Medical Claims Specialist remote jobs

Salary: $85,000+ depending on experience Skills: Auditing, Inpatient Coding, DRG Validation, Quality Review About the Company / Opportunity: Are you passionate about upholding quality standards in health information management and coding practices? Our client, an industry leader in the hospitals and health care sector, provides nationwide revenue cycle services to a vast network of hospitals and physician practices. This remote opportunity allows you to leverage your expertise in coding quality review, ensuring compliance with national guidelines and maintaining data integrity. Join a mission-driven organization focused on supporting patient outcomes and enhancing health care delivery through excellence in coding quality. Responsibilities: Lead, coordinate, and perform all functions of quality review for inpatient and outpatient coding across multiple facilities. Conduct routine, pre-bill, policy-driven, and incentive plan-driven coding quality audits to ensure compliance with established guidelines and policies. Support coding staff adherence to national coding guidelines and company policies through audits and targeted feedback. Apply expert-level knowledge of medical coding practices to identify areas for improvement and provide education to coding staff. Participate in special projects or reviews as needed to support continuous quality improvement. Maintain or exceed productivity and accuracy standards (95%+). Stay current on official data quality standards, coding guidelines, and ongoing educational requirements. Must-Have Skills: CCS, RHIA, and/or RHIT (mandatory). At least 10 years of hospital medical coding experience, with a minimum of 3 years auditing MS-DRG Inpatient medical records. Demonstrated expertise as an IP Coding Auditor with advanced MS-DRG auditing experience. Proven experience coding across all body systems (not limited to specialty areas). Strong understanding of official coding guidelines, data quality standards, and hospital coding compliance. Nice-to-Have Skills: Undergraduate degree in Health Information Management (HIM) or Health Information Technology (HIT) (Associate's or Bachelor's preferred). Experience participating in special quality review projects or process improvement initiatives. Background supporting multi-site health systems or large-scale coding review teams. Familiarity with remote work tools and distributed team collaboration. Ongoing commitment to professional development and continuous education in medical coding.

Reliant Health Partners is an innovative medical claims repricing service provider, helping employers achieve maximum health plan savings with minimum noise. We tailor our services to each client's needs, providing everything from individual specialty claims repricing, to full plan replacement as a high-performance, open-access network alternative. As a Medical Claims Appeal Specialist, you are responsible for contacting providers to educate on NSA process/payments, respond to appeals for various products, and negotiate these post pay appealed claims to resolve payment disputes. Primary Responsibilities Monitor and manage your post payment queues. Conduct outreach, education, and negotiation calls to providers for post payment claims. Effectively communicate with providers to verify/confirm understanding of NSA claims payments and regulations. Effectively communicate with providers to explain claim payments for various pricing products. Maintain compliance, including but not limited to Confidentiality and HIPAA requirements. Maintain acceptable levels of production including but limited to turn around time standards as mandated by the regulation(s). Document all conversations and record name, phone number, and email of contact person if available, payment rates offered on behalf of clients, and any counter offers by the provider. Adhere to client specific and Reliant protocols, scripts, and other requirements. Develop a comprehensive understanding of the state and federal regulations that will impact payments to providers. Develop a comprehensive understanding of our various products. Perform other job-related duties and special projects as required. Qualifications 2-3 years of related job experience - appeals, negotiations, medical billing. Experience conducting outreach to providers via phone calls or other communication means. Experience understanding Reliant critical behaviors and compliance requirements. Broad healthcare policy and payment understanding. Experience with claims workflow tools or systems. Individual compensation will be commensurate with the candidate's experience and qualifications. Certain roles may be eligible for additional compensation, including bonuses, and merit increases. Additionally, certain roles have the opportunity to receive sales commissions that are based on the terms of the sales commission plan applicable to the role. Pay Transparency$50,000-$60,000 USDBenefits: Comprehensive medical, dental, vision, and life insurance coverage 401(k) retirement plan with employer match Health Savings Account (HSA) & Flexible Spending Accounts (FSAs) Paid time off (PTO) and disability leave Employee Assistance Program (EAP) Equal Employment Opportunity: At Reliant, we know we are better together. We value, respect, and protect the uniqueness each of us brings. Innovation flourishes by including all voices and makes our business-and our society-stronger. Reliant Health Partners is an equal opportunity employer and we are committed to providing equal opportunity in all of our employment practices, including selection, hiring, performance management, promotion, transfer, compensation, benefits, education, training, social, and recreational activities to all persons regardless of race, religious creed, color, national origin, ancestry, physical disability, mental disability, genetic information, pregnancy, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, and military and veteran status, or any other protected status protected by local, state or federal law.

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.

At Labcorp, you are part of a journey to accelerate life-changing healthcare breakthroughs and improve the delivery of care for all. You'll be inspired to discover more, develop new skills and pursue career-building opportunities as we help solve some of today's biggest health challenges around the world. Together, let's embrace possibilities and change lives! Billing Specialist Subsidiary- (Hybrid Role -San Antonio TX) Work as an active partner with the revenue cycle staff, sites, insurance carriers and internal staff to support the overall revenue cycle process. DUTIES & RESPONSIBILITIES : This individual's areas of responsibility may include, but are not limited to: Prepares and submits electronic and paper claims. Denial management to resolve claim issues. Resolve incoming inquiries from third party payers, sites, and patients. Performs research and resolution for suspended and unbillable claims. Works third party aging reports. Accurately post insurance, patient, and site payments Performs various collection activities by contacting patients, sites, and third-party payers. Processes remittance advice and explanation of benefits completely and accurately Prepares, reviews, and sends patient statements. Conducts self in accordance with RCM's employee guide. Building effective working relationships with internal team members Maintains strict confidentiality; adheres to all HIPAA guidelines/regulations. QUALIFICATIONS: High School Diploma or equivalent required; Associate's degree or higher preferred. Minimum two + years previous work experience required Experience in A/R, Billing, Collections and Revenue Cycle Management Experience strongly preferred Knowledge of billing regulations for government and other payors strongly preferred CPT and ICD-10 knowledge strongly preferred Intermediate Excel skills strongly preferred Proficient in mathematical computation preferred Advanced skills in alphanumeric data entry preferred Other Desired Skills: Strong interpersonal and communication skills Clear, concise, and persuasive writing and presentation skills Strong orientation to deadline and detail Demonstrated ability to work effectively and congenially with employees at diverse levels. Decisive and exercises good judgment under pressure. Ability to work effectively in a team environment. Ability to manage a diverse and demanding workload. Application Window Closes: 9-16-2025 Pay Range: $15.25-20/hr (State minimum wages apply if higher) Shift: Monday-Friday 7:00am-3:30pm CST HYBRID ROLE; Rotating 2 Days On-Site in San Antonio TX / 3 Days Remote All job offers will be based on a candidate's skills and prior relevant experience, applicable degrees/certifications, as well as internal equity and market data. Benefits: Employees regularly scheduled to work 20 or more hours per week are eligible for comprehensive benefits including: Medical, Dental, Vision, Life, STD/LTD, 401(k), Paid Time Off (PTO) or Flexible Time Off (FTO), Tuition Reimbursement and Employee Stock Purchase Plan. Casual, PRN & Part Time employees regularly scheduled to work less than 20 hours are eligible to participate in the 401(k) Plan only. For more detailed information, please click here. . Labcorp is proud to be an Equal Opportunity Employer: Labcorp strives for inclusion and belonging in the workforce and does not tolerate harassment or discrimination of any kind. We make employment decisions based on the needs of our business and the qualifications and merit of the individual. Qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex (including pregnancy, childbirth, or related medical conditions), family or parental status, marital, civil union or domestic partnership status, sexual orientation, gender identity, gender expression, personal appearance, age, veteran status, disability, genetic information, or any other legally protected characteristic. Additionally, all qualified applicants with arrest or conviction records will be considered for employment in accordance with applicable law. We encourage all to apply If you are an individual with a disability who needs assistance using our online tools to search and apply for jobs, or needs an accommodation, please visit our accessibility site or contact us at Labcorp Accessibility. For more information about how we collect and store your personal data, please see our Privacy Statement.

Agilent is seeking a proactive and detail-oriented Federal Government Billing Specialist to join our Customer Operations Center (COpC). This position plays a key role in supporting the Order Management process by ensuring accurate and compliant billing for federal contracts. The ideal candidate will manage complex invoices in accordance with FAR, DFARS, CAS, and other agency-specific billing requirements, while maintaining operational excellence and compliance across all transactions. Working within the COpC, this role partners closely with cross-functional teams across Agilent, including Credit and Collections, Revenue team, Sales and other COpC teams, to ensure timely and compliant billing. The Specialist will also support internal and external audits, uphold high standards of data accuracy, and contribute to continuous improvement initiatives within the Customer Operations Center. Key Responsibilities Prepare and submit invoices via federal platforms (WAWF, IPP, Tungsten, etc.). Review contract terms and funding modifications for billing accuracy. Monitor unbilled receivables and resolve holds or rejections. Collaborate with Contracts, Project Management, Accounting, and other COpC teams. Maintain billing documentation and support audits (DCAA, DCMA). Assist with month-end close activities and revenue reconciliation. Ensure compliance with federal regulations and company policies. Provide excellent customer service to government agencies and internal teams. Manage portal invoicing based on agency-specific requirements to prevent rework and ensure timely payment. Act as liaison with the collections team to resolve issues and ensure billing integrity. Additional Information This is a complex role requiring adaptability, attention to detail, and a customer-focused mindset. You'll thrive in a fast-paced, diverse environment where ownership and collaboration are key. Schedule: Flexibility required; occasional overtime and late hours on the last working day of each month Qualifications Required Qualifications Associate's or Bachelor's degree in Accounting, Finance, or related field (or equivalent experience). 2+ years of experience in federal billing or government contract accounting. Familiarity with FAR/DFARS and federal audit processes. Proficiency in Microsoft Excel and ERP systems (SAP, Oracle, Deltek). Strong communication, organizational, and time management skills. Ability to work independently and manage multiple priorities. Preferred Qualifications Experience with DCAA-compliant accounting systems. Knowledge of indirect rate structures and cost allocations. Prior experience in a government contractor environment. SAP/CRM experience. Proficiency in Microsoft Office Suite (Outlook, Excel, Word, PowerPoint, OneNote). Additional Details This job has a full time weekly schedule. It includes the option to work remotely. Applications for this job will be accepted until at least December 16, 2025 or until the job is no longer posted.The full-time equivalent pay range for this position is $28.27 - $44.17/hr plus eligibility for bonus, stock and benefits. Our pay ranges are determined by role, level, and location. Within the range, individual pay is determined by work location and additional factors, including job-related skills, experience, and relevant education or training. During the hiring process, a recruiter can share more about the specific pay range for a preferred location. Pay and benefit information by country are available at: ************************************* Agilent Technologies, Inc. is an Equal Employment Opportunity and merit-based employer that values individuals of all backgrounds at all levels. All individuals, regardless of personal characteristics, are encouraged to apply. All qualified applicants will receive consideration for employment without regard to sex, pregnancy, race, religion or religious creed, color, gender, gender identity, gender expression, national origin, ancestry, physical or mental disability, medical condition, genetic information, marital status, registered domestic partner status, age, sexual orientation, military or veteran status, protected veteran status, or any other basis protected by federal, state, local law, ordinance, or regulation and will not be discriminated against on these bases. Agilent Technologies, Inc., is committed to creating and maintaining an inclusive in the workplace where everyone is welcome, and strives to support candidates with disabilities. If you have a disability and need assistance with any part of the application or interview process or have questions about workplace accessibility, please email job_******************* or contact ***************. For more information about equal employment opportunity protections, please visit *************************************** Required: NoShift: DayDuration: No End DateJob Function: Customer Service

Wisdom blends industry expertise with advanced technology to make dental practices work better for everyone involved. We believe dentistry is about people, and we exist to make the future of dentistry stronger and more sustainable for dentists, their teams, and the patients they serve. We match administrative teams with expert billers and custom-built technology to take on the heavy lifting of dental billing while maximizing dentists' time in-office, and their bottom line. Coming from a fresh $21M Series A round of funding we are looking for exceptional candidates to help us build a category-defining company. We are a fully distributed, remote-first team with employees across the US. About The Role Our Insurance Billing Specialists focus on keeping insurance billing moving by submitting claims, posting dental insurance payments, and working insurance aging reports for our customers. This work is at the heart of Wisdom's service offerings, and is a large part of what allows us to provide outstanding services to the dental offices we serve. As an Insurance Billing Specialist, you'll: Prepare and submit dental insurance claims promptly and accurately, following up as necessary to ensure prompt payment and resolve any issues or discrepancies with insurance companies Post insurance payments and adjustments to patient accounts, reconciling insurance payments with the PMS and investigating any discrepancies Monitor and manage accounts receivable, ensuring timely collection of outstanding insurance balances and running regular reports on AR to identify trends and areas for improvement Partner directly with offices and insurance companies, acting as their primary point of contact for any insurance-related inquiries and regularly communicating challenges and successes Coordinate with dental offices to ensure accurate coding and documentation for all insurance claims Why Wisdom? Work remotely alongside a fully remote team that knows how to get stuff done, without the pain and drama of in-office work. Flexible hours Support and inclusion no matter your background. Whether you're a seasoned remote biller or you're testing the waters for the first time, we'll set you up with the tools, training, and community support you need to succeed at Wisdom. A better experience for billers. We're building tools and leveraging technology to save you time and let you focus on earning more, faster. We'd Love to Hear From You If You Have At least 5 years of experience in dental insurance claim submission, claim posting, and AR management Must have a minimum of 8 hours per week of availability during standard business hours (Monday-Friday, 8am-5pm CST) Strong knowledge of dental insurance plans, procedures, and coding Exceptional problem-solving skills and the ability to handle complex billing issues with care and a commitment to patient confidentiality and data security Excellent communication, interpersonal, and follow-up skills Proficiency in dental practice management software (e.g., Dentrix, Eaglesoft) and Google Workspaces Wisdom is an equal opportunity employer. We provide employment opportunities without regard to age, race, color, ancestry, national origin, religion, disability, sex, gender identity or expression, sexual orientation, veteran status, or any other protected status in accordance with applicable law.

Reimbursement Specialist/Medical Coder - Surgery - (909360) Description WHY UT SOUTHWESTERN?With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we strive to provide the best possible care, resources, and benefits for our valued employees. Ranked as the number 1 hospital in Dallas-Fort Worth according to U. S. News & World Report, we invest in you with opportunities for career growth and development to align with your future goals. Our highly competitive benefits package offers healthcare, PTO and paid holidays, on-site childcare, wage, merit increases and so much more. We invite you to be a part of the UT Southwestern team where you'll discover a culture of teamwork, professionalism, and a rewarding career! JOB SUMMARYWorks under moderate supervision to provide policy analysis and recommendations to management related to reimbursement projects and functions. BENEFITSUT Southwestern is proud to offer a competitive and comprehensive benefits package to eligible employees. Our benefits are designed to support your overall wellbeing, and include:PPO medical plan, available day one at no cost for full-time employee-only coverage100% coverage for preventive healthcare-no copay Paid Time Off, available day one Retirement Programs through the Teacher Retirement System of Texas (TRS) Paid Parental Leave BenefitWellness programs Tuition ReimbursementPublic Service Loan Forgiveness (PSLF) Qualified EmployerLearn more about these and other UTSW employee benefits!Work Schedule: Monday-Friday (8am-5pm). This position is 100% remote. Candidate must live in Texas. EXPERIENCE AND EDUCATIONRequiredEducationHigh School Diploma or equivalent Experience4 years of progressively responsible experience in medical insurance, medical billing or medical reimbursement. PreferredLicenses and Certifications(CPC) CERT PROFESSIONAL CODER Upon Hire or Advanced Records Technician (ART) Upon Hire or(RRA) REGISTERED RECORDS ADMIN Upon Hire JOB DUTIESPerforms policy analysis for managed care issues by reviewing contracts, writing clause revisions, making recommendations for reimbursement policy changes, reviewing reports and financial data, and analyzing fee schedules, encounter forms, diagnosis, and procedure codes; ensures contracts reflect appropriate business decisions. Ensures projects related to reimbursement issues are completed on time and changes are implemented appropriately by conducting meetings, organizing activities, reviewing data analyses and reports, and creating reimbursement policies and procedures. Documents findings by writing inquiry letters, constructing opinion letters, maintaining contract files, and maintaining files for research documents. Performs other duties as assigned. SECURITY AND EEO STATEMENTSecurityThis position is security-sensitive and subject to Texas Education Code 51. 215, which authorizes UT Southwestern to obtain criminal history record information. EEOUT Southwestern Medical Center is committed to an educational and working environment that provides equal opportunity to all members of the University community. As an equal opportunity employer, UT Southwestern prohibits unlawful discrimination, including discrimination on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity, gender expression, age, disability, genetic information, citizenship status, or veteran status. Primary Location: Texas-Dallas-5323 Harry Hines BlvdWork Locations: 5323 Harry Hines Blvd 5323 Harry Hines Blvd Dallas 75390Job: Insurance/BillingOrganization: 429001 - SY-Clinical Revenue CycleSchedule: Full-time Shift: Day JobEmployee Status: RegularJob Type: StandardJob Posting: Dec 18, 2025, 3:04:12 AM

Pioneering trusted medical solutions to improve the lives we touch: Convatec is a global medical products and technologies company, focused on solutions for the management of chronic conditions, with leading positions in Advanced Wound Care, Ostomy Care, Continence Care, and Infusion Care. With more than 10,000 colleagues, we provide our products and services in around 90 countries, united by a promise to be forever caring. Our solutions provide a range of benefits, from infection prevention and protection of at-risk skin, to improved patient outcomes and reduced care costs. Convatec's revenues in 2024 were over $2 billion. The company is a constituent of the FTSE 100 Index (LSE:CTEC). To learn more please visit **************************** Summary Billing & Invoicing work is focused on designing and ensuring compliance with billing and invoicing processes including: •Information verification (e.g., ensure accuracy of billing information, negotiated terms and compliance with current legislation) •Monitoring customer accounts (e.g., ensure payments made on time, report on overdue accounts, etc.) •Resolving billing discrepancies (e.g., investigate and resolve billing & invoicing errors, recommend process improvements to avoid future errors, etc.) •May include collections activities Job Description Requires basic knowledge of job procedures and tools obtained through work experience and may require vocational or technical education. May require the following proficiency: • Works under moderate supervision. • Problems are typically of a routine nature but may at times require interpretation or deviation from standard procedures. • Communicates information that requires some explanation or interpretation. Key Responsibilities: Responsible for claim review and submission to Medicare, Medicaid, commercial and private insurance payers. Verifies accuracy and completeness of all required information prior to submission. Follows up with insurance companies on unpaid or rejected claims. Resolves issues and resubmits claims. Reads and interprets insurance explanation of benefits. Maintains specialized knowledge in insurance processes and guidelines, including authorizations and limitations. Investigates insurance claim denials, exceptions, or exclusions. Takes necessary action to resolve claim and payer issues in an effort to recover proper reimbursement. Provides customer service relating to all billing inquiries and complaints. Able to explain insurance processes, benefits, and exclusions. Follows HIPAA guidelines in handling customer information. Performs other billing duties as requested by the Billing Supervisor, Billing Manager, or Director of Billing. Qualifications/Education: Must have a high school diploma, college degree preferred, not required. Six months to one year of related experience and/or training; or equivalent combination of education and experience. Proficient in use of computers and software including, but not limited to: practice management software, word processing and spreadsheet applications. Detail oriented with ability to multi-task. Manages one's own time with minimal supervision. Strong mathematics and problem-solving skills. Seeks and shares pertinent information related to insurance or internal processes. Communicates effectively both verbally and in writing to convey and receive information. Use logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems. Self-evaluates performance to make improvements or take corrective action. Consider the relative costs and benefits of potential actions to choose the most appropriate one. Use equipment, facilities, and materials appropriately as needed to do certain work. This position must commit to 9 months in the role before applying for alternative roles within the organization. Exceptions must be approved by Department leadership. Physical Demands Regularly required to sit, stand, walk, and occasionally bend and move about the facility. Infrequent light physical effort required. Occasional lifting under 10 lbs. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Working Conditions Work performed in an office environment, Special Factors This role can be performed remotely. Beware of scams online or from individuals claiming to represent Convatec A formal recruitment process is required for all our opportunities prior to any offer of employment. This will include an interview confirmed by an official Convatec email address. If you receive a suspicious approach over social media, text message, email or phone call about recruitment at Convatec, do not disclose any personal information or pay any fees whatsoever. If you're unsure, please contact us at ********************. Equal opportunities Convatec provides equal employment opportunities for all current employees and applicants for employment. This policy means that no one will be discriminated against because of race, religion, creed, color, national origin, nationality, citizenship, ancestry, sex, age, marital status, physical or mental disability, affectional or sexual orientation, gender identity, military or veteran status, genetic predisposing characteristics or any other basis prohibited by law. Notice to Agency and Search Firm Representatives Convatec is not accepting unsolicited resumes from agencies and/or search firms for this job posting. Resumes submitted to any Convatec employee by a third party agency and/or search firm without a valid written and signed search agreement, will become the sole property of Convatec. No fee will be paid if a candidate is hired for this position as a result of an unsolicited agency or search firm referral. Thank you. Already a Convatec employee? If you are an active employee at Convatec, please do not apply here. Go to the Career Worklet on your Workday home page and View "Convatec Internal Career Site - Find Jobs". Thank you!

Welcome to Ovation Healthcare! At Ovation Healthcare, we've been making local healthcare better for more than 40 years. Our mission is to strengthen independent community healthcare. We provide independent hospitals and health systems with the support, guidance and tech-enabled shared services needed to remain strong and viable. With a strong sense of purpose and commitment to operating excellence, we help rural healthcare providers fulfill their missions. The Ovation Healthcare difference is the extraordinary combination of operations experience and consulting guidance that fulfills our mission of creating a sustainable future for healthcare organizations. Ovation Healthcare's vision is to be a dynamic, integrated professional services company delivering innovative and executable solutions through experience and thought leadership, while valuing trust, respect, and customer focused behavior. We're looking for talented, motivated professionals with a desire to help independent hospitals thrive. Working with Ovation Healthcare you will have the opportunity to collaborate with highly skilled subject matter specialists and operations executives, in a collegial atmosphere of professionalism and teamwork. Ovation Healthcare's corporate headquarters is located in Brentwood, TN. For more information, visit ********************** Duties and Responsibilities: Extensive understanding of billing guidelines for UB/1500 claims and a deep understanding of each claim field requirement. Maintain a list of split billing requirements by payer and add to the team crosswalk and keep abreast of any payer changes. The billing specialist should be well versed in Payer portal appeal uploads and assist with providing the internal team feedback when necessary. Import claims from host system into claims processing system when required. Review claims that are pended for edits and resolve. Prepare and submit accurate claims for patient services, ensuring compliance with third party payer guidelines and regulations. Review patient accounts and reconcile payments with secondary payers and review remittance advice, ensuring all payments are posted correctly and outstanding balances are addressed before filing the secondary payer. Ensure all billing and collection practices are compliant with CMS regulations, HIPAA, and company policies. Maintain accurate records of all claims and ensure proper documentation in the patient account system. Meet daily productivity and quality standards as assigned. Work with internal departments, such as patient financial services, finance, and billing, to address any issues or disputes affecting patient accounts. Assist management in maintaining or reducing account receivable (AR) days to meet industry standards and improve organizational cash flows. Knowledge, Skills, and Abilities: Proven experience in third party insurance billing, collections, or patient accounts, preferably in a healthcare setting. In-depth knowledge of billing codes, guidelines, and regulations. Familiarity with electronic health record (EHR) systems, billing software, and remittance advice processing. Strong communication skills, with the ability to explain Medicare billing details and resolve patient concerns effectively. Ability to handle sensitive information and maintain confidentiality in accordance with HIPAA regulations. Detail-oriented with strong organizational skills and the ability to manage multiple accounts simultaneously. Problem-solving abilities, particularly regarding billing discrepancies and denied claims. Work Experience, Education, and Certifications: Experience utilizing Payer portals, client systems and clearing house requirements 3-5 years of experience as a primary biller in hospital Business Office. Medical Terminology, ICD-10, CPT and DRG knowledge a preferred, knowledge of third-party Insurance payer guidelines High school diploma or equivalent; additional training in medical billing is a plus. Working Conditions: Work from home and remote location with a stable internet connection, a quiet and dedicated workspace free of distractions, and access to necessary office equipment. The ability to have daily communication with team members, management, and clients through email, phone calls, video meetings and other collaborative tools. Primarily requires sitting at a desk for extended period. Proper lighting and ergonomics shole be maintained to reduce eye strain. 100% Remote

ABOUT US: Ethos Risk Services is a leading insurance claims investigation and medical management company committed to providing better data that translates into better decision-making for our clients. We are at the forefront of innovation in our space, and our success is driven by a dynamic team passionate about delivering exceptional services to our customers. JOB SUMMARY: Our dynamic Ethos Medical Management Team is growing and seeking a full-time Bill Review Negotiation Specialist (REMOTE) to ensure accuracy and cost savings within our Workers' Compensation bill review process. This position is responsible for reviewing, auditing, and negotiating medical bills in compliance with state fee schedules and customer guidelines. The ideal candidate is detail-oriented, skilled in negotiations, and committed to providing excellent customer service while maintaining confidentiality and accuracy. KEY RESPONSIBILITIES: Contact and negotiate with medical providers to secure additional savings through signed agreements. Review, audit, and process Workers' Compensation medical bills using industry-standard methodologies (Medicare, UCR, and state fee schedules). Maintain accurate records of negotiations and provider interactions. Research and interpret state fee schedules, customer guidelines, and regulations. Process reconsiderations and disputed bills in a timely and accurate manner. Provide high-quality customer service and resolve inquiries efficiently. Maintain strict confidentiality and compliance with company policies and industry regulations. Perform other related duties as assigned. QUALIFICATIONS: Education: High school diploma or equivalent required. Associate degree or higher preferred. Experience: Minimum of 3 to 5 years of experience in medical bill review, with a minimum of 1 year of experience in customer service required. An equivalent combination of education and experience is required. Knowledge of CPT, ICD-10, and HCPCS coding required. Experience with Conduent Strataware software, or other comparable platforms, preferred. Skills: Strong oral and written communication skills. Proven negotiation and customer service abilities. Proficient with Microsoft Office Suite and other computer applications. Excellent organizational skills with the ability to multi-task. Team player with strong interpersonal skills. Discretion, confidentiality, and attention to detail. Licensing/Certification: Certification in medical coding or medical terminology preferred but not required. WORKING CONDITIONS: This position is 100% remote, with required availability during standard business hours. This role requires a dedicated workspace with reliable internet. The role involves prolonged periods of sitting, operating a computer, and communicating via phone and email. Ethos Risk Services is an equal opportunity employer that does not discriminate on the basis of religious creed, sex, national origin, race, veteran status, disability, age, marital status, color or sexual orientation or any other characteristics.

We are looking for a smart, driven, and detailed-oriented professional to join our Accounting Team as Payroll & Billing Specialist. This position requires a strong attention to detail, ability to manage time well, and interact professionally with employees, clients, and vendors. Pay: $21.50-$23.00 / hour (depending on experience) Benefits: Full Time benefits eligible including Medical, Dental, Vision, Time Off, Wellness Program, Retirement, and more. Fully Remote: Preference given to applications in MST, CST, and EST time zones. Responsibilities (Payroll) Assist with Processing semi-monthly payroll for employees across multiple departments. Calculating and process employee deductions, benefits, and garnishments. Ensuring compliance with tax regulations and labor laws. Preparing and distribute payroll reports to management. Responding to employee inquiries regarding payroll issues. Collaborating with HR and Finance teams to ensure accurate employee data. Maintaining payroll records and ensure data integrity. Year-end reporting, including W-2s and other tax documents. Responsibilities (Billing) Assist with Preparing and sending invoices to clients/customers in a timely manner. Reviewing contracts and agreements to ensure accurate billing. Monitoring accounts receivable and follow-up on outstanding payments. Resolving billing issues and respond to customer inquiries. Maintaining billing records and documentation. Collaborating with internal departments to ensure billing accuracy. Month-end closing and reporting. Requirements Some college preferably in Accounting, Business, or related field. Two to three years of Payroll and Accounting or Bookkeeping experience. Proficient using computer and Microsoft Office products including Excel. Self-starter attitude with tenacity and drive. Consistently looks for ways to improve processes and procedures. Effective communicator and comfortable working remotely. Preferred Qualifications Associate's or Bachelor's degree in accounting, Business, or related field. Previous work experience using NetSuite ERP and/or Paylocity. Employment is contingent upon completing and passing a background check and drug test. MetaSource is an equal opportunity employer.

Ambulance Billing-Prebiller (Remote) Job Description BELL Ambulance is a progressive, client-oriented company devoted to providing high-quality emergency and non-emergency medical services. BELL Ambulance has been in operation since 1977 and has grown to be the largest provider of ambulance service in the State of Wisconsin, responding to over 100,000 ambulance calls annually. Job Summary: An ambulance billing-coder is responsible for accurately coding and billing for ambulance services provided to patients, ensuring compliance with healthcare regulations and insurance requirements. This role requires strong attention to detail, knowledge of Medicare Part B Ambulance medical coding systems, and the ability to work collaboratively with healthcare providers and insurance companies. Key Responsibilities: Verification: Verify patient insurance information and eligibility to determine coverage for ambulance services. Documentation Review: Review patient medical records, transport documentation, and other relevant information to ensure accuracy in coding and billing. Compliance: Stay updated on healthcare regulations, coding guidelines, and payer policies to ensure compliance and accurate reimbursement. Queries: Collaborate with healthcare providers to clarify documentation and coding-related queries, ensuring accurate coding and billing. Data Entry: Accurately enter patient and billing information into the healthcare organization's billing system. Customer Service: Assist patients and their families with billing inquiries, explain charges, and provide assistance in resolving billing issues. You will be required to both make and receive client-related phone calls Qualifications: High school diploma or equivalent Knowledge of Medicare Part B Ambulance medical coding systems (e.g., CPT, ICD-10, HCPCS). Familiarity with Traumasoft billing software and electronic health records (EHR) systems. Strong attention to detail and accuracy. Understanding of healthcare regulations, including HIPAA. Excellent communication and interpersonal skills. Ability to work independently and as part of a team. Problem-solving and analytical skills. Time management and organizational skills. Experience: Previous experience in Medicare Part B Ambulance medical billing is necessary. ***MUST HAVE PROFIENCENCY IN TRAUMASOFT*** Bell can offer you a competitive wage based on your knowledge and experience, with opportunities for advancement. Bell also offers some of the best benefits in the industry, including medical, dental, vision, and a matching 401(K) program. This is a full-time, 100% remote opportunity. Hours of work are flexible, but ideally between 8:30 a.m. and 5:00 p.m.

Diverse experiences. A shared passion. At Annexus Health, we are a team of dedicated professionals with backgrounds in life sciences, healthcare software technology development, and the healthcare provider setting. While we approach our work from different angles, we are united by our commitment to reducing financial and administrative burdens across the patient access journey to improve access to care and combat financial toxicity at both the patient level and the healthcare organization level. Billing Specialist We are seeking a Billing Specialist to join our growing Adparo team . This person will serve as a key liaison between our clients, financial assistance payers, and internal stakeholders to ensure accurate claims submission, timely resolution of claim issues, and correct payment application. The ideal candidate is detail-oriented, thrives in a service-focused, fast-paced environment, and is motivated by our mission of improving patient access to care. What You Will Do: Serve as the primary contact for outreach with financial assistance payers to resolve claims issues and manage open workflows. Collaborate with client business offices to: Obtain necessary documentation to secure claim approvals. Ensure accurate payment posting, including processing of virtual debit cards and checks. Resolve payment discrepancies and ensure proper claim routing upstream/downstream as needed. Support external partners on complex patient cases requiring advanced billing knowledge. Review and act on assigned tasks daily, updating task status, ownership, and notes across AssistPoint and client systems (billing software, EHR, etc.). Follow up on claims submitted to patient assistance programs and monitor claims aging reports to ensure timely payment. Enroll patients in assistance programs and submit claims based on identified opportunities. Facilitate secure, professional communication with clients and internal team members to ensure timely resolution of claim-related activities. Respond to any inbound client questions related to patient cases specific to claims management. Participate in discussions with leadership on overall claim queue health and progress. About You: This is a contract-to-hire position. During the contract period, you will work a standard schedule of 40 hours per week. The timing for conversion to full-time employment may vary and will be determined based on performance, business needs, and mutual fit. 3+ years of physician or medical billing experience (IV infusion billing preferred) Familiarity with billing systems such as GE Centricity, Unlimited Systems, or Epic Detail-oriented with strong organizational and problem-solving skills Clear, confident communicator with the ability to tailor messaging across stakeholders Self-motivated, able to work independently in a remote setting Tech-savvy and adaptable to multiple systems and workflow platforms Oncology or specialty billing experience is a plus Passionate about improving patient outcomes and access to care Love to have fun! Annexus Health is proud to be an equal opportunity employer and is committed to maintaining a diverse and inclusive work environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, physical or mental disability, age, or veteran status or any other basis protected by federal, state, or local law. Read more about the Annexus Health culture at annexushealth.com/about/.

At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees are key factors in our company's growth, market presence and our ability to help our clients stay a step ahead of the competition. 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. 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. Pay Rate: $18/hr 100% Remote, we provide equipment **In this Role the candidate will be responsible for:** + 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 **Requirements:** + 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. + **Previously performing - in P&Q work environment; work from queue; remotely** + Key board skills and computer familiarity - + **Toggling back and forth between screens** /can you navigate multiple systems. + Working knowledge of MS office products - Outlook, MS Word and **MS-Excel** . + Must be able to work **7am - 4 pm CST** online/remote (training is **required on-camera** ). + Effective **troubleshooting where you can leverage your research, analysis and problem-solving abilities** + **Time management with the ability to cope in a complex, changing environment** + **Ability to communicate (oral/written) effectively** in a professional office setting **Preferred Skills & Experiences:** + Amisys &/or Xcelys Preferred **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. 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 one of the leading providers of digital and AI infrastructure in the world. NTT DATA is a part of NTT Group, which invests over $3.6 billion each year in R&D to help organizations and society move confidently and sustainably into the digital future. Visit us at us.nttdata.com (************************* 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/hour. 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. NTT DATA endeavors to make ********************** (**********************/en) accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact us at **********************/en/contact-us . This contact information is for accommodation requests only and cannot be used to inquire about the status of applications. NTT DATA is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. For our EEO Policy Statement, please click here (**********************/en/compliance#eeos) . If you'd like more information on your EEO rights under the law, please click here (**********************/en/compliance#know-your-rights) . For Pay Transparency information, please click here (**********************/en/compliance#ppnp) .

Billing Specialist - Substance Use Disorder (Behavioral Health) Remote | Eastern or Central Time Zone Company: Wise Path Recovery Centers (part of the Ascension Recovery Services network) Make an Impact in Behavioral Health Billing Wise Path Recovery Centers is expanding its in-house billing operations and seeking a Billing Specialist to support our behavioral health and substance use disorder (SUD) programs. This position is ideal for someone who is detail-oriented, analytical, and thrives on solving billing puzzles, improving processes, and contributing to a mission-driven organization that helps individuals on their recovery journey. You'll play a key role in our EMR and billing platform transition-configuring workflows, validating payer rules, and ensuring clean, compliant claims from start to finish. What You'll Do Prepare, review, and submit claims for behavioral health and SUD services. Verify insurance coverage, benefits, and authorizations prior to admission. Track and reconcile claims, resolve denials, and post payments accurately. Support billing configuration and validation during the EMR transition. Collaborate with Utilization Review, Admissions, and Finance teams to ensure clean claim submission. Identify process gaps and help standardize billing workflows and SOPs. Maintain compliance with HIPAA, 42 CFR Part 2, and payer documentation requirements. What We're Looking For Minimum Qualifications 2+ years of healthcare billing experience (behavioral health or SUD preferred). Working knowledge of CPT, HCPCS, and ICD-10 coding. Experience with Medicaid, Medicare, and commercial payers. Proficiency in EMR and billing software, plus strong Excel skills. High school diploma or equivalent. Preferred Associate's or Bachelor's degree in Business, Accounting, or Healthcare Administration. Experience with EMR transitions or billing system implementations. Familiarity with UB-04 and CMS-1500 claim forms. Understanding of multi-site or multi-state behavioral health operations. Top Candidate Traits Accurate: You take pride in getting the details right every time. Analytical: You're curious about why a claim denied-and determined to fix it. Structured: You thrive on order, process, and well-designed systems. Technical: You're comfortable learning and testing new software tools. Dependable: You consistently meet deadlines and keep things moving smoothly. Why Join Wise Path Help build a growing in-house billing department with long-term career potential. Contribute to a mission that changes lives through quality addiction and behavioral health treatment. Work remotely with a collaborative team across multiple states. Competitive pay and professional development opportunities. Equal Opportunity Employer Wise Path Recovery Centers, in partnership with Ascension Recovery Services, provides equal employment opportunities to all employees and applicants regardless of race, color, religion, gender, sexual orientation, gender identity or expression, national origin, genetics, disability, age, or veteran status.

ABA Billing Specialist (REMOTE) - (Texas ONLY) Must have Central Reach Experience Status: Full-time, non-exempt Billing Specialist (REMOTE) Status: Full Time Join us at Little Spurs! (Overview): Little Spurs Autism Centers is seeking an experienced ABA biller to join our dynamic team. Under general direction, the billing specialist will exercise independent judgement while adhering to established policies and procedures, regulations, and best practices. What You Need (Qualifications): To perform this job successfully, and individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions. High school diploma or equivalent required; Associates or bachelor's degree in Finance, Accounting, Business Administration, or related field preferred 3 + years of billing and coding experience in ABA therapy specialty. Must possess in-depth knowledge of medical billing; experience with pediatric billing preferred Experience with robust practice management/EMR system, preferably Central Reach and Waystar. The Perks (Benefits): Medical, Dental & Vision Benefits available employee, spouse, and dependents Voluntary Short-Term & Long-Term Disability & Voluntary Life Insurance (Employee, Spouse, Children). 401k with 4% company match on 5% employee contribution. Holiday pay (Closed Thanksgiving and Christmas); shorter holiday hours. 80 hours of PTO accumulated through the year; available for rollover More PTO accrued after three and five years of service Free in-house medical care for employee and dependent children Employee recognition and appreciation programs Professional Development Opportunities REQURIED SKILLS AND ABILITIES: Comprehensive knowledge of coding, billing, processes and requirements Knowledge of local payers, to include billing and claims resolution processes Knowledge in physician practice technology as it relates to creating, transmitting and collecting claims Knowledge of physiology, anatomy, neurology and medical terminology. Ability to communicate clearly both written and verbally. Ability to work independently with detail and accuracy. Excellent interpersonal communication skills Ability to act with discretion, tact, and professionalism in all situations. Ability to work in a remote or hybrid work environment. Ability to work well within a team dynamic. Proficiency in Microsoft Office Suite (Word, Excel, Outlook, PowerPoint) Ability to use a fax machine, copier and a scanner Must have a passion for Revenue Cycle and a positive mindset Bilingual a plus! We use E-Verify ESSENTIAL DUTIES AND RESPONSIBILITIES include the following: Performs all necessary tasks to provide overall direction and support in billing, accounts receivable and related areas. Responsible for managing the charge capture, coding, billing and billing edits. Responsible for coordinating with providers and Regional Medical Directors to create efficient, accurate templates and automated charging/billing processes Analyze trends, impacting charges, coding, and collections and take appropriate action to realign staff and revise policies. Analyze billing and claims for accuracy and completeness and submit claims to proper insurance entities and follow up on any issues. Ensures that the correct coding and compliance guidelines are being adhered to. Maintains systems, policies & procedures to ensure compliance with all contractual obligations of payers. Responsible for monitoring reimbursements. Responsible for staying familiar with federal and state regulations and company policies. Effectively communicates to employees and hold yourself accountable for meeting those same expectations. Assists with staff communication providing updates, resolving issues, setting goals and maintaining standards. Assists with work allocation and problem resolution. Assists with month end reports Performs other related duties as assigned. The Nitty Gritty (Your Day to Day): Performs appropriate billing/payment posting functions as assigned. Follows up on unpaid or improperly paid claims as necessary. Reviews and monitors select accounts within the accounts receivable system. Determines and performs appropriate collection efforts to resolve accounts, to include follow-up online, by phone and written correspondence. Effectively applies protocol in company EMR: Invoice Balance Responsibility/Applies Invoice Status correctly. Builds claims and applies knowledge of medical terminology, ICD/CPT codes to complete daily Corrects denied submission and denied claims in a timely manner and notes invoice accordingly. Submits claims electronically and by paper. Assist with telephone inquiries and billing questions promptly, with professionalism and courtesy. Generates and reviews patient statements effectively and ensures appropriate collection correspondence is sent and documented per protocol. We offer competitive benefits which include: Medical, Dental, Vision, Life, Disability, PTO, Holiday Pay and Retirement Savings Account (401k).

Billing/Collections Specialist Billing/Collection Agent Full Time Billing / Collections Specialist Full TIME BILLING/COLLECTIONS POSITION AVAILABLE IN FISHKILL, NY LOOKING FOR A RELIABLE CANDIDATE!!!!!!! HOURS: 8AM - 4:30PM Monday through Friday Must be motivated and detail oriented. Must have a strong background in Medicare, insurance and patient collections as well as all other aspects of billing. THIS POSITION IS NOT A REMOTE POSITION, PLEASE CONSIDER CAREFULLY EMAIL RESUME AND SALARY REQUIREMENTS Job Type: Full-time Pay: From $18.00 per hour - $25.00 per hour

Job Details Cotswold - Charlotte, NC Full Time High School Diploma / GED None Day Health Care The Billing Specialist I is responsible for incoming billing inquiries. This may include, but is not limited to, account research, payment posting and balancing, adjustments, collections, patient and insurance company phone calls and inquiries. ESSENTIAL DUTIES AND RESPONSIBILITIES: Answers telephone and emails promptly and courteously, responds to billing questions, following HEC policy for self-pay balances. Refers escalated inquiries to appropriate patient account representative. Corrects faulty information and advises supervisor of patterns or trends of errors noted. Uses available technology (Virtual Swipe, Electronic Checks, and Online) to offer patients immediate payment options and encourage timely payment of balances due. Understands the process of the “Token” number to encourage patients to sign in on the online portal for patient payments. Prepares requests for refunds or non-contractual adjustments for review by Refunds PAR or Business Services Manager. Ensures that all email and voice mail messages are handled on a daily basis. If the issue cannot be resolved on the same day, employee will notify parties involved about pending status. Processes/Research all returned mail to update the patient information in Nextgen in a timely manner for appropriate filing. Possesses a full understanding of patient accounts workflow, adheres to all processes and participates in improving departmental problems. Abides by the Collector on Call schedule and coordinates schedule with co-workers to maintain proper coverage for patient needs. Performs all necessary job functions related to new technological implementations. Has an understanding of Retina financial assistance. Obtains payments through the Chronic Disease portal, and faxes or mail claims to the other financial assistance programs such as Eylea Copay Card and Lucentis Copay Card. Answers billing correspondence received through lockbox and through patient portal. Research returned business office mailings for corrected addresses and updates demographics in system. POSITION REQUIREMENTS: Minimum Qualifications: High school diploma or equivalent One year of clerical medical office experience. Ability to understand explanations of benefits (EOBs). Preferred Qualifications: Experience in insurance billing. General knowledge of CPT and ICD coding. General knowledge of medical terminology

The Medical Billing Specialist is responsible for accurately coding fertility diagnostic ,treatment services and surgical procedures, submitting insurance claims, and managing the billing process for a fertility practice or healthcare facility. They ensure compliance with healthcare regulations and maximize revenue by optimizing reimbursement. General Summary of Duties: Responsible for gathering charge information, coding, entering into data base complete billing process and distributing billing information. Responsible for processing and filing insurance claims and assists patients in completing insurance forms. Essential Functions: o Prepare and submit insurance claims accurately and in a timely manner. o Verify patient insurance coverage and eligibility for fertility services( treatments and surgical procedures). o Review and address coding-related denials and discrepancies. o Researches all information needed to complete billing process including getting charge information from physicians. o Assists in the processing of insurance claims o Processes all insurance provider's correspondence, signature, and insurance forms. o Assists patients in completing all necessary forms, to include payment arrangements made with patients. Answers patient questions and concerns. o Keys charge information into entry program and produces billing. o Processes and distributes copies of billings according to clinic policies. o Records payments for entry into billing system. o Follows-up with insurance companies and ensures claims are paid/processed. o Resubmits insurance claims that have received no response or are not on file. o Works with other staff to follow-up on accounts until zero balance. o Assists error resolution. o Maintains required billing records, reports, files. o Research return mail. o Maintains strictest confidentiality. o Other duties as assigned o Identify opportunities to optimize revenue through accurate coding and billing practices. o Assist in developing strategies to increase reimbursement rates and reduce claim denials. Benefits: Offers nationally competitive compensation and benefits. Our benefits program provides a comprehensive array of services to our employees including, but not limited to health insurance (Primarily covered by the company), paid time off, retirement contributions (401k), & flexible spending account