to $103,000 annually. Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees - and their family members - achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA's benefits, please visit cnabenefits.com. CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact ***************************.
$35k-43k yearly est. Auto-Apply 22d ago
Sr. E&S Agency Billing Rep (Bala Cynwyd, PA or Naperville, IL)
Philadelphia Insurance Companies 4.8
Pennsylvania jobs
Marketing Statement: Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries. We have been in operation since 1962 and are nationally recognized as a member of Ward's Top 50 and rated A++ by A.M.Best. We are looking for a Sr. E&S Agency Billing Representative to join our team in either our Bala Cynwyd, PA or Naperville, IL offices! Summary: Establish and maintain service relationship with assigned high-priority agents to facilitate successful and timely premium collection of receivables. Advise, verify and approve work items of team members as a Subject Matter Expert. A typical day will include the following: * Support team and report daily operations to Supervisor * Relationships with High Priority Agents * Manage Service Escalations * Conduct Assessments * Mentor and Train Team * Collect receivables to Prevent Past Due Status Qualifications: * High School Diploma * Minimum of 3 years of Accounts Receivable experience * Customer Service experience * Intermediate excel skills * Strong written and verbal communication skills EEO Statement: Tokio Marine Group of Companies (including, but not limited to the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an Equal Opportunity Employer. In order to remain competitive we must attract, develop, motivate, and retain the most qualified employees regardless of age, color, race, religion, gender, disability, national or ethnic origin, family circumstances, life experiences, marital status, military status, sexual orientation and/or any other status protected by law. Benefits: We offer a comprehensive benefit package, which includes tuition reimbursement and a generous 401K match. Our rich history of outstanding results and growth allow us to focus our business plan on continued growth, new products, people development and internal career opportunities. If you enjoy working in a fast paced work environment with growth potential please apply online. Additional information on Volunteer Benefits, Paid Vacation, Medical Benefits, Educational Incentives, Family Friendly Benefits and Investment Incentives can be found at ***************************************** Share: mail Apply Now
$34k-40k yearly est. 3d ago
Sr. E&S Agency Billing Rep (Bala Cynwyd, PA or Naperville, IL)
Philadelphia Insurance Companies 4.8
Pennsylvania jobs
Marketing Statement: Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries. We have been in operation since 1962 and are nationally recognized as a member of Ward's Top 50 and rated A++ by A.M.Best. We are looking for a Sr. E&S Agency Billing Representative to join our team in either our Bala Cynwyd, PA or Naperville, IL offices! Summary: Establish and maintain service relationship with assigned high-priority agents to facilitate successful and timely premium collection of receivables. Advise, verify and approve work items of team members as a Subject Matter Expert. A typical day will include the following: Support team and report daily operations to Supervisor Relationships with High Priority Agents Manage Service Escalations Conduct Assessments Mentor and Train Team Collect receivables to Prevent Past Due Status Qualifications: High School Diploma Minimum of 3 years of Accounts Receivable experience Customer Service experience Intermediate excel skills Strong written and verbal communication skills EEO Statement: Tokio Marine Group of Companies (including, but not limited to the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an Equal Opportunity Employer. In order to remain competitive we must attract, develop, motivate, and retain the most qualified employees regardless of age, color, race, religion, gender, disability, national or ethnic origin, family circumstances, life experiences, marital status, military status, sexual orientation and/or any other status protected by law. Benefits: We offer a comprehensive benefit package, which includes tuition reimbursement and a generous 401K match. Our rich history of outstanding results and growth allow us to focus our business plan on continued growth, new products, people development and internal career opportunities. If you enjoy working in a fast paced work environment with growth potential please apply online. Additional information on Volunteer Benefits, Paid Vacation, Medical Benefits, Educational Incentives, Family Friendly Benefits and Investment Incentives can be found at *****************************************
$34k-40k yearly est. Auto-Apply 13d ago
Medical Billing Specialist
The Panther Group 3.9
Norwood, MA jobs
The Panther Group is hiring for a Medical Billing Specialist, or Insurance Recovery Analysts (IRA), with experience in General Liability Claims, Workman's Compensation & Motor Vehicle. The IRAs are responsible for processing commercial, governmental and/or third-party liability (workman's compensation, general liability, and motor vehicle liability) medical claims. This position ensures that ClaimAssist's clients (hospitals) recover the maximum allowable medical fees in the most timely, efficient, and confidential manner. ESSENTIAL FUNCTIONS: Investigates, negotiates, bills and follows-up for payment regarding first and third-party claims involving any and all coverages, liability, and legal issues. Identifies viable payers, obtains IBs, UBs, HCFAs, correspondence, and medical records when necessary. Maintains the highest level of privacy in accordance with HIPAA requirements and laws. Works their inventory by route while maintaining an acceptable level of aged accounts receivable. Contacts patients, payers, hospitals, attorneys, employers, and any other parties involved to collect the necessary information and ensure reimbursement for our client. Recovers maximum dollars for the hospital through coordination of benefits in a timely manner. Appeals claims when applicable. Meets monthly company, team, and individual goals, and all deadlines set by the Team Lead and Manager, Operations. Completes special projects, as requested. QUALIFICATIONS: Minimum of four (4) years of directly related industry experience. Emdeon/ChangeHealthcare billing experience is a plus. EPIC, CERNER and/or MEDITECH experience is a plus. Experience working claims in multiple states is a plus. Strong technical knowledge in one or more areas of commercial insurance, government insurance, workman's compensation, motor vehicle liability, general liability and claims processing systems. Knowledge of medical and insurance terminology. Knowledge of coordination of benefits. Working knowledge of FACS (ClaimAssist's host system) or comparable management software system. Ability to speak confidently over the phone Basic knowledge of Microsoft Excel and Word. Ability to provide quality customer service to all parties. Ability to work in a fast-paced environment Demonstrated knowledge of state laws and insurance statutes. Excellent interpersonal and verbal/written communications skills. Highly motivated, self-starter, organized and detail-oriented. Ability to work well individually, as well as part of a team. Coachable: receptive to feedback, willing to learn, embraces continuous improvement, and responsive to change. EDUCATION REQUIREMENTS: Bachelor's degree in business or related field preferred High school or equivalent is required Insurance Institute Certificate(s) highly desirable. Pay Rate: $22.00-$24.00 (depending on experience) PLUS monthly Bonus #ZR
$22-24 hourly 60d+ ago
Medical Billing Specialist
Group Health Cooperative of South Central Wisconsin 3.2
Madison, WI jobs
This is a hybrid position which will have a combination of remote and onsite work on a weekly basis. Applicants must be a resident of Wisconsin and have the ability to work onsite as scheduled. 1.0 FTE / 40 hours per week. The Medical Billing Specialist is responsible for all Fee-for-Service (FFS) patient accounts. This includes timely billing of non-covered services, services covered by other health insurance, co-payments and deductibles. They are also responsible for the collection and posting of all payments related to patient accounts. Additionally, they provide assistance to members with billing inquiries, complaints and compliments; and performs credentialing certification for GHC-SCW providers for billing purposes. The Medical Billing Specialist is responsible for enrollment of uninsured individuals in the Community Care Program and students in the Madison College Student Health Services. The Medical Billing Specialist works under the general supervision and guidance of the Medical Billing Supervisor. GHC-SCW is a quality driven cooperative built on collaboration, community involvement, innovation, and belonging. In dedication to the health and well-being of our employees, we offer a comprehensive benefits package that includes health and dental insurance, along with paid short-term disability, long-term disability, and life insurance. Additional benefits include paid parental leave, a flexible spending account, employee assistance programs, tuition reimbursement, pet insurance, eyewear discounts, and more. Check us out by clicking on Many Talents, One Mission! The Benefits of Working at GHC-SCW. Job Specific Qualifications High school graduation or equivalent is required. A minimum of one (1) or more years of accounting/billing related experience is required. Experience in insurance or medical billing is preferred but not required. Basic knowledge of or ability to learn reimbursement/insurance practices for medical care is required. Basic knowledge of Coordination of Benefits rules and regulations pertaining to Medicare, duplicate health coverage, Medicaid and privately sponsored plans is preferred. Knowledge of or ability to learn medical, legal and insurance terminology is required. Knowledge of or ability to learn diagnostic and procedure codes, CPT-4, ICD-9 and ICD-10 coding is required. Good written and verbal communication skills are required to research issues with members and outside providers. Excellent customer service skills are required. Ability to be culturally sensitive and to work with diverse populations is required. Strong listening skills both on the telephone and in person. Good organizational skills are required, including the ability to organize a high volume of work effectively and meet multiple deadlines. Ability to maintain patient and company confidentiality required. Knowledge of or ability to learn HIPAA requirements. Knowledge of and/or ability to learn and use computer-based applications such as MS Office, word processing, database, email, calendar and electronic insurance and records systems. Experience with EPIC is desirable. Must type a minimum of 40 WPM with minimal errors. Ability to use a keyboard extensively is required. Ability to analyze, calculate, plan, explain, investigate, and work independently is required. Ability to adapt and adhere to workflow and department changes is required. Ability to climb, stoop, kneel and crouch is required. Ability to bend, reach, lift, pull, push and/or carry up to 10 pounds regularly and up to 50 pounds occasionally is required. Ability to sit for prolonged periods of time is required. Ability to file at various heights is required. Ability to move and twist head is required. Ability to manage a high volume of telephone calls is required. Ability to work in an office environment is required. Ability to perform fingering and handling with one or both hands required. The incumbent knows and abides by all Group Health Cooperative of South-Central Wisconsin (GHC-SCW) organizational and departmental policies, sets personal standards and strives for high quality work in completing assignments, performs job duties in a timely manner, and represents the organization in a positive manner. The incumbent understands our Mission, Vision, and Common Values (stated below) and is committed to promote these values in behavior and attitude. Our Mission Statement: We partner with members and the communities we serve to maximize health and well-being. Our Vision: As a local, not-for-profit, member-owned Cooperative, we are the most trusted resource for lifelong health and well-being in the communities we serve. Our Values We are a not-for-profit Cooperative We are member-centered We are equitable and inclusive We are quality-driven We are innovative We are community involved We believe: Healthcare is a human right. In treating all people with dignity and respect. There is strength in diversity. Equity celebrates our humanity. We are better together.
$34k-42k yearly est. 5d ago
Car Biller/Billing Clerk
Jim Reed Automotive 4.0
Columbia, SC jobs
CAR BILLER / BILLING CLERK Competitive Pay Plan Based on Experience + Great Benefits! Experience Required Jim Hudson Automotive needs to hire a Car Biller/Billing Clerk to start immediately. Our primary concern is the satisfaction of our customers and we are looking for professionals that are committed to the same level of excellence. If you're interested in joining our growing team, Apply Online now, and be sure to complete the online assessment and upload your Resume! We believe culture makes a difference and we strive to build lasting relationships with our employees, customers, and the community. We value our employees and invest in their success. We offer: Competitive pay plan based on experience Pay rate: $20+per hour Medical, Dental and Vision Insurance $25K employer paid life insurance Disability Insurance 401(k) retirement plan with employer match Employee Assistance Program Employee Assistance Fund Flexible Scheduling Corporate Chaplain Paid Vacation and Personal Leave Paid Holidays Career advancement opportunities A positive and professional work environment Training Responsibilities - Car Biller: Costing and finalizing deals into accounting Manage and maintain schedules Month-End closing Activities Payoff flooring Perform various other accounting functions as needed Requirements Requirements - Car Biller: Car billing experience required Reynolds & Reynolds experience preferred Excellent communication and customer service skills Understand deadlines and be able to apply appropriate sense of urgency to all tasks Professional appearance and work ethic Strong attention to detail Must be organized, dependable, and detail-oriented Must enjoy working in a team and multi-tasking Must be authorized to work in the U.S. without sponsorship and be a current resident. Must pass pre-employment testing to include background checks, MVR, and drug screen. We are an Equal Opportunity Employer . All qualified applicants considered regardless of ethnicity, nationality, gender, veteran or disability status, religion, age, gender orientation or other protected status. Salary Description $20+ per hour based on experience
$20 hourly 60d+ ago
Billing Specialist
First Financial Group of America 3.7
Houston, TX jobs
Job Title: Billing Specialist Reports to: Operations Manager As a critical key member of a reputable Third Party Administrator (TPA) in North Houston, this position is responsible for group benefit administration with multiple lines of coverage. We're looking for an actively engaged individual to assist with group benefit billing implementation. Position will process complex monthly billings for IRS Section 125 Cafeteria employer group plans using proprietary technology. Competency with Microsoft Excel is critical. The position requires analytical thinking, a desire to solve complex problems and interact collaboratively with team members, clients and plan participants. Position works with PHI and NPII. Qualifications * 1 -2 years benefit administration or 3rd party billing reconciliation or bank reconciliation or accounts payable/accounts receivable experience. * 2-4 years customer service or general accounting and/or insurance billing * Microsoft Office skills including proficiency in Excel in a work capacity * Proven oral and written communication skills through work * Proficiency with numbers and basics of accounting a must * Ability to handle multiple priorities in a fast-paced team environment * Personal pride in work product and customer satisfaction * Able to grasp new concept/processes and embrace change/technology * High School diploma OR, equivalency (GED) required Preferred Qualifications * Familiar with a benefit management/billing system highly preferred * Functional understanding of Microsoft Dynamics CRM preferred* Must be able to obtain and maintain security clearances and successfully complete a thorough background check. EQUAL OPPORTUNITY EMPLOYER
$34k-45k yearly est. 12d ago
Billing Specialist
Peoples Health Centers Family of Companies 4.3
Saint Louis, MO jobs
About Company: Betty Jean Kerr People's Health Centers provides quality health care and social services to thousands of uninsured and medically underserved. Our mission is to enhance the quality of life for all residents of the community by providing healthcare that is comprehensive, equitable and trauma informed, including primary care, dental and behavioral health services rooted in compassion, hope, dignity, and cultural competency. PHC is committed to serving the impoverished, uninsured populations in St. Louis and St Louis County communities. With three (3) conveniently located health centers, three (3) behavioral health sites and a friendly welcoming staff, PHC aspires to serve all the health care and wellness needs of the entire family. About the Role: The Billing Specialist plays a critical role in ensuring the accuracy and timeliness of billing processes within the organization. This position is responsible for managing invoicing, processing payments, and resolving any discrepancies related to customer accounts. The Billing Specialist collaborates closely with finance, sales, and customer service teams to maintain clear and effective communication regarding billing matters. By maintaining detailed records and adhering to company policies and regulatory requirements, this role supports the organization's financial health and customer satisfaction. Ultimately, the Billing Specialist contributes to streamlined revenue collection and accurate financial reporting. Minimum Qualifications: * High school diploma or equivalent; associate degree or higher preferred. * Proven experience in billing, invoicing, or accounts receivable roles. * Proficiency with billing software and Microsoft Office Suite, especially Excel. * Strong attention to detail and accuracy in data entry and financial transactions. * Excellent communication skills, both written and verbal. Preferred Qualifications: * Experience with ERP systems such as SAP, Oracle, or QuickBooks. * Knowledge of relevant financial regulations and compliance standards. * Background in customer service or account management. * Certification in billing or accounting (e.g., Certified Billing Specialist). * Ability to analyze billing data and generate reports. Responsibilities: * Prepare and issue accurate invoices to customers in a timely manner. * Review billing data for accuracy and resolve discrepancies or errors promptly. * Process payments and update customer accounts accordingly. * Communicate with customers and internal teams to address billing inquiries and disputes. * Maintain detailed records of billing transactions and ensure compliance with company policies. * Collaborate with finance and sales departments to support month-end and year-end closing activities. * Assist in the development and improvement of billing procedures and systems. Skills: The Billing Specialist utilizes strong organizational and analytical skills daily to ensure billing accuracy and resolve discrepancies efficiently. Proficiency in billing software and Excel enables the specialist to manage large volumes of data and generate detailed reports that support financial decision-making. Effective communication skills are essential for interacting with customers and internal teams to clarify billing issues and maintain positive relationships. Attention to detail is critical in reviewing invoices and payment records to prevent errors and ensure compliance with company policies. Additionally, problem-solving skills help the specialist identify process improvements that enhance billing operations and overall revenue management.
$32k-41k yearly est. 14d ago
Billing Specialist
People's Health Centers 4.3
Saint Louis, MO jobs
Job Description About Company: Betty Jean Kerr People's Health Centers provides quality health care and social services to thousands of uninsured and medically underserved. Our mission is to enhance the quality of life for all residents of the community by providing healthcare that is comprehensive, equitable and trauma informed, including primary care, dental and behavioral health services rooted in compassion, hope, dignity, and cultural competency. PHC is committed to serving the impoverished, uninsured populations in St. Louis and St Louis County communities. With three (3) conveniently located health centers, three (3) behavioral health sites and a friendly welcoming staff, PHC aspires to serve all the health care and wellness needs of the entire family. About the Role: The Billing Specialist plays a critical role in ensuring the accuracy and timeliness of billing processes within the organization. This position is responsible for managing invoicing, processing payments, and resolving any discrepancies related to customer accounts. The Billing Specialist collaborates closely with finance, sales, and customer service teams to maintain clear and effective communication regarding billing matters. By maintaining detailed records and adhering to company policies and regulatory requirements, this role supports the organization's financial health and customer satisfaction. Ultimately, the Billing Specialist contributes to streamlined revenue collection and accurate financial reporting. Minimum Qualifications: High school diploma or equivalent; associate degree or higher preferred. Proven experience in billing, invoicing, or accounts receivable roles. Proficiency with billing software and Microsoft Office Suite, especially Excel. Strong attention to detail and accuracy in data entry and financial transactions. Excellent communication skills, both written and verbal. Preferred Qualifications: Experience with ERP systems such as SAP, Oracle, or QuickBooks. Knowledge of relevant financial regulations and compliance standards. Background in customer service or account management. Certification in billing or accounting (e.g., Certified Billing Specialist). Ability to analyze billing data and generate reports. Responsibilities: Prepare and issue accurate invoices to customers in a timely manner. Review billing data for accuracy and resolve discrepancies or errors promptly. Process payments and update customer accounts accordingly. Communicate with customers and internal teams to address billing inquiries and disputes. Maintain detailed records of billing transactions and ensure compliance with company policies. Collaborate with finance and sales departments to support month-end and year-end closing activities. Assist in the development and improvement of billing procedures and systems. Skills: The Billing Specialist utilizes strong organizational and analytical skills daily to ensure billing accuracy and resolve discrepancies efficiently. Proficiency in billing software and Excel enables the specialist to manage large volumes of data and generate detailed reports that support financial decision-making. Effective communication skills are essential for interacting with customers and internal teams to clarify billing issues and maintain positive relationships. Attention to detail is critical in reviewing invoices and payment records to prevent errors and ensure compliance with company policies. Additionally, problem-solving skills help the specialist identify process improvements that enhance billing operations and overall revenue management.
$32k-41k yearly est. 27d ago
Billing Specialist
Acrisure, LLC 4.4
Springfield, IL jobs
Job DescriptionGeneral Description The Billing Specialist assists the Senior Accountants in monitoring the insured accounts receivable, servicing the billing issues of our insureds and agents and processing the daily accounting transactions such as vendor payables and insured payments. ESSENTIAL FUNCTIONS Answer phone calls from the accounting phone queue. Calls are typically insureds and agents making payments, requesting information or asking questions regarding their bills and/or coverage. The specialist must be knowledgeable about billing procedures and worker's compensation insurance overall. Monitors insured receivables. This includes communicating with insureds regarding late payments and turning accounts over to our collection agencies as necessary. The specialist are also in charge of ensuring refunds are sent out timely according to company policy. Posts insured payments to their accounts and creates deposits to go to the bank Processes Vendor Payables Print Checks (claims, insured refunds, commissions) Special projects assigned by Senior Accountant Competencies/qualifications Strong telephone and/or customer services skills Strong verbal/written communication skills Proficient computer skills including but not limited to Microsoft Office suite; specifically Excel. Good organizational and multi-tasking abilities. Quick critical thinking skills Education/Experience requirements Minimum Education: High School Diploma or equivalent Preferred Education: Some college course work in accounting. 1+ years of general business/office experience 1+ years of customer service preferable over the telephone Work environment This job operates in a clerical, office setting. This role routinely uses standard office equipment such as computers, telephones, photocopiers and the like. Working over the telephone with challenging persons should be expected. Physical requirements Sitting for 4+ hours of time is usual in this role Candidate should be able to lift 10-15 pounds. Large amounts of keyboarding and working with a computer mouse requires dexterity of the hands. Bending over to file periodically is also required The candidate must be able to use close, distance, and color vision. Benefits and Perks: Competitive compensation Generous vacation policy, paid holidays, and paid sick time Medical Insurance, Dental Insurance, and Vision Insurance (employee-paid) Company-paid Short-Term and Long-Term Disability Insurance Company-paid Group Life insurance Company-paid Employee Assistance Program (EAP) and Calm App subscription Employee-paid Pet Insurance and optional supplemental insurance coverage Vested 401(k) with company match and financial wellness programs Flexible Spending Account (FSA), Health Savings Account (HSA) and commuter benefits options Paid maternity leave, paid paternity leave, and fertility benefits Career growth and learning opportunities …and so much more! Please note: This list is not reflective of all benefits. Enrollment waiting periods or eligibility criteria may apply to certain benefits. Offerings may vary based on subsidiary entity or geographic location. Pay Details: The base compensation range for this position is $15 - $17. This range reflects Acrisure's good faith estimate at the time of this posting. Placement within the range will be based on a variety of factors, including but not limited to skills, experience, qualifications, location, and internal equity. Acrisure is committed to employing a diverse workforce. All applicants will be considered for employment without attention to race, color, religion, age, sex, sexual orientation, gender identity, national origin, veteran, or disability status. California residents can learn more about our privacy practices for applicants by visiting the Acrisure California Applicant Privacy Policy available at ************************************* To Executive Search Firms & Staffing Agencies: Acrisure does not accept unsolicited resumes from any agencies that have not signed a mutual service agreement. All unsolicited resumes will be considered Acrisure's property, and Acrisure will not be obligated to pay a referral fee. This includes resumes submitted directly to Hiring Managers without contacting Acrisure's Human Resources Talent Department.
$15-17 hourly Auto-Apply 60d+ ago
Billing Specialist
Jewish Family Service of Dallasorporated 3.7
Dallas, TX jobs
The Billing Specialist, along with the front desk and the claims vendor, coordinates client service fees and billing payments. This position supports, promotes and furthers our goal of providing the highest standards of culturally relevant and sensitive professional service consistent with our mission. ESSENTIAL DUTIES AND RESPONSIBILITIES: Files insurance claims and applies payments to client's accounts Works with clients to verify insurance eligibility, and set self-pay fees Coordinates with claims vendor to verify eligibility, terms of policy for remittance of claims and corrects mailing addresses for claims Records all payment information on client logs Prepares monthly billing reports and sends to claims vendor in a timely manner Follows-up on claims denials in coordination with claims vendor In coordination with claims vendor, procures documents required for insurance company credentialing Answers billing questions from providers, staff and clients Prepares monthly productivity reports Provides front desk coverage Provides excellent and culturally sensitive customer service Other duties as assigned QUALIFICATIONS: High school diploma or equivalent, with 2 years plus experience in billing Additional related college courses preferred Must be able to be present at meetings as needed Proficient in Microsoft Office products BENEFITS: JFS offers excellent benefits to eligible employees, including health, dental and vision insurance, generous paid vacation days, and a 403(b) match! Jewish Family Service (JFS) is an equal opportunity employer, complying with all applicable Federal and state employment laws and regulations, that exists to provide professional, effective, and affordable mental health and social services that promote lifelong self-sufficiency and well-being for anyone in need. JFS is an E-Verify participant.
$30k-41k yearly est. 6d ago
Billing Specialist
Memorial Health System 4.3
Springfield, IL jobs
Analyzes, investigates, and resolves claims/billing information and/or errors associated with the more complex inpatient/outpatient medical insurance claims. Ensures compliance with managed care guidelines and MMC organizational policies. Embodies the Memorial Health System Performance Excellence Standards of Safety, Courtesy, Quality, and Efficiency that support our mission, vision and values. Qualifications Education: · Education equivalent to graduation from high school or GED is required. Licensure/Certification/Registry: Experience: · Two or more years as a Billing Specialist (or comparable medical claims/billing experience), with the technical knowledge to process all types of applicable claims and resolve errors and complex issues associated with them. Other Knowledge/Skills/Abilities: · Demonstrates thorough knowledge of medical terminology, medical procedural (CPT) and diagnosis (ICD-9 CM) coding, and hospital billing claim form UB04 is required. · Demonstrates a comprehensive knowledge of the electronic billing system and key contract billing guidelines and possess the ability to train others on the entire billing process. · Basic working knowledge of personal computers and their associate user software is required. Experience with Microsoft Office products Word and Excel is preferred. · Ability to work within the guidelines of defined managed care contract policy provisions and company procedures. · Demonstrates ability to work successfully with internal customers and external contacts is required. · Possesses a highly-developed detail orientation, critical thinking, and problem solving ability. · Demonstrates excellent oral and written communication, keyboarding, and basic math skills. · Demonstrates ability to work unsupervised as well as the ability to work in a group setting. Responsibilities Receives and examines daily listings for assigned billing claims and determines which require further analysis and action. Investigates assigned billing claims with incomplete/incorrect information and resolves the more complex problems or errors to ensure complete and compliant information accompanies the claim. Prioritizes claims based on specified criteria and files the claim, either electronically or via paper claim. Ensures careful adherence to insurance guidelines, timeliness, accuracy, and processing procedures. Researches and resolves complex issues associated with patient insurance accounts. As applicable, identifies, documents, and reports problematic trends to management. Embodies the Memorial Health System Performance Excellence Standards of Safety, Courtesy, Quality, and Efficiency that support our mission, vision and values: SAFETY: Prevent Harm - I put safety first in everything I do. I take action to ensure the safety of others. COURTESY: Serve Others - I treat others with dignity and respect. I project a professional image and positive attitude. QUALITY: Improve Outcomes - I continually advance my knowledge, skills and performance. I work with others to achieve superior results. EFFICIENCY: Reduce Waste - I use time and resources wisely. I prevent defects and delays. Analyzes reports containing rejected account information and performs the necessary research to resolve the reason(s) for the rejection and secures any other required information. Provides input regarding system edits designed to identify and ensure consistent and compliant data necessary for processing medical insurance claims. Responds to requests from internal departments regarding the proper coding, billing, and processing of medical insurance claims. Communicates and resolves issues with a variety of internal and external sources regarding medical insurance claims. This may include internal departments, patients (or other responsible parties), third-party payors, social service agencies, Medicare/Medicaid staff, other insurance carriers, service providers, and collection agencies. Initiates corrections to charges and contractuals / allowances within scope of expertise and authority granted. Identifies and researches the appropriateness of late charges and, as necessary, adjusts the charge / patient account based on research findings Identifies and calculates write-off amounts and secures the necessary approvals from management for processing. Documents online systems and electronic files to ensure accurate data is noted regarding the status of claims and payments. Ensures compliance to managed care contract guidelines and processes at each work step to facilitate accurate and timely reimbursements to the organization. May assist with special projects, analyses, or audits. As directed and defined by management, orients and cross-trains on other unit duties which are outside of regularly assigned area of responsibility. May serve as a back-up for other areas within the unit or department, especially during times of special needs or staff absences. Performs other related work as required or requested. The intent of this job description is to provide a representative summary of the major duties and responsibilities performed by incumbents of this job. Incumbents may be requested to perform tasks other than those specifically presented in this description. Not ready to apply? Connect with us for general consideration.
$32k-43k yearly est. Auto-Apply 47d ago