Insurance processor jobs near me - 283 jobs

This role plays a key part in ensuring maternity care bills are processed accurately and members receive timely support during an important season of life. The specialist serves as a detail-oriented professional who upholds CHM's commitment to excellence, compassion, and integrity. WHAT WE OFFER Compensation based on experience. Faith and purpose-based career opportunity! Fully paid health benefits Retirement and Life Insurance 12 paid holidays PLUS birthday Lunch is provided DAILY. Professional Development Paid Training ESSENTIAL JOB FUNCTIONS Compile, verify, and organize information according to priorities to prepare data for entry Check for duplicate records before processing Accurately enter medical billing information into the company's software system Research and correct documents submitted with incomplete or inaccurate details Verify member information such as enrollment date, participation level, coverage status, and date of service before processing medical bills Review data for accuracy and completeness Uphold the values and culture of the organization Follow company policies, procedures, and guidelines Verify eligibility in accordance with established policies and definitions Identify and escalate concerns to leadership as appropriate Maintain daily productivity standards Demonstrate eagerness and initiative to learn and take on a variety of tasks Support the overall mission and culture of the organization Perform other duties as assigned by management SKILLS & COMPETENCIES Core strengths like problem-solving, attention to detail, adaptability, collaboration, and time management. Soft skills such as empathy (especially important in maternity care), professionalism, and being able to handle sensitive information with care. EXPERIENCE REQUIREMENTS Required: High school diploma or passage of a high school equivalency exam Medical background preferred but not required. Capacity to maintain confidentiality. Ability to recognize, research and maintain accuracy. Excellent communication skills both written and verbal. Able to operate a PC, including working with information systems/applications. Previous experience with Microsoft Office programs (I.e., Outlook, Word, Excel & Access) Experience operating routine office equipment (i.e., faxes, copy machines, printers, multi-line telephones, etc.) About Christian Healthcare Ministries Founded in 1981, Christian Healthcare Ministries (CHM) is a health care sharing ministry for Christians. CHM is a nonprofit, voluntary cost-sharing ministry through which participating Christians meet each other's medical bills. The mission of CHM is to glorify God, show Christian love, and experience God's presence as Christians share each other's medical bills.

One of our top clients is looking for a team of Patient Access Representatives within a call center environment in Beverly Hills, CA! This person will be responsible for handling about 50+ calls per day for multiple specialty offices across Southern California. This position is fully on-site for 2 - 4 months, then fully remote. Required Skills & Experience HS Diploma 2+ years healthcare call center experience (with an average call time of 5 minutes or less on calls) Proficient with scheduling appointments through an EHR software 2+ years experience scheduling patient appointments for multiple physicians in one practice 40+ WPM typing speed Experience handling multiple phone lines Nice to Have Skills & Experience Proficient in EPIC Experience verifying insurances Basic experience with Excel and standard workbooks Experience in either pain management, dermatology, Neurology, Endocrinology, Rheumatology, or Nephrology. Responsibilities Include: Answering phones, triaging patients, providing directions/parking instructions, contacting clinic facility to notify if a patient is running late, scheduling and rescheduling patients' appointments, verifying insurances, and assisting with referrals/follow up care. This position is on-site until fully trained and passing multiple assessments (typically around 2-4 months of working on-site - depending on performance) where it will then go remote.

RAYUS now offers DailyPay! Work today, get paid today! is $20.70 - $29.93 based on direct and relevant experience. RAYUS Radiology is looking for an Insurance Denials Specialist II to join our team. We are challenging the status quo by shining light on radiology and making it a critical first step in diagnosis and proper treatment. Come join us and shine brighter together! As an Insurance Denials Specialist you will investigate and determine the reason for a denied or unpaid claim, and take necessary steps to expedite the medical billing and collections of the accounts receivable. At CDI our passion for our patients, customers and purpose requires teamwork and dedication from all of our associates. Working in a team environment, you'll communicate with patients, insurance carriers, co-workers, centers, markets, referral sources and attorneys in a timely, effective manner.This is a 100% remote full-time position working 40 hours per week. Shifts are from 8:00 AM - 4:30 PM. ESSENTIAL DUTIES AND RESPONSIBILITIES: (90%) Insurance Denial Follow-up Accurately and efficiently reviews denied claim information using the payer's explanation of benefits, website, and by making outbound phone calls to the payer's provider relations department for multiple denial types, payers, and/or states Reviews and obtains appropriate information or documentation from claim re-submission for all denied services, per insurance guidelines and requirements Communicates with patients, insurance carriers, co-workers, centers, markets, referral sources and attorneys in a timely, effective manner to expedite the billing and collection of accounts receivable Documents all communications with coworkers, patients, and payer sources in the billing system Contributes to the steady reduction of the days-sales-outstanding (DSO), increases monthly gross collections and increases percentage of collections Prioritizes work load, concentrating on "priority" work which will enhance bottom line results and achievement of the most important objectives Contributes to a team environment Recognizes and communicates trends in workflow to departmental leaders Meets or exceeds RCM Quality Assurance standards Ensures timely follow-up and completion of all daily tasks and responsibilities (10%) Performs other duties as assigned As backup for customer service team, communicates and responds to customer inquiries as needed

Job We are seeking a motivated and results driven Life Insurance Sales Representative to join our team In this role you will be responsible forselling life insurance policies to potential clients that have reach out to our agency requesting information This is a commission only meaning you will be compensated based on the policies you sell Both full and part time sales and team management positions are available Work from anywhere Job DetailsFull Time or Part Time Commission ONLY This is a position with the Parker Agency that you can start part time if needed and build your income until it matches what you are currently making full timethen make the transition Also if you are just looking for an extra income each month this is an ideal position for you Responsibilities Service our inbound leads Scheduling Your Own Appointments From Clients Who Mailed In A Request To Be CalledIdentify and understand the needs of potential clients to offer appropriate life insurance products Present and explain insurance policy options to clients and provide professional advice to help them make informed decisions Maintain accurate records of sales customer information and client interactions Follow up with clients and prospective clients to ensure customer satisfaction and to close sales Attend training sessions and stay up to date on industry trends and regulations Requirements Disciplined work ethic and a desire to succeed Excellent communication and interpersonal skills Ability to work independently and manage your own schedule Strong customer service skills and a client focused mindset Ability to build and maintain relationships with clients and potential clients Active life insurance license in the states you will be selling in Compensation This is acommission onlyposition meaning you will be compensated based on the policies you sell The earning potential is unlimited and high performing sales representatives have the opportunity to make a significant income We provide training and support to help you succeed in this role If you are a self motivated results driven sales professional looking for a commission only position with unlimited earning potential we want to hear from you Please submit your resume and cover letter to apply for this position If you are interested you will be expected to schedule a phone interview as soon as you apply and be on time for that appointment Once you apply you will receive an email and a text with instructions as to what we want you to do before you click on the link to schedule your phone interview As a licensed agent does it hurt to take a look at the different approach we offer We look forward to partnering with you Chadd Parker Regional Sales Manager Schedule Your Interview Timehttpscalendlycomchaddparker P ************ No agents success earnings or production results should be viewed as typical average or expected Not all agents achieve the same or similar results and no particular results are guaranteed Your level of success will be determined by several factors including the amount of work you put in your ability to successfully follow and implement our training and sales system and engage with our lead system and the insurance needs of the customers in the geographic areas in which you choose to work

At Broadway Ventures, we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB), we empower government and private sector clients by delivering tailored solutions that drive operational success, sustainability, and growth. Built on integrity, collaboration, and excellence, we're more than a service provider-we're your trusted partner in innovation. Become an integral part of a dedicated team supporting the World Trade Center Health Program. In this role, you will leverage your strong attention to detail and commitment to accuracy in processing complex medical claims. If you are eager to make a positive impact in the community through your administrative skills, we encourage you to apply. Work Schedule Remote Monday through Friday, 8:30 AM to 5:00 PM EST Must be able to work 8am - 5pm Eastern Standard Time Responsibilities Claims Review and Processing Analyze and process a variety of complex medical claims in accordance with program policies and procedures, ensuring accuracy and compliance. Critical Analysis Adjudicate claims according to program guidelines, applying critical thinking skills to navigate complex scenarios. Timely Processing Ensure prompt claims processing to meet client standards and regulatory requirements. Identify and resolve any barriers using effective problem-solving strategies. Issue Resolution Collaborate with internal departments to proactively resolve discrepancies and issues. Use analytical skills to identify root causes and implement solutions. Confidentiality Maintenance Uphold confidentiality of patient records and company information in accordance with HIPAA regulations. Detailed Record Keeping Maintain thorough and accurate records of claims processed, denied, or requiring further investigation. Trend Monitoring Analyze and report trends in claim issues or irregularities to management. Assist Team Leads with reporting to contribute to continuous process improvements. Audit Participation Engage in audits and compliance reviews to ensure adherence to internal and external regulations. Critically evaluate and recommend process improvements when necessary. Mentoring Mentor and train new claims processors as needed. Requirements High school diploma or equivalent. Minimum of five years of experience in medical claims processing, including professional and facility claims, as well as complex and high-dollar claims. Billing experience doesn't count towards years of experience qualification Familiarity with ICD-10, CPT, and HCPCS coding systems. Understanding of medical terminology, healthcare services, and insurance procedures (experience with worker's compensation claims is a plus). Strong attention to detail and accuracy. Ability to interpret and apply insurance program policies and government regulations effectively. Excellent written and verbal communication skills. Proficiency in Microsoft Office Suite (Word, Excel, Outlook). Ability to work independently and collaboratively within a team environment. Commitment to ongoing education and staying current with industry standards and technology advancements. Experience with claim denial resolution and the appeals process. Ability to manage a high volume of claims efficiently. Strong problem-solving capabilities and a customer service-oriented mindset. Flexibility to adjust to the evolving needs of the client and program changes. Benefits 401(k) with employer matching Health insurance Dental insurance Vision insurance Life insurance Flexible Paid Time Off (PTO) Paid Holidays What to Expect Next: After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with a recruiter to verify resume specifics and discuss salary requirements. Management will be conducting interviews with the most qualified candidates. We perform a background and drug test prior to the start of every new hires' employment. In addition, some positions may also require fingerprinting. Broadway Ventures is an equal-opportunity employer and a VEVRAA Federal Contractor committed to providing a workplace free from harassment and discrimination. We celebrate the unique differences of our employees because they drive curiosity, innovation, and the success of our business. We do not discriminate based on military status, race, religion, color, national origin, gender, age, marital status, veteran status, disability, or any other status protected by the laws or regulations in the locations where we operate. Accommodations are available for applicants with disabilities.

Thank you for your interest in joining our team. If you're looking to be part of a team that values integrity, humility, excellence, challenge, and life-long learning, you've come to the right place. At First Bank we believe in offering opportunities to help individuals build a long and lasting career, and we are currently seeking a Title Insurance Clerk. The Title Insurance Clerk helps Southern Illinois Title fulfill its vision by providing quality service and creating profitable trusted relationships. Duties and Responsibilities Answers telephone calls, answers inquiries and follows up on requests for information. Travels to closings and county courthouses. Processes quotes. Researches the proper legal description of properties. Researches and obtains records at courthouse. Examines documentation such as mortgages, liens, judgments, easements, plat books, maps, contracts, and agreements to verify factors such as properties' legal descriptions, ownership, or restrictions. Evaluates information related to legal matters in public or personal records. Researches relevant legal materials to aid decision making. Prepares reports describing any title encumbrances encountered during searching activities, and outlining actions needed to clear titles. Prepares and issues Title Commitments and Title Insurance Policies based on information compiled from title search. Confers with realtors, lending institution personnel, buyers, sellers, contractors, surveyors, and courthouse personnel to exchange title-related information, resolve problems and schedule appointments. Accurately calculates and collects for closing costs. Prepares and reviews closing documents and settlement statement for loan or cash closings. Obtains funding approval, verification and disbursement of funds. Conducts insured closings with clients, realtors, and loan officers. Maintains a streamline approach to meet deadlines. Records all recordable documents. Conducts 1099 reporting. Helps scan files into System. Protects the company and clients by following company policies and procedures. Performs other duties as assigned. Qualifications Skill Requirements: Analytical skills Interpreting Researching Reporting Problem solving Computer usage Verbal and written communication Detail orientation Critical thinking Complaint resolution Knowledge: Title Insurance Work experience: 5 years of banking or title insurance Certifications: None required Management experience: None required Education: High school diploma Motivations: Desire to grow in career Work Environment Work Hours: Monday through Friday, 8:00-5:00 (Additional hours may be required for company meetings or training.) Job Arrangement: Full-time, permanent Travel Requirement: Frequent travel is required for closings and research. Additional travel may be required from time to time for client meetings, training, or other work-related duties. Remote Work: The job role is primarily in-person. A personal or work crisis could prompt the role to become temporarily remote. Physical Effort: May require sitting for prolonged periods. May occasionally require moving objects up to 30 pounds. Environmental Conditions: No adverse environmental conditions expected. Client Facing Role: Yes The position offers a competitive salary, medical insurance coverage, 401K-retirement plan, and other benefits. EO / M /F/ Vet / Disability. First Bank is an equal opportunity employer. It is our policy to provide opportunities to all qualified persons without regard to race, creed, color, religious belief, sex, sexual orientation, gender identification, age, national origin, ancestry, physical or mental handicap, or veteran's status. Equal access to programs, service, and employment is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process should notify human resources. This application will be given every consideration, but its receipt does not imply that the applicant will be employed. Applications will be considered for vacancies which arise during the 60-day period following submission. Applicants should complete an updated application if not contacted and/or hired during this 60-day evaluation period. Replies to all questions will be held in strictest confidence. In order to be considered for employment, this application must be completed in full. APPLICANT'S STATEMENT By submitting an application I agree to the following statement: (A) In consideration for the Bank's review of this application, I authorize investigation of all statements contained in this electronic application. My cooperation includes authorizing the Bank to conduct a pre-employment drug screen and, when requested by the Bank, a criminal or credit history investigation. (B) As a candidate for employment, I realize that the Bank requires information concerning my past work performance, background, and qualifications. Much of this information may only be supplied by my prior employers. In consideration for the Bank evaluating my application, I request that the previous employers referenced in my application provide information to the Bank's human resource representatives concerning my work performance, my employment relationship, my qualifications, and my conduct while an employee of their organizations. Recognizing that this information is necessary for the Bank to consider me for employment, I release these prior employers and waive any claims which I may have against those employers for providing this information. (C) I understand that my employment, if hired, is not for a definite period and may be terminated with or without cause at my option or the option of the Bank at any time without any previous notice. (D) If hired, I will comply with all rules and regulations as set forth in the Bank's policy manual and other communications distributed to employees. (E) If hired, I understand that I am obligated to advise the Bank if I am subject to or observe sexual harassment, or other forms of prohibited harassment or discrimination. (F) The information submitted in my application is true and complete to the best of my knowledge. I understand that any false or misleading statements or omissions, whether intentional or unintentional, are grounds for disqualification from further consideration of employment or dismissal from employment regardless of when the false or misleading information is discovered. (G) I hereby acknowledge that I have read the above statement and understand the same.

CrossCountry Mortgage (CCM) is the nation's number one distributed retail mortgage lender with more than 7,000 employees operating over 700 branches and servicing loans across all 50 states, D.C. and Puerto Rico. Our company has been recognized ten times on the Inc. 5000 list of America's fastest-growing private businesses and has received many awards for our standout culture. A culture where you can grow! CCM has created an exceptional culture driving employee engagement, exceeding employee expectations, and directly impacting company success. At our core, our entrepreneurial spirit empowers every employee to be who they are to help us move forward together. You'll get unwavering support from all departments and total transparency from the top down. CCM offers eligible employees a competitive compensation plan and a robust benefits package, including medical, dental, vision, as well as a 401K. We also offer company-provided short-term disability, an employee assistance program, and a wellness program. Position Overview: The Insuring Specialist validates loan file information and accurately enters data into FHA Connection, VA WebLGY, and USDA LINC to obtain the required mortgage insurance certificate. This role actively manages a daily pipeline of loans to ensure prompt endorsement. The Insuring Specialist is responsible for meeting daily production goals set by management. Job Responsibilities: Pay upfront fees and accurately record transactions in Encompass. Review all required documents to ensure compliance with government agency guidelines. Request missing or unsigned documents to ensure complete and compliant loan files. Verify loan file data and promptly insure all eligible loans by entering accurate information into FHA Connection, VA WebLGY, and USDA LINC to obtain the required mortgage insurance certificate. Prepare and stack files for manual endorsement when required. Endorse loan files, update insuring information in Encompass, and upload the applicable mortgage insurance certificate to the Encompass eFolder. Promptly escalate all unresolved loan issues to insuring management. Proactively manage a loan pipeline, maintaining up-to-date comments that reflect current loan status. Meet daily production goal set by management. Qualifications and Skills: High School Diploma or equivalent. Experience in paying and insuring government loans. Experience navigating government agency websites, particularly insuring platforms. 3+ years of experience in loan processing and insuring, preferred. Knowledge of government agency fees and the specific processes required for payment. Familiarity with the overall loan process and the responsibilities of related departments. Excellent communication and collaboration skills to effectively request or correct required documentation. This is intended to convey information essential to understanding the scope of the job and the general nature and level of work performed by job holders within this job. However, this job description is not intended to be an exhaustive list of qualifications, skills, efforts, duties, responsibilities or working conditions associated with the position. Pay Range: Hourly Rate: $19.23 - $21.63 The posted pay range considers a wide range of compensation factors, including candidate background, experience and work location, while also allowing for salary growth within the position. CrossCountry Mortgage, LLC offers MORE than a job, we offer a career. Apply now to begin your path to success! careersatccm.com CrossCountry Mortgage, LLC strives to provide employees with a robust benefit package: ********************************** California residents: Please see CrossCountry's privacy statement for information about how CrossCountry collects and uses personal information about California applicants. CrossCountry Mortgage supports equal employment opportunity in hiring, development and advancement for all qualified persons without regard to race, color, religion, religious creed, national origin, age, physical or mental disability, ancestry, marital status, uniformed service, covered veteran status, citizenship status, sex (including pregnancy, childbirth, and related medical conditions, and lactation), sexual orientation, gender identity, gender expression, transgender status, domestic violence victim status (where applicable), protected hair style or texture, genetic information (testing or characteristics), or any other protected status of an individual or because of the individual's association with a member of a protected group or any other characteristic protected by federal, state, or local law (“Protected Characteristics”). The collective sum of the individual differences, life experiences, knowledge, inventiveness, innovation, self-expression, unique capabilities and talent that our employees invest in their work represents a significant part of not only our culture, but our reputation. The Company is committed to fostering, cultivating and preserving a culture that welcomes diversity and inclusion. CrossCountry Mortgage, LLC (NMLS3029) is an FHA Approved Lending Institution and is not acting on behalf of or at the direction of HUD/FHA or the Federal government. To verify licensing, please visit ***************************

We are recruiting 100 entry level Remote Insurance Verification Representatives in FL, NV, SD, TX, and WY. If you are looking for steady work from home with consistent pay then this is the opportunity for you. To make sure this is a fit for you, please understand: You will be on the phone the entire shift. You will need to overcome simple objections and maintain a positive attitude. You will need to purchase a USB Headset (if you don't already have one). True W2 pay check and direct deposit company (not gimmick 1099 pay) No phone line needed No cellphone needed No driving required No people to meet No packaging materials No shipping No ebay accounts No phone experience needed (but a serious advantage) Company Culture This compant prides itself on empowering their team to be responsible, "show up" on time for their shift(s), and stay focused on their task(s) the whole time. Working from home is a blessing, but it can also be the biggest distraction. That's why they their staff with the utmost respect and expect the same from them. This is a serious opportunity from one of the most modern work from home companies on the planet. They are literally a bunch of people spread out around the country with a common goal of helping select customers complete their car insurance quotes. They skype together all day and everyone supports eachother as a team even though 95% all work from REMOTE locations. This company has been in the online and insurance marketing business for over 3 years now, and the founder has been in this industry for over 10 years now. Compensation $8.25/hr starting or 3$ per lead depending on which is more. Focused and aggressive verifiers make $15-$19 an hour. Scheduling The shifts that are available are 9am-1pm / 1pm-5pm / 5pm-9pm M-F. (Eastern Time). Depending on your location and availability you will be assigned (1) of these shifts temporarily until you are well trained and established. You will start as PART TIME. Once you are established Full time is possible and many reps choose full time. Full on-going success training is provided. (You are NOT required to purchase training materials or anything from them or us.) Again all you need is your own computer, high speed internet, 5 MBPS Download Speeds and 1 MBPS Upload Speeds USB headset.

At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees have been key factors in our company's growth and market presence. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here. For more than 25 years, NTT DATA have focused on impacting the core of your business operations with industry-leading outsourcing services and automation. With our industry-specific platforms, we deliver continuous value addition, and innovation that will improve your business outcomes. Outsourcing is not just a method of gaining a one-time cost advantage, but an effective strategy for gaining and maintaining competitive advantages when executed as part of an overall sourcing strategy. NTT DATA is seeking to hire a **Remote Claims Processing Associate** to work for our end client and their team. **Note** : This is a US based, W-2 project. All candidates will be paid through NTT DATA only. **Role Responsibilities** + Processing of Professional claim forms files by provider + Reviewing the policies and benefits + Comply with company regulations regarding HIPAA, confidentiality, and PHI + Abide with the timelines to complete compliance training of NTT Data/Client + Work independently to research, review and act on the claims + Prioritize work and adjudicate claims as per turnaround time/SLAs + Ensure claims are adjudicated as per clients defined workflows, guidelines + Sustaining and meeting the client productivity/quality targets to avoid penalties + Maintaining and sustaining quality scores above 98.5% PA and 99.75% FA. + Timely response and resolution of claims received via emails as priority work + Correctly calculate claims payable amount using applicable methodology/ fee schedule **Required Skills/Experience** + 1-3 year(s) hands-on experience in Healthcare Claims Processing + 2+ year(s) using a computer with Windows applications using a keyboard, navigating multiple screens and computer systems, and learning new software tools + High school diploma or GED. **Preferences** + Amisys &/or Xcelys Preferred + Time management with the ability to cope in a complex, changing environment + Effective troubleshooting where you can leverage your research, analysis and problem-solving abilities + Previously performing - in P&Q work environment; work from queue; remotely **Must be able to work 7am - 4 pm CST online/remote (training is required on-camera).** \#LI-NorthAmerica About NTT DATA: NTT DATA is a $30+ billion trusted global innovator of business and technology services. We serve 75% of the Fortune Global 100 and are committed to helping clients innovate, optimize, and transform for long-term success. We invest over $3.6 billion each year in R&D to help organizations and society move confidently and sustainably into the digital future. As a Global Top Employer, we have diverse experts in more than 50 countries and a robust partner ecosystem of established and start-up companies. Our services include business and technology consulting, data and artificial intelligence, industry solutions, as well as the development, implementation and management of applications, infrastructure, and connectivity. We are also one of the leading providers of digital and AI infrastructure in the world. NTT DATA is part of NTT Group and headquartered in Tokyo. Visit us at us.nttdata.com. NTT DATA is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team. Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting hourly range for this remote role is ($18.00 - $18.00/hourly ). This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications. This position is eligible for company benefits that will depend on the nature of the role offered. Company benefits may include medical, dental, and vision insurance, flexible spending or health savings account, life, and AD&D insurance, short-and long-term disability coverage, paid time off, employee assistance, participation in a 401k program with company match, and additional voluntary or legally required benefits.

Requirements Proficient knowledge of ICD-10/HCPCS Proficient knowledge of Microsoft office & Google based webpages A/R Follow-up experience (Preferred) Collections experience (Preferred) Physical Therapy Claims experience ( Preferred ) Ability to multi-task & a keen attention to detail a must Minimum of 2+ Years of Medical Billing experience (outside of schooling / externship). *Remote work setting available after completion of on-site training/probationary period. At the discretion of management and needs of the company. Note: This job description is intended to provide a general overview of the position. It is not an exhaustive list of all responsibilities, skills, or qualifications required for the role. *Sunbelt Healthcare provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Salary Description $16.00

Responsibilities * Perform insurance verification and manage documentation. * Handle referrals efficiently and accurately. * Handle medical billing * Work with Athena EMR system for patient management. * Communicate effectively with a diverse patient base, including Spanish-speaking individuals. Essential Skills * Proficiency in Athena EMR system. * Bilingual in Spanish, with strong reading, writing, and speaking abilities. * Experience with lab instrumentation and sterilization techniques. * Strong administrative skills and attention to detail. Additional Skills & Qualifications * Ability to thrive in a fast-paced, high-volume environment. * Experience with Nextgen EMR system is a plus. Job Type & Location This is a Contract to Hire position based out of Los Angeles, CA. Pay and Benefits The pay range for this position is $21.00 - $23.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully onsite position in Los Angeles,CA. Application Deadline This position is anticipated to close on Jan 24, 2026. About Actalent Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.

Engage with us for your next career opportunity. Right Here. Job Type: Regular Scheduled Hours: 40 💙 Why You'll Love Working with St. Elizabeth Healthcare At St. Elizabeth Healthcare, every role supports our mission to provide comprehensive and compassionate care to the communities we serve. For more than 160 years, St. Elizabeth Healthcare has been a trusted provider of quality care across Kentucky, Indiana, and Ohio. We're guided by our mission to improve the health of the communities we serve and by our values of excellence, integrity, compassion, and teamwork. Our associates are the heart of everything we do. 🌟 Benefits That Support You We invest in you - personally and professionally. Enjoy: - Competitive pay and comprehensive health coverage within the first 30 days. - Generous paid time off and flexible work schedules - Retirement savings with employer match - Tuition reimbursement and professional development opportunities - Wellness, mental health, and recognition programs - Career advancement through mentorship and internal mobility Job Summary: This position is responsible for timely and accurate billing of assigned accounts to a variety of payors using the computerized patient accounting systems. Responsibilities also include staying current with UB-04 and HCFA-1500 billing requirements, HIPAA Regulations, Payor Regulations, and Payor Contractual Agreements to ensure proper billing and compliance. This position is responsible for communication to supervisor/manager as to identify issues associated with charges, billing, etc. so billing systems are programmed accurately for billing. Demonstrate respect, dignity, kindness, and empathy in each encounter with all patients, families, visitors and other employees regardless of cultural background. Job Description: Billing Responsibilities Review bills and related information for accuracy and reasonableness of charges Audit claims for overlap (charges, dates, coding, condition codes, modifiers, discharge status) and resolves issues with medical records and revenue department heads. (as applicable) Work Specific Reports (as applicable) Submit bills to payers electronically if possible, otherwise paper Proficient in Commercial/Medicare/Medicaid Government regulations and reimbursement policies Proficient in third party contractual agreements and regulations to apply requirements for accurate billing and to make recommendations for system changes as needed Stay current with third party contractual arrangements and regulations (Medicare, Medicaid, Champus, managed care, etc.) to apply requirements for accurate billing and to make recommendations for system changes as needed. Compute required adjustments to bills, balances to support, and inputs debits/credits to billing system to appropriate codes to ensure accurate billing. Follow up on unbilled claims pending Medical Records coding, claim forms, etc. in order to bill on a timely basis. Take appropriate action to resolve claims. Execute any, and all, steps to resolve unpaid, including but not limited to; rebill of claim Perform due diligence on all collection efforts Assist other associates when necessary, as determined by manager, work with staff to identify and resolve issues and develop standard Elevate serious barriers to claim resolution to appropriate management Demonstrate adequate, appropriate, and professional levels of communication with insurance company representatives, team members, supervisors, and managers Record approved detailed note in the billing system Ensure expected reimbursement is secured with knowledge of billing system Expected Reimbursement data or payor contract Meets productivity and quality standards on a weekly basis Understand and adhere to the concepts of stratification Demonstrate ability to work with high volume edits Ensure timely turnaround of internal requests (EOB's, medical records) Seek opportunity for training and informs supervisor of all training needs Other Complete special projects & tasks by the established time frame which can include organizing workload and/or associates for successful account resolution: proactively notify supervisor of any barriers that prohibit billing and/or payment of claims Assume duties of supervisor or lead as needed. Assist co-worker in problem solving, with reports, meetings, etc. Complete other billing tasks and duties as assigned by manager Execute training of contract staff (internal and external) Act as a preceptor for new employees and as a resource within the department Communication/Trending Trends weekly productivity, Billing CFB, Open AR Edit WQs (Securing required data necessary for billing.) Attends weekly billing staff meetings Identifies payer & billing issues Participates in a positive & constructive manner Respond to internal and external customer calls or concerns. Continuing Education & Training Seeks opportunity for training & informs supervisor of all training needs. Attends Seminars and workshops as assigned by manager, to obtain billing and/or follow up information related to specific payers. Perform other duties as assigned. Education, Credentials, Licenses: High School diploma or GED Specialized Knowledge: PC Skills, including Word and Excel. Detail Oriented Customer Service Skills Excellent Communication Skills Billing or Follow Up experience Kind and Length of Experience: One year's experience in billing or follow-up activities Experience in customer service, billing or related field. FLSA Status: Non-Exempt Right Career. Right Here. If you're looking for the right careers in healthcare, the right place to be is at St. Elizabeth. Join us, and you'll take pride in the level of care we offer our community.

Welcome! We're excited you're considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you'll find other important information about this position. This position is responsible for obtaining authorizations for elective infusions and injections to financially clear patients and ensure reimbursement for the organization. Payor resources and any other applicable reference material such as payor and medical policies should be utilized to verify accurate prior authorization requirements. Escalates financial clearance risks as appropriate in compliance with the Financial Clearance Program. Serving as a liaison between clinical teams and pharmacists ensuring effective communication regarding infusion prior authorization issues. Cases are to be coded, and clinical documentation reviewed to ensure the documentation is complete to maximize reimbursement. MINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. High school graduate or equivalent with 2 years working experience in a medical environment, (such as a hospital, doctor's office, or ambulatory clinic.) OR 2. Associate's degree and 1 year of experience in a medical environment. PREFERRED QUALIFICATIONS: EXPERIENCE: 1. 3 years' experience of knowledge and interpretation of medical terminology, ICD-10, and CPT codes. 2. Understanding of authorization processes, insurance guidelines, and third-party payors practices. 3. Proficiency in Microsoft Office applications. 4. Excellent communication and interpersonal skills. 5. Ability to prioritize to meet deadlines and multitask a large work volume with a high level of efficiency and attention to detail. 6. Basic computer skills. CORE DUTIES AND RESPONSIBILITIES: As an advocate for WVUH/UHA employees, company and departmental goals and initiatives and HR Compliance, demonstrate knowledge of management and employee needs and apply that knowledge to create solutions. 1. Utilize work queues within the EPIC system to manage workloads and prioritize to meet deadlines. 2. Collect and communicate outpatient benefit information to the Patient Financial Services team via queues and billing indicators in Epic. 3. Refer to medical and coverage policies for medications. 4. Research CPT codes for drugs/injections. 5. Verify authorization requirements by utilizing insurance portals or calling insurances. 6. Submit authorizations as a buy-and-bill via medical benefit for outpatient on-campus hospital requests by utilizing insurance portals, prior authorization forms, or calling insurances. 7. Review and interpret medical record documentation to answer clinical questions during the authorization process. 8. Clearly and effectively communicate with clinics when additional information is needed. 9. Uses hospital communications systems (fax, pagers, telephones, copiers, scanners, and computers) in accordance with hospital standards. 10. Daily follow up on submitted authorization requests. 11. Scheduling and following up on peer to peers. 12. Submitting and following up with prior authorization appeals for denied medications. 13. Clearly and effectively communicate to the appropriate persons when home infusion or pharmacy benefit is needed. 14. Verification of referrals and authorizations in work queues. 15. Identify changes in medication dosing/frequency. 16. Assists Patient Financial Services with denial management issues and will obtain retro authorizations as needed. 17. Maintain in baskets in Epic and emails in Outlook. 18. Participate in monthly team meetings and one-on-ones. 19. Builds admissions and submit authorization for elective inpatient chemotherapy admission and observations. 20. Follows established workflows, identifies deviations or deficiencies in standards/systems/processes and communicates problems to supervisor or manager. 21. Is polite and respectful when communicating with staff, physicians, patients, and families. Approaches interpersonal relations in a positive manner. 22. Maintains confidentiality according to policy when interacting with patients, physicians, families, co-workers, and the public regarding demographic/clinical/financial information. PHYSICAL REQUIREMENTS: 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. 1. Prolonged periods of sitting. 2. Extended periods on the telephone requiring clarity of hearing and speaking. 3. Manual dexterity required to operate standard office equipment. 4. Must have manual dexterity to operate keyboards, fax machines, telephones, and other business equipment. WORKING 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. 1. Outpatient clinical environment. SKILLS AND ABILITIES: 1. Excellent oral and written communication skills. 2. Basic knowledge of medical terminology. 3. Basic knowledge of ICD-10 and CPT coding. 4. Basic knowledge of third-party payors. 5. Basic knowledge of business math. 6. General knowledge of time-of-service collection procedures. 7. Excellent customer service and telephone etiquette. 8. Minimum typing speed of 25 works per minute. 9. Must have reading and comprehension ability. Additional Job Description: Scheduled Weekly Hours: 40 Shift: Exempt/Non-Exempt: United States of America (Non-Exempt) Company: SYSTEM West Virginia University Health System Cost Center: 536 SYSTEM Hospital Authorization Unit

About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. JOB SUMMARY: ESSENTIAL DUTIES AND RESPONSIBILITIES: Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member's performance objectives as outlined by the Team Member's immediate Leadership Team Member. Resolve complex, higher-dollar unpaid/denied claims by leveraging proprietary software system, making phone calls, generating letters, accessing client systems and insurance carrier web portals in the pursuit of getting a claim resolved. Identify and report trends found during the account resolution process such as CPT/HCPCS errors/deletions, duplicate claims, revenue code mapping mismatches, missing charges, no claim on file. Perform financial account assessment functions including but not limited to adjustments and NRP to patient. Work within client systems to complete rebill functions. Perform administrative functions including but not limited to medical record submissions, billing claims, patient assistance outreach, obtaining documents from client systems and insurance plan code updates, review corrected claim requests and approve for client assistance or correct the bill within client platform, review and submit payment verification assistance requests. Maintain familiarity with client preferences and known issues across multiple client accounts. Support special projects for clients as needed. Other duties as assigned. QUALIFICATIONS High School Diploma or equivalent 5+ years relevant industry experience in registration, billing, collections, required 3+ years experience with insurance carrier claims resolution, required 3+years of Epic, Cerner, Meditech or other EMR experience preferred Knowledge of UB04 claim forms, EOB's and medical records required ICD-9, ICD-10, CPT and HCPCS coding knowledge required Ability to conduct detailed research to resolve complex claims Intermediate mathematics skills (addition, subtraction, ability to identify trends, etc.) Advanced knowledge of Excel and Power Point Ability to compile and summarize data Strong verbal and written communication skills Ability to analyze and interpret complex documents, contracts, notes, and other correspondence Ability to prioritize and multitask in a fast-paced environment Ability to work effectively in a remote environment Investigative mind set to identify issues and implement solutions. PHYSICAL DEMANDS: Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines. A is only intended as a guideline and is only part of the Team Member's function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

GoTo Telemed seeks an exceptional Remote Medical Biller to manage comprehensive Revenue Cycle Management (RCM) operations for our rapidly expanding telehealth platform serving multiple medical specialties and healthcare providers nationwide. As a key member of our distributed RCM team, you will process, manage, and optimize medical claims for an increasing portfolio of telehealth providers-with new clients and provider networks added every month as our organization scales. In this critical role, you will be the financial backbone of our provider network, managing the complete end-to-end billing lifecycle including patient eligibility verification, insurance claim submission, payment posting, accounts receivable follow-up, and comprehensive denial management. Your expertise in medical coding (CPT, ICD-10-CM, HCPCS), telehealth modifiers, payer policies, and compliance will directly impact provider revenue, patient satisfaction, and our organizational growth trajectory. This position offers exceptional opportunity for professional growth, career advancement, and organizational scaling as GoTo Telemed expands its provider network and service offerings monthly. You will receive comprehensive training, access to cutting-edge RCM tools and resources, and mentorship to develop into a senior RCM specialist or team lead. Why Join GoTo TelemedUnlimited Growth Opportunity Monthly Provider & Client Expansion: As GoTo Telemed adds new healthcare providers and medical specialties every month, your responsibilities and earning potential expand proportionally Scalability without Chaos: We implement systematic processes, training, and resources to ensure smooth scaling-you grow professionally without being overwhelmed Career Advancement Path: Progress from Medical Biller → Senior Biller → RCM Team Lead → RCM Manager → Director of Revenue Operations Skill Diversification: Work with multiple medical specialties (primary care, cardiology, orthopedics, behavioral health, urgent care, etc.), expanding your coding and compliance expertise Comprehensive Support & Resources Professional Training Programs: Formal onboarding, continuous education on CPT/ICD-10 updates, telehealth policy changes, and payer-specific requirements Certification Support: Full reimbursement for CPB, CPC, CCA, or other healthcare credentials; study time and exam fees covered Advanced RCM Technology: Access to best-in-class practice management systems, claims clearinghouses, coding software, and automation tools Expert Mentorship: Paired with experienced RCM professionals for guidance on complex coding scenarios, denial resolution, and process optimization Peer Collaboration: Work with a talented distributed team of medical billers, coders, and RCM specialists-regular team meetings, knowledge sharing, and collaborative problem-solving Remote Work Flexibility 100% Work-from-Home: Eliminate commuting; work from anywhere with reliable internet Flexible Schedule: Core hours 8 AM - 5 PM CST, with flexibility for medical appointments, personal needs, and work-life balance Home Office Support: $500 annual stipend for home office equipment, internet upgrades, and ergonomic setup Distributed Team Culture: Collaborate with colleagues across time zones; async communication tools support flexible scheduling Financial Rewards & Growth Performance-Based Incentives: Earn bonuses based on claims processed, approval rates, AR reduction, and denial prevention-your accuracy and efficiency directly increase earnings Annual Raises & Reviews: Merit-based salary increases tied to performance, certifications, and expanded responsibilities Unlimited Earning Potential: As the provider network grows, so do opportunities for higher-volume processing, team oversight, and management roles with corresponding salary increases Transparent Compensation: Clear performance metrics and bonus structure; you always know how to increase earnings Primary ResponsibilitiesInsurance Eligibility & Verification Verify patient medical insurance eligibility and benefits prior to telehealth appointment scheduling using secure insurance verification portals and phone verification Confirm coverage details including deductibles, out-of-pocket maximums, copays, coinsurance, frequency limitations, and telehealth coverage status Identify medical necessity requirements, pre-authorization, and referral requirements; obtain all necessary approvals before service delivery Maintain accurate, current insurance information in practice management systems; update policies when changes occur Identify coverage gaps, exclusions (telehealth limitations, specialty exclusions, etc.), and conditions affecting billing and collections Document all verification activities and flag special requirements or coverage concerns for clinical and billing teams Patient Registration & Demographics Ensure complete, accurate patient demographic and insurance data capture at appointment booking Validate patient information accuracy (name, date of birth, insurance policy numbers, group numbers, member IDs, etc.) Update patient records when insurance changes, policies renew, or coverage terminations occur Communicate patient financial responsibilities, copays, deductibles, and projected out-of-pocket costs before service delivery Capture patient consent for services and billing; document in compliance with HIPAA and state telehealth regulations Medical Coding & Claims Preparation Accurately code telehealth visits and medical services using Current Procedural Terminology (CPT) codes and appropriate modifiers Assign correct ICD-10-CM codes for all diagnoses documented in clinical notes Apply telehealth-specific modifiers (93 for audio-only, 95 for audio/video synchronous, GT, FQ, FR) in accordance with payer policies and CMS guidance Verify correct place of service (POS) coding for telehealth encounters (POS 02 for provider office, POS 10 for patient home, POS 11 for patient location as specified) Ensure complete charge capture and accurate medical necessity documentation; identify any missing information before claim submission Review clinical documentation for specificity (laterality, severity, complexity) and communicate coding queries to providers when documentation is insufficient Stay current with annual CPT/ICD-10 updates, new telehealth codes (98000-series), and payer-specific coding requirements Claims Submission & Management Submit medical claims electronically through clearinghouses (837 EDI format) within 3-5 days of service delivery Prepare and manage claims via multiple submission pathways: electronic clearinghouse, direct payer portals, and print-to-mail for specific payers or situations Track all submitted claims with documentation of submission date, claim number, claim status, and clearinghouse identification Monitor claim status continuously; flag claims at risk of denial or delay for proactive follow-up Manage front-end claim edits and rejections; correct claim errors and resubmit within 24 hours Comply with all payer-specific requirements: claim format, documentation attachments, modifier usage, and submission deadlines Maintain detailed claim tracking logs for audit and reporting purposes Accounts Receivable (AR) Follow-Up & Collections Monitor outstanding claims daily; conduct systematic follow-up on all claims past 15, 30, 45, and 60 days Contact insurance companies via phone, email, and secure payer portals to obtain claim status, identify delay reasons, and resolve pending issues Review Explanations of Benefits (EOBs) and identify payment discrepancies, underpayments, or improper adjustments Send timely patient statements weekly for patient responsibility balances exceeding 30 days Follow up on patient balances through professional phone calls, patient statements, and secure messaging Implement systematic collection procedures for patient accounts 30+ days past due Negotiate payment plans and settlements with patients while maintaining professional, ethical communication Document all collection activities, patient communications, and payment arrangements in patient records Maintain compliance with Fair Debt Collection Practices Act (FDCPA) and state collection laws Claims Denial Management & Appeals Analyze all claim denials and rejections; identify root causes (coding errors, missing documentation, eligibility issues, medical necessity, prior authorization gaps, etc.) Prepare corrected claims with necessary documentation changes; resubmit per payer guidelines Prepare formal written appeals for denied claims with supporting clinical documentation and policy justification Track appeal submissions and responses; resubmit appeals as needed until resolution Calculate impact of denials on provider revenue; prioritize high-value or recurring denials for focused remediation Maintain denial tracking reports to identify patterns by payer, code, diagnosis, or provider Implement process improvements to prevent recurrence of common denial reasons Identify underpayments and contractual adjustment errors; prepare documentation for recovery or credit adjustment Payment Posting & Reconciliation Post insurance payments and Explanations of Benefits (EOBs) to patient accounts accurately and timely Reconcile posted EOBs with submitted claims and identify discrepancies, missing payments, or claim-to-claim variation Post patient payments from multiple sources: patient payments, payment plans, refund processing Apply payments to correct patient accounts and claim lines; maintain clear audit trail for all transactions Process contractual adjustments and write-offs per payer fee schedules and provider agreements Reconcile monthly insurance payments and EOBs with banking records; reconcile provider revenue reports Identify and resolve payment discrepancies, missing EOBs, and payment delays within 5 business days Print-to-Mail Operations Identify claims, appeals, and patient statements requiring physical mail delivery per payer requirements Prepare documentation for printing and mailing; ensure compliance with HIPAA Privacy Rule requirements Maintain print-to-mail logs with tracking information and addresses Verify patient and provider mailing addresses; ensure HIPAA-compliant delivery Track delivery of critical documents using postal tracking when available and appropriate Reporting & Analytics Generate daily claim processing reports (claims submitted, claims pending, claims approved) Produce weekly and monthly revenue cycle reports including: Days in Accounts Receivable (DAR) by payer Claim submission volume and claim approval rates Denial rates, denial reasons, and denial trends Patient collection rates and aging AR analysis Payment posting timeliness and payment discrepancies Clean claim rates (first-pass acceptance) Identify trends and process improvement opportunities; communicate findings to management Track Key Performance Indicators (KPIs) and compare performance against industry benchmarks Support management reporting and financial forecasting Requirements Compliance & Documentation Maintain strict adherence to HIPAA Privacy Rule, Security Rule, and Breach Notification Rule Ensure all patient communications comply with state-specific telehealth patient rights and privacy requirements Follow OIG compliance program guidelines including periodic HHS OIG LEIE database checks Comply with Anti-Kickback Statute (AKS), Stark Law, and False Claims Act requirements in all billing activities Document all billing activities, communications, and decisions in patient records for audit readiness Maintain confidentiality of patient Protected Health Information (PHI) at all times Report potential compliance concerns through established compliance and ethics channels Participate in compliance training annually and whenever policies are updated Multi-Specialty & Multi-Payer Experience Manage claims across multiple medical specialties and service types as GoTo Telemed expands its provider network Learn specialty-specific coding requirements (behavioral health, primary care, specialty visits, behavioral health, etc.) Adapt to evolving payer policies and coverage decisions as new providers and payers are added monthly Share knowledge with new team members as the RCM team scales Support training of new medical billers joining the team Required Qualifications & SkillsEducation & Certification High school diploma or GED required Formal training in medical billing, medical coding, healthcare administration, or related field required Current or willingness to obtain medical billing certifications within 12 months: Certified Professional Biller (CPB) through AAPC (preferred) Certified Professional Coder (CPC) through AAPC (preferred) Certified Coding Associate (CCA) through AAPC Certified Healthcare Billing and Management Executive (CHBME) Comprehensive, current knowledge of: CPT codes and medical coding principles ICD-10-CM diagnostic coding HCPCS Level II codes Telehealth-specific modifiers (93, 95, GT, FQ, FR) Medical terminology and anatomy. Professional Experience Demonstrated telehealth/telemedicine billing experience strongly preferred Hands-on experience with insurance verification and patient eligibility determination Professional experience with medical claims submission (electronic and paper) Direct accounts receivable follow-up and patient collections experience Denial management and claims appeal experience EOB/ERA reconciliation and payment posting experience Experience with multiple medical specialties (primary care, urgent care, specialty practices, etc.) preferred Experience with multi-state provider networks and varying payer policies preferred Technical Skills & Software Proficiency Advanced proficiency with Microsoft Office Suite (Excel, Word, Outlook) Hands-on experience with medical billing software and practice management systems (eClinicalWorks, Athenahealth, Kareo, NextGen, Medidata, or similar platforms) Proficiency with electronic health record (EHR) systems common to telehealth environments Experience with insurance company portals, claim submission systems, and clearinghouses (Availity, Change Healthcare, Emdeon, NTPC) Strong data entry, spreadsheet, and database management skills Familiarity with medical coding software and/or encoder systems (OptumInsight, Codebook, Pathways, etc.) Ability to navigate multiple software platforms simultaneously and switch between systems efficiently Comfort learning new software and platforms quickly as organizational tools evolve Compliance & Regulatory Knowledge Comprehensive understanding of HIPAA Privacy Rule, Security Rule, and Breach Notification Rule Working knowledge of OIG Anti-Kickback Statute, Stark Law, and exclusion list compliance Understanding of CMS Medicare policies, modifiers, and reimbursement methodologies for telehealth Knowledge of state-specific telehealth regulations and billing requirements (particularly states where GoTo Telemed operates) Familiarity with medical necessity and coverage determination processes Understanding of CPT coding standards, payer-specific coding guidelines, and LCD/NCD policies Knowledge of Explanation of Benefits (EOB) interpretation and claim-to-EOB reconciliation Soft Skills & Competencies Attention to Detail: Exceptional accuracy in data entry, coding, claims processing, and payment reconciliation; ability to spot and correct errors Communication: Strong written and verbal communication skills for professional interaction with patients, insurance companies, healthcare providers, and internal teams; ability to explain complex billing concepts clearly Problem-Solving: Analytical ability to investigate claim denials, identify root causes, research payer policies, and implement solutions Time Management: Ability to prioritize multiple tasks, manage high claim volumes, and meet established deadlines consistently Customer Service: Patience, professionalism, and empathy when handling patient billing inquiries and collections conversations Organization: Ability to maintain accurate records, manage complex workflows, and track multiple claims across stages Analytical Thinking: Ability to interpret EOBs, identify trends, create process improvements, and contribute to data-driven decision-making Professionalism: Unwavering commitment to ethical billing practices, regulatory compliance, and patient confidentiality Adaptability: Ability to learn new systems, adjust to evolving payer policies and regulations, and handle changing priorities Self-Direction: Ability to work independently in a remote environment; strong self-motivation and ownership of responsibilities Growth Mindset: Enthusiasm for professional development, certification, and expanding expertise across specialties and payers Preferred Qualifications Active Certified Professional Biller (CPB) or Certified Professional Coder (CPC) certification Experience with multiple state healthcare regulations and licensure requirements Knowledge of managed care, capitation, and alternative reimbursement models Experience with RPA (Robotic Process Automation) or medical billing automation and workflow tools Behavioral health or mental health telehealth billing experience Multi-specialty coding experience (primary care, urgent care, orthopedics, cardiology, etc.) Experience with insurance appeals, litigation support, and legal hold documentation Bilingual capabilities (English + Spanish or other languages aligned with patient populations) Previous experience in medical billing team leadership or mentoring Knowledge of healthcare revenue cycle analytics and financial reporting Experience with vendor management or integration of multiple billing systems Work Environment & Schedule Work Setting: 100% Remote (work from home); operates from any location within the United States with reliable high-speed internet Core Hours: 8:00 AM - 5:00 PM CST, Monday-Friday Schedule Flexibility: Schedule flexibility available within core hours for medical appointments, personal needs, and work-life balance; manager approval required for significant changes Occasional Overtime: May be required during high-volume periods, month-end close, or AR aging campaigns (paid at overtime rate) Shift Availability: Willingness to adjust schedule to accommodate new provider launches or peak processing periods (communicated in advance) Communication: Regular availability via email, chat, video calls, and phone during core hours; async communication tools support flexible coordination Technology Requirements: Personal computer (Windows or Mac, meeting minimum specifications), dual monitors recommended for efficiency, high-speed internet (minimum 25 Mbps), secure encrypted data storage, HIPAA-compliant communication devices Professional Development: Participation in monthly training, quarterly compliance updates, and annual strategy meetings (some may be virtual group sessions) Physical & Mental Demands Ability to sit for extended periods at a computer workstation (6-8 hours daily) Ability to read small print and review detailed documentation accurately; comfort with computer screens for extended periods Strong focus and concentration for sustained periods; ability to maintain accuracy amid distractions Emotional resilience when managing difficult collection conversations and high-pressure situations Ability to multitask and context-switch between claims, patients, and payers while maintaining accuracy Ability to handle sensitive patient information with discretion and professionalism Physical dexterity for keyboard and mouse use Reliable, stable internet connection and quiet workspace environment Compliance, Background & Regulatory Requirements Pre-Employment & Ongoing Verification: OIG Exclusion List Check: Candidate will be checked against HHS OIG LEIE database before hire; periodic re-verification conducted annually Background Check: Standard criminal background check required per healthcare industry standards; no felony convictions or healthcare fraud history State Medical Billing License Verification: If applicable to candidate's state, verification of any required healthcare administrative or medical billing licenses Tax Identification Verification: W-4 and IRS verification for employment eligibility HIPAA Compliance Certification: Mandatory HIPAA Privacy and Security training required before starting date; annual recertification required Professional Conduct Agreement: Signature confirming commitment to ethical billing practices, fraud and abuse law compliance, and state medical practice regulations Exclusion List Monitoring: Candidate agrees to annual re-verification against HHS OIG LEIE and state-specific exclusion databases during employment Confidentiality & NDA: Execution of Business Associate Agreement (BAA) and non-disclosure agreement

Summary: This position supports the Organization by functioning as a liaison between patients and health care providers or agencies in assisting, organizing, coordinating, and providing optimal health care service. Reports to: Clinical Systems and Quality Manager Supervises: N/A Dress Requirement: Business casual Work Schedule: Monday through Friday during standard business hours Times are subject to change due to business necessity Non-Exempt Job Duties, these are considered essential to the successful performance of this position: Collects and evaluates information about a patient in regard to opportunities to assist in achieving patient/family need, continuity of care and realistic outcomes Refers and coordinates appropriate processes as assigned Researches, documents and informs co-workers and patients about the available health resources at the local, state and federal levels Notifies the patient of appointments scheduled, makes follow-up calls to specialist to ensure that client attended appointments and reminds provider to submit a Consultation Report Maintains competency in obtaining and inputting medical information to and from clinical and /or other information systems including accessing information as required to complete the referral process Accurately, clearly and efficiently documents actions taken and activities performed Provides continuity of care to each patient and their family members Completes Prior Authorizations/Pre-Certification for procedures for that patients are referrals This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice Job Qualifications (Experience, Knowledge, Skills and Abilities) Preferred associate degree or higher. Experience with healthcare referrals preferred. Experience with Medical Assisting preferred. Willingness to work with all cultural and socioeconomic groups without judgment or bias Demonstrates ability to cooperatively work/mediate with all age groups and family groups Compliance with the HIPAA law and regulation; ability to confidentially retain information, passing only necessary information to those needed to perform their duty Ability to work with minimal supervision and exercise sound independent judgment Excellent familiarity and application with medical terminology Equipment Operated: Telephone Computer Printer Fax machine Copier Scanner Credit card machine Calculator Other office equipment as assigned Facility Environment: Heart of Ohio Family Health operates in multiple locations, in Columbus, OH area. All facilities have a medical office environment with front-desk reception area, separate patient examination rooms, nursing stations, pharmacy stock room, business offices, hallways and private toilet facilities. All facilities are ADA compliant. The office area is: kept at a normal working temperature sanitized daily maintains standard office environment furniture with adjustable chairs maintains standard office equipment; ie, computer, copier, fax machine, etc. at a normal working height Physical Demands and Requirements: these may be modified to accurately perform the essential functions of the position: Mobility = ability to easily move without assistance Bending = occasional bending from the waist and knees Reaching = occasional reaching no higher than normal arm stretch Lifting/Carry = ability to lift and carry a normal stack of documents and/or files Pushing/Pulling = ability to push or pull a normal office environment Dexterity = ability to handle and/or grasp, use a keyboard, calculator, and other office equipment accurately and quickly Hearing = ability to accurately hear and react to the normal tone of a person's voice Visual = ability to safely and accurately see and react to factors and objects in a normal setting Speaking = ability to pronounce words clearly to be understood by another individual

We are seeking a skilled Medical Biller to join our client's healthcare team. The ideal candidate will be responsible for accurately and efficiently processing medical claims and invoices, ensuring timely reimbursement from insurance companies and patients. The Medical Biller will work closely with healthcare providers, insurance companies, and patients to resolve billing discrepancies and ensure compliance with regulatory requirements. Requirements Job Responsibilities: Claims Processing: Prepare and submit accurate medical claims to insurance companies, Medicare, and Medicaid for reimbursement. Billing: Generate and send invoices to patients for services rendered, following up on outstanding balances and resolving billing discrepancies. Insurance Verification: Verify patients' insurance coverage and eligibility, ensuring all necessary authorizations and referrals are obtained before services being rendered. Coding: Assign appropriate medical codes (ICD-10, CPT, HCPCS) to diagnoses and procedures for billing purposes, ensuring compliance with coding guidelines and regulations. Payment Posting: Record and reconcile payments received from insurance companies and patients, applying them to the appropriate accounts in the billing system. Denial Management: Investigate and appeal claim denials and rejections, identifying and addressing root causes to prevent future issues. Patient Communication: Communicate with patients regarding billing inquiries, payment plans, and financial assistance options, providing excellent customer service while resolving concerns. Documentation: Maintain accurate and up-to-date records of billing activities, including claims submissions, payments, and correspondence with insurance companies and patients. Compliance: Adhere to all relevant healthcare regulations, including HIPAA and billing compliance guidelines, to ensure the integrity and confidentiality of patient information. Requirements Education: High school diploma or equivalent required; additional medical billing and coding certification is preferred. Experience: Minimum of one year of experience in medical billing, preferably in a healthcare setting. Knowledge: Proficient in medical terminology, billing software (e.g., Epic, Cerner), and insurance claim processing procedures. Skills: Strong attention to detail, excellent organizational and time management skills, and the ability to multitask in a fast-paced environment. Communication: Effective verbal and written communication skills, with the ability to interact professionally with patients, providers, and insurance representatives. Problem-Solving: Demonstrated ability to analyze billing issues, identify solutions, and implement process improvements to optimize revenue cycle management. Teamwork: Ability to collaborate with colleagues across departments to resolve billing-related issues and achieve organizational goals. Minimum Technical and Work Environment Requirements: Internet Connection: Primary internet connection with a minimum speed of 15 Mbps. Backup internet connection with at least 10 Mbps. Backup connection must be capable of supporting work during a power outage. Primary Device: Desktop or laptop equipped with at least: Intel Core i5 (8th generation or newer), Intel Core i3 (10th generation or newer), AMD Ryzen 5, or an equivalent processor. A minimum of 8 GB RAM. Backup Device: Must meet or exceed the performance of an Intel Core i3 processor. Must be functional during power interruptions. Peripherals and Workspace: A functioning webcam. A noise-canceling USB headset. A quiet, dedicated home office space. A smartphone for communication and verification purposes. Benefits Join Our Dynamic Team: Experience our fun, inclusive, innovative culture that values your unique contributions and supports your professional growth. Embrace the Opportunities: Seize daily chances to learn, innovate, and excel. Make a real impact in your field. Limitless Career Growth: Unlock a world of possibilities and resources to propel your career forward. Fast-Paced Thrills: Thrive in a high-energy, engaging atmosphere. Embrace challenges and reap stimulating rewards. Flexibility, Your Way: Embrace the freedom to work from home or any location of your choice. Create your ideal work environment. Work-Life Balance at Its Best: Say goodbye to stressful commutes and hello to quality time with loved ones. Achieve a healthy work-life integration to perform at your best.

Job Type: Full-Time | Remote | Flexible Hours Compensation: $90,000 - $120,000 per year, typical first year Extras: Weekly Pay | Equity Opportunity | Bonus Program | Vested Renewals AO Globe Life is actively hiring Remote Client Support Specialists to join our mission-driven, fully remote team. This position is ideal for recent or soon-to-be graduates in business, marketing, communications, or individuals seeking a people-centered role with strong professional growth potential. We offer hands-on training, warm inbound leads, and structured mentorship to help you succeed-all from wherever you choose to work. Key Responsibilities Conduct scheduled virtual consultations with clients via Zoom Guide individuals and families through personalized benefit options and the enrollment process Maintain accurate and organized digital records of client interactions Deliver excellent service and follow-up to ensure client satisfaction Participate in regular team training, development programs, and mentorship Build long-term client relationships that support both their needs and your professional growth Qualifications Strong communication and interpersonal skills Organized, self-driven, and comfortable working independently Confident using video communication and digital platforms Passion for helping others and working in a purpose-driven environment Customer service, sales, or client support experience is helpful but not required Authorized to work in the U.S. Access to a reliable internet connection and a Windows-based laptop or PC with a webcam What We Offer 100% remote work with flexible scheduling Commission-based pay with weekly payouts All warm, pre-qualified leads provided-no cold calling Vested renewals for long-term income growth Full training and licensing support Equity opportunity (3%) for qualified team members Monthly and quarterly performance bonuses Career advancement opportunities, including leadership pathways A collaborative and supportive culture focused on people and performance About AO Globe Life AO Globe Life serves working-class families across the U.S., specializing in supplemental benefits for union members, credit unions, and veterans. With a 70+ year legacy of service and a growing remote workforce, we're committed to empowering our team members to make a lasting impact-flexibly, ethically, and with purpose. If you're ready to start a career with real flexibility, upward mobility, and mission-aligned work-apply today. We're here to support your success.

Starting at $19.50 hourly Join Our Team as a Referrals Specialist! Are you passionate about providing excellent patient care and making a difference in your community? Hawaii Island Community Health Center is looking for a dedicated Referrals Specialist to join our team! Position Summary: As a Referrals Specialist, you will play a crucial role in managing external patient referrals and follow-up in collaboration with the provider and other members of the patient care team. Under the general direction of the Health Services Manager and Referrals Supervisor, you will maintain electronic patient files, respond to and fulfill requests for medical records, and assist in the collection of data. Additionally, you will coordinate travel for patients to and from appointments. Schedule: Monday-Friday (most weekends off) Work hours are between 6:00 AM and 6:00 PM, with shifts totaling either 8 hours or 10 hours per day. Opportunity to work from home on occasions, following work from home guidelines. Benefits Include: Retirement plan Medical, Vision, and Dental Insurance Pet insurance Paid time off Employee Assistance Program Other ancillary benefits Education and Experience: High School graduate or GED certificate One year of related clinical office experience and/or training; OR any equivalent combination of experience, training, and/or education Desirable experience includes: Familiarity with QUEST and other insurance programs Familiarity with Hawaiʻi Health Care Networks Knowledge of ICD-10 and CPT coding Key Responsibilities: Prioritize patient referrals to manage patient flow for maximum efficiency and optimum care provision Utilize medical records appropriately to document care within the scope of job duties Coordinate referrals, preauthorization, and follow-up with appropriate external resources Develop and maintain tracking systems for referrals to outside resources Actively participate in quality improvement and risk management programs Participate as an active team member on the patient care team Engage in continuing education activities Demonstrate competency in managed care preauthorization for travel Document appropriately in the patient medical record Facilitate quality specialty medical, diagnostic, and therapeutic services via appropriate referral and tracking for follow-up Maintain positive interpersonal relations with physicians, patients, patient families, visitors, and co-workers in a professional and confidential manner Embrace the philosophy of continuous quality improvement Maintain a safe, clean, and confidential working environment consistent with OSHA, HIPAA, and HHC standards Communicate accurate and pertinent information with patient care providers and other members of the care delivery team to facilitate effective and efficient patient referrals and tracking Apply age-specific/cultural considerations to the referral process Manage changes in work demand during the workday Ensure patient/family satisfaction with referral services Keep supervisor informed of problems or issues; monitor supplies needed; perform other duties as assigned Why Join Us? At Hawaii Island Community Health Center, we are committed to providing high-quality healthcare services to our community. Join our team and be part of a supportive and dynamic environment where you can grow professionally and make a meaningful impact. Apply Today! If you are ready to take on this rewarding role, please submit your application and resume. We look forward to welcoming you to our team!