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Insurance Processor remote jobs - 193 jobs

  • Patient Access Representative

    Insight Global

    Remote job

    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.
    $33k-42k yearly est. 5d ago
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  • Insurance Denials Specialist II

    Radiology Partners 4.3company rating

    Remote job

    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
    $36k-50k yearly est. 21h ago
  • Remote Life Insurance Specialist

    Asurea Insurance Services 4.6company rating

    Remote job

    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
    $37k-50k yearly est. 60d+ ago
  • Remote Medical Biller

    Actalent

    Remote job

    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.
    $21-23 hourly 7d ago
  • Medical Biller

    Goto Telemed

    Remote job

    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
    $33k-41k yearly est. Auto-Apply 13d ago
  • Medical Claims Processor I

    Broadway Ventures 4.2company rating

    Remote job

    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.
    $33k-43k yearly est. Auto-Apply 57d ago
  • Medical Biller (Client)

    Crewbloom

    Remote job

    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.
    $31k-38k yearly est. Auto-Apply 60d+ ago
  • Work from Home - Insurance Verification Representative

    Creative Works 3.2company rating

    Remote job

    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.
    $15-19 hourly 60d+ ago
  • Title Insurance Agency Clerk

    First Bank 4.6company rating

    Remote job

    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.
    $32k-36k yearly est. 60d+ ago
  • Entry-Level Data Verification Representative (Remote)

    Focusgrouppanel

    Remote job

    We appreciate you checking us out! Work At Home Data Entry Research Panelist Jobs - Part Time, Full Time This work-from-home position is ideal for anyone with a diverse professional background, including administrative assistants, data entry clerks and typists, customer service reps or drivers. Unleash your skillset within an accommodating role that can be managed from any location! Are you searching for a new way to make money? Look no further - we are seeking individuals now who can work remotely from their own homes! Whether it's part-time or full-time, discover an opportunity that works best with your schedule. You will find both full-time and part-time remote opportunities in a variety of career fields. To secure a legitimate work from home data entry position, expertise in that field isn't an absolute must. Companies providing these jobs offer comprehensive training to the successful applicant so they can excel at their role! JOB REQUIREMENTS Computer with internet access Quiet work space away from distractions Must be able and comfortable to working in an environment without immediate supervision Ability to read, understand, and follow oral and written instructions. Data entry or administrative assistant experience is not needed but can be a bonus We are recruiting those who have a background in health care, warehouse worker, delivery drivers, customer service, etc - we welcome all backgrounds so long as you're ready to learn JOB PAY up to $250hr. (single session research studies) up to $3,000 (multi-session research studies) Applying on our website is necessary to ensure you receive important updates from us. Keep an eye out for emails with further instructions! To get started, these are the essential elements you'll need! LapTop. You may be asked to use your webcam. These types of studies typically pay more. You'll need a stable internet connection. You may be asked to conduct a study using your SmartPhone. Data entry skills. All studies require that you be able to read, write and take direction as well as type a minimum of 25 words per minute. Backgrounds in Customer Service, Administrative Assisting, Sales and Sales Support helpful but not mandatory We're eager to collaborate with you! Take the next step and reach out via email--apply now for a position today! Take control of your work schedule with our flexible position that allows for remote or in-person participation. With no minimum hours, you can choose to tackle this role part time or full time from the comfort of home. Plus, gain exclusive access to complimentary samples from sponsors and partners as a reward for offering valuable feedback on their products! Act now by clicking 'Apply' and launch into an exciting new work at home job today! This position is open to anyone looking for short-term, work at home, part-time or full-time job. Do you want to add an extra stream of income? Let us help! By participating in our paid market survey, people from all walks of life can earn some money. No prior experience is needed and the hours are flexible-perfect for those looking for a part-time job they can do remotely. Roles include data entry clerk, customer service agent, nurse or medical assistant - just choose what suits your skills best and start earning!
    $30k-34k yearly est. Auto-Apply 58d ago
  • Experienced Medicare Biller

    CPSI 4.7company rating

    Remote job

    Prepares and submits hospital, hospital-based physician and Rural Health Clinic claims to Medicare either electronically or in DDE Secures needed medical documentation required or requested by Medicare Follows up with Medicare on unpaid claims till claims are paid or only self-pay balance remains. Processes rejections by either making accounts private or correcting any billing error and resubmitting claims to Medicare or third-party insurance carriers. Responsible for consistently meeting production and quality assurance standards. Maintains quality customer service by following company policies and procedures as well as policies and procedures specific to each customer. Updates job knowledge by participating in company offered education opportunities. Protects customer information by keeping all information confidential. Processes miscellaneous paperwork. Ability to work with high profile customers with difficult processes. May regularly be asked to help with team projects. Ensure all claims are submitted daily with a goal of zero errors. Timely follow up on insurance claim status. Reading and interpreting an EOB (Explanation of Benefits). Respond to inquiries by insurance companies. Denial Management. Meet with Billing Manager/Supervisor to discuss and resolve reimbursement issues or billing obstacles. Review reports identifying readmissions or overlapping service dates and ignore, merge, or split-bill according to the payer's rules and the client's policy. Review credit reports, resolve credits belonging to a payer when able, and submit a listing of credits to the facility as required by the payer. Minimum Requirements: Education/Experience/Certification Requirements · At least 3 years' hospital billing experience, can include time outside of TruBridge · Medicare DDE experience required · Experience in CPT and ICD-10 coding preferred · Experience in filing claim appeals with insurance companies to ensure maximum reimbursement preferred · Excellent communication (written and oral) and interpersonal skills. · Strong organizational, multi-tasking, and time-management skills. · Must be detail oriented and able to follow through on issues to resolution. · Must be able to act both independently and as a team member. · High School Diploma or equivalent combination of education and relevant experience needed. · Excellent critical thinking, organizational, and time management skills with a strong attention to detail, accuracy, and follow through Business Support
    $33k-40k yearly est. Auto-Apply 9d ago
  • Medical Biller

    Sunbelt Healthcare

    Remote job

    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
    $30k-37k yearly est. 60d+ ago
  • Remote Life Insurance Specialist

    Quility

    Remote job

    We are seeking a motivated and results-driven Life Insurance Sales Representative to join our team. In this role, you will be responsible for selling life insurance policies to potential clients that have reach out to our agency requesting information. This is a commission-only position, 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 Details: Full- 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-time...then 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 Called Identify 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 state(s) you will be selling in. Compensation: This is a commission-only position, 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 Time. ******************************** P: ************ No agent s 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
    $33k-44k yearly est. 60d+ ago
  • Insurance Verifier

    United Surgical Partners International

    Remote job

    USPI Hill Country Ambulatory Surgery Center is seeking a motivated Insurance Verifier to join our team. We have 1 OR room and 3 Procedure rooms. We perform outpatient surgical procedures in Gastroenterology. We are looking for a candidate to be available Monday-Friday, schedule subject to changed based on surgical schedule and flow of day. Candidate needs to be available for some early mornings and later evenings. NOT A REMOTE POSITION Job Summary: Validating and entering patient information and insurance coverage into the appropriate computer system. Verify insurance benefits by reviewing our contract and patient's quoted benefits. Determine co-pay. Post all insurance and billing comments. Enter all information into the patient accounting system. Contact patients regarding money due prior to the date of surgery. Insurance coverage into the appropriate computer system. Duties may also include communicating with physician offices, insurance carriers, and patient follow-ups. Duties may also include communicating with physician offices, insurance carriers, and patient follow-ups. #LI-CM1 Required Skills: Qualifications: * Minimum 2 years of experience in insurance verification. * High school graduate or equivalent * Excellent communication skills and the ability to communicate with patients over the phone and in person * Medical Terminology experience preferred * Forty-five (45) wpm typing skills required. * Must have the skills necessary to operate the office equipment required to fulfill job duties. * Familiar with patient accounting software, especially AdvantX. * Knowledge of Internet Explorer, Microsoft Excel, Microsoft Word, and Outlook.
    $27k-34k yearly est. 60d+ ago
  • Acute Hospital Insurance Specialist 3

    Corrohealth

    Remote job

    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.
    $30k-38k yearly est. Auto-Apply 35d ago
  • Entry-Level Insurance Professional

    Bridge Specialty Group

    Remote job

    Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. Bridge Specialty Group is seeking an Entry-Level Insurance Professional to join our growing team! This is a hybrid position, requiring two days per week on-site and three days remote. The Entry-Level Insurance Professional will play a key role in expanding our current operation by helping to build customer relationships and supporting our sales initiatives. This role will solicit, establish, and maintain rapport with retail agents to secure new and renewal business as well as participate in USLI's 50/50 Sales training program. In this role, you will spend 50% of your time meeting with agents in the field and the other 50% in the office How You Will Contribute: Conducting outbound calls to retail agents to drive new opportunities in, convert leads to submissions and turn quotes into binding orders. Weekly reporting of sales calls and results is expected. Educate customers on quoting platforms and services. Drive daily submissions goals and relay information to the marketing team to maximize opportunities. Review web and phone quoting activity to spot trends positive and negative and address trends with customers and team. Establish an active relationship with the territory sales executives and regularly discuss strategy and tactics including training, sales issues and follow-up. Resolve agent issues as they arise. Assist underwriters to place business. Pursue a path of personal and professional development. Perform other duties as assigned. Licenses and Certifications: P&C insurance license within 90 days of employment Skills & Experience to Be Successful: Bachelor's degree or equivalent business experience Strong interpersonal skills with a professional, positive phone presence and the ability to build relationships Self-motivated and independent, with excellent time management and problem-solving abilities Team-oriented with a high level of integrity and professionalism Proficient in Microsoft Office, especially PowerPoint and Excel Open to feedback, coaching, and continuous improvement Ability to prioritize tasks and work independently in a fast-paced environment This position may require the team members to drive their own vehicle or a rental vehicle. Acceptable results of a Motor Vehicle Record report at the time of hire and periodically thereafter, and maintenance of minimum acceptable insurance coverages are a requirement of this position. About Us: Bridge Specialty Group creates a seamless way to connect the varying needs of our retail partners with the market clout and talents of our wholesale entities. Our more than 25 niche-focused brands reflect our deep experience and specialization in construction, general casualty, environmental liability, professional liability, health care, public entity, workers' comp, property and personal lines. With more than 50 locations and more than 2,000 team members throughout the United States and Europe, Bridge has access to more than 200 standard and excess & surplus lines carriers that support our $7+ billion premium book. Our focus is on bringing the power of collective size and specialty to the wholesale brokerage marketplace. Bridge Specialty Group - aligning risk with greater reach. Teammate Benefits & Total Well-Being We go beyond standard benefits, focusing on the total well-being of our teammates, including: Health Benefits : Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance Financial Benefits : ESPP; 401k; Student Loan Assistance; Tuition Reimbursement Mental Health & Wellness : Free Mental Health & Enhanced Advocacy Services Beyond Benefits : Paid Time Off, Holidays, Preferred Partner Discounts and more. Not reflective of all benefits. Enrollment waiting periods or eligibility criteria may apply to certain benefits. Benefit details and offerings may vary for subsidiary entities or in specific geographic locations. The Power To Be Yourself As an Equal Opportunity Employer, we are committed to fostering an inclusive environment comprised of people from all backgrounds, with a variety of experiences and perspectives, guided by our Diversity, Inclusion & Belonging (DIB) motto, “The Power to Be Yourself”.
    $30k-38k yearly est. Auto-Apply 14d ago
  • Insurance Biller

    Seh Saint Elizabeth Medical Center

    Remote job

    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.
    $31k-40k yearly est. Auto-Apply 18d ago
  • Life Insurance Specialist

    Country Financial-Figge Levin and Associates

    Remote job

    Job Description Welcome to Country Financial - Figge Levin and Associates, a place where you can genuinely make a difference in people's lives right here in Olathe, Kansas. We're not just selling insurance; we're building futures and providing peace of mind to our community. Our team is like a family, dedicated to supporting each other and celebrating every success. If you're looking for a career where you can truly connect with people, understand their dreams, and help them protect what matters most, then this might be the perfect fit for you. As our Life Insurance Specialist, you'll be the go-to person for helping individuals and families secure their financial well-being through comprehensive life insurance solutions. You'll have the opportunity to grow your expertise, build lasting relationships, and be rewarded for your dedication. Join us and become an essential part of a supportive and thriving agency that values your contribution and impact. Benefits Annual Base Salary + Commission + Bonus Opportunities Flexible Schedule Hands on Training Work from Home Responsibilities Develop and implement strategies to identify and cultivate new client relationships. Conduct needs-based client consultations to understand their financial goals and protection needs. Educate prospective clients on the benefits and features of various life insurance products. Prepare and present tailored insurance proposals and policy recommendations. Service existing clients by providing ongoing support, policy reviews, and addressing inquiries. Collaborate with team members to share best practices and contribute to a positive agency culture. Requirements Life and Health Insurance License (or willingness to obtain). Proven ability to build rapport and establish trust with clients. Excellent communication and interpersonal skills. Self-motivated with a strong work ethic. Adaptability and eagerness to learn about financial planning. Previous sales experience is a plus.
    $28k-37k yearly est. 10d ago
  • Medical Claims Processor - Remote

    NTT Data North America 4.7company rating

    Remote job

    NTT DATA is currently seeking 20 Remote Claims Examiners to join our team. (Amisys or Xcelys experience is a plus) *****Must be able to work Monday to Friday 7 AM to 4 PM Central time.** In this Role the candidate will be responsible for: + Processing of Professional and Hospital 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 for this role include: + 2 years of healthcare claims processing (full cycle: Pay, Pend, Deny) + 2 years using a computer with Windows applications that required you to use a keyboard, navigate multiple screens and computer systems, and learn new software tools + High school diploma or GED. Preference + Experience processing claims in Amisys or Xcelys is a plus. + Ability to communicate (oral/written) effectively in a professional office setting + Familiar with toggling back and forth between screens/can you navigate multiple systems. + Working knowledge of MS office products like - Outlook, MS word and MS-excel. 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 hourly rate for this remote role is $18 hourly. This rate reflects the 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. \#INDHRS \#LI-NORTHAMERICA
    $18 hourly 60d+ ago
  • Referrals Specialist

    Hawai'i Island Community Health Center 3.8company rating

    Remote job

    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!
    $19.5 hourly Auto-Apply 60d+ ago

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