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  • Maternity Care Authorization Specialist (Hybrid Potential)

    Christian Healthcare Ministries 4.1company rating

    Remote medicare specialist job

    This role plays a key part in ensuring maternity care bills are processed accurately and members receive timely support during an important season of life. The specialist serves as a detail-oriented professional who upholds CHM's commitment to excellence, compassion, and integrity. WHAT WE OFFER Compensation based on experience. Faith and purpose-based career opportunity! Fully paid health benefits Retirement and Life Insurance 12 paid holidays PLUS birthday Lunch is provided DAILY. Professional Development Paid Training ESSENTIAL JOB FUNCTIONS Compile, verify, and organize information according to priorities to prepare data for entry Check for duplicate records before processing Accurately enter medical billing information into the company's software system Research and correct documents submitted with incomplete or inaccurate details Verify member information such as enrollment date, participation level, coverage status, and date of service before processing medical bills Review data for accuracy and completeness Uphold the values and culture of the organization Follow company policies, procedures, and guidelines Verify eligibility in accordance with established policies and definitions Identify and escalate concerns to leadership as appropriate Maintain daily productivity standards Demonstrate eagerness and initiative to learn and take on a variety of tasks Support the overall mission and culture of the organization Perform other duties as assigned by management SKILLS & COMPETENCIES Core strengths like problem-solving, attention to detail, adaptability, collaboration, and time management. Soft skills such as empathy (especially important in maternity care), professionalism, and being able to handle sensitive information with care. EXPERIENCE REQUIREMENTS Required: High school diploma or passage of a high school equivalency exam Medical background preferred but not required. Capacity to maintain confidentiality. Ability to recognize, research and maintain accuracy. Excellent communication skills both written and verbal. Able to operate a PC, including working with information systems/applications. Previous experience with Microsoft Office programs (I.e., Outlook, Word, Excel & Access) Experience operating routine office equipment (i.e., faxes, copy machines, printers, multi-line telephones, etc.) About Christian Healthcare Ministries Founded in 1981, Christian Healthcare Ministries (CHM) is a health care sharing ministry for Christians. CHM is a nonprofit, voluntary cost-sharing ministry through which participating Christians meet each other's medical bills. The mission of CHM is to glorify God, show Christian love, and experience God's presence as Christians share each other's medical bills.
    $31k-35k yearly est. 9h ago
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  • Colorectal Surgery Coder

    Teksystems 4.4company rating

    Remote medicare specialist job

    Perform direct surgical coding for colorectal, general surgery, and gastroenterology cases with a high level of accuracy. Utilize PMD to review documentation, pull autonotes, and complete coding assignments efficiently. Apply CPT, ICD10, and PATH guidelines to ensure correct code selection while following the instruction to "do not level." Review surgeon documentation and operative reports to validate coding requirements and resolve missing or unclear details. *Skills* coding experience, colorectal coding experience, PATH experience, Surgery coding, Gastro Coding Experience *Additional Skills & Qualifications* Detail Oriented Confident Good at collaborating with team Not afraid to ask questions *Experience Level* Intermediate Level *Job Type & Location*This is a Contract to Hire position based out of Dallas, TX. *Pay and Benefits*The pay range for this position is $25.00 - $25.00/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 remote position. *Application Deadline*This position is anticipated to close on Jan 27, 2026. h4>About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. About TEKsystems and TEKsystems Global Services We're a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We're a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We're strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We're building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com. 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.
    $25-25 hourly 3d ago
  • Insurance Verification Specialist II #Full Time #Remote

    61St. Street Service Corp

    Remote medicare specialist job

    Top Healthcare Provider Network The 61st Street Service Corporation, provides administrative and clinical support staff for ColumbiaDoctors . This position will support ColumbiaDoctors, one of the largest multi-specialty practices in the Northeast. ColumbiaDoctors practices comprise an experienced group of more than 2,800 physicians, surgeons, dentists, and nurses, offering more than 240 specialties and subspecialties. This position is primarily remote, candidates must reside in the Tri-State area. Note: There may be occasional requirements to visit the office for training, meetings, and other business needs. Opportunity to grow as part of a Revenue Cycle Career Ladder! Job Summary: The Insurance Verification Specialist II is responsible for verifying health insurance benefits for all new patients or existing patients. This position will contact patient s insurance company to verify coverage levels and works with patients to walk them through their benefits information. Notify patient and help arrange alternative payment methods when insurance coverage does not cover services. Job Responsibilities: Responsible for verifying patient insurance coverage, to ensure necessary procedures are covered by an individual s provider. Notify patient and help arrange alternative payment methods when insurance coverage does not cover services. Responsible for entering data in an accurate manner in order to update patient benefit information correctly in EMR and verify that existing information is accurate. Perform routine administrative and clerical tasks. Verify insurance coverage in a timely matter. Request payments from patients and guarantors where appropriate. Perform related duties as assigned. Complete insurance verification for more complex visit types (e.g. major surgery). Act as a point of escalation and monitor supervisory or secondary work queues. Work with complex insurance companies for verifications. Job Requirements: High school graduate or GED certificate is required. A minimum of 1-year experience in a physician billing or third party payer environment. Candidate must demonstrate working knowledge of contracts, insurance benefits, exclusions and other billing requirements as well as claim forms, HMOs, PPOs, Medicare, Medicaid and compliance program regulations. Candidate must demonstrate the ability to understand and navigate the payer adjudication process. Patient financial and practice management system experience in Epic and or other of electronic billing systems is preferred. Knowledge of medical terminology is preferred. Previous experience in an academic healthcare setting is preferred. Hourly Rate Ranges: $23.69 - $32.00 Note: Our salary offers will fall within these ranges based on a variety of factors, including but not limited to experience, skill set, training and education. 61st Street Service Corporation At 61st Street Service Corporation we are committed to providing our client with excellent customer service while maintaining a productive environment for all employees. The Service Corporation offers a competitive comprehensive Benefit package to eligible employees; including Healthcare and various other benefits including Paid Time off to promote a healthy lifestyle. We are an equal employment opportunity employer and we adhere to all requirements of all applicable federal, state, and local civil rights laws.
    $23.7-32 hourly 28d ago
  • Release of Information Specialist

    Charlie Health

    Remote medicare specialist job

    Why Charlie Health? Millions of people across the country are navigating mental health conditions, substance use disorders, and eating disorders, but too often, they're met with barriers to care. From limited local options and long wait times to treatment that lacks personalization, behavioral healthcare can leave people feeling unseen and unsupported. Charlie Health exists to change that. Our mission is to connect the world to life-saving behavioral health treatment. We deliver personalized, virtual care rooted in connection-between clients and clinicians, care teams, loved ones, and the communities that support them. By focusing on people with complex needs, we're expanding access to meaningful care and driving better outcomes from the comfort of home. As a rapidly growing organization, we're reaching more communities every day and building a team that's redefining what behavioral health treatment can look like. If you're ready to use your skills to drive lasting change and help more people access the care they deserve, we'd love to meet you. About the Role The Release of Information Specialist supports secure and authorized exchange of protected health information at Charlie Health. This role will be responsible for ensuring Charlie Health complies with all state and federal privacy laws while providing access to care documentation. Our team is composed of passionate, forward-thinking professionals eager to take on the challenge of the mental health crisis and play a formative role in providing life-saving solutions. We are looking for a candidate who is inspired by our mission and excited by the opportunity to build a business that will impact millions of lives in a profound way. We're a team of passionate, forward-thinking professionals eager to take on the challenge of the mental health crisis and play a formative role in providing life-saving solutions. If you're inspired by our mission and energized by the opportunity to increase access to mental healthcare and impact millions of lives in a profound way, apply today. Responsibilities Maintains confidentiality and security with all protected information. Receives and processes requests for patient health information in accordance with company, state, and federal guidelines. Ensures seamless and secure access of protected health information. Establishes proficiency in Health Information Management (HIM) electronic document management (EDM) systems. Answers calls to the medical records department and responds to voice messages. Retrieves electronic communication, faxes, opening postal mail, and data entry. Responds to internal requests via email, slack, or any other communication platform. Documents inquiries in the requests for information log and track steps of the process through completion. Determines validity from documentation provided on authorizations, subpoenas, depositions, affidavits, power attorney directives, short term disability insurance, workers compensation, health care providers, disability determination services, state protective services, regulatory oversight agencies and any other sources. Sends invalid request notifications as needed. Retrieves correct patient information from the electronic medical record (EMR) and other record sources. Verifies correct patient information and dates of services on all documents before releasing. Provides records in the requested format. Acts in an informative role within the organization regarding general release of information questions and assists with developmental training. Documents accounting of disclosures not requiring patient authorization. Scans or uploads documents and correspondence in EMR. Communicates feedback, new ideas, fluctuating volumes, difficulties, or concerns to the HIM Director. Participates in teams to advance operations, initiatives, and performance improvement. Assists with other administrative duties or responsibilities as evident or required. Requirements Associates Degree required or equivalent in release of information experience. 1 year experience in a behavioral health medical records department, or related fields. Experience in a healthcare setting is highly desirable. Experienced use of email, phones, fax, copiers, MS office, and other business applications. Ability to prioritize multiple tasks and respond to requests in a fast-paced environment. Ability to maintain strict confidentiality. Extreme attention to detail as it relates to accurate information for medical records. Professional verbal and written communication skills in the English language. Work authorized in the United States and native or bilingual English proficiency Familiarity with and willingness to use cloud-based communication software-Google Suite, Slack, Zoom, Dropbox, Salesforce-in addition to EMR and survey software on a daily basis. Please note that members of this team who live within 45 minutes of a Charlie Health office are expected to adhere to a hybrid work schedule. Please note that this role is not available to candidates in Alaska, California, Colorado, Connecticut, Maine, Massachusetts, Minnesota, New Jersey, New York, Oregon, Washington State, or Washington, DC. Benefits Charlie Health is pleased to offer comprehensive benefits to all full-time, exempt employees. Read more about our benefits here. The total target base compensation for this role will be between $44,000 and $60,000 per year at the commencement of employment. Please note, pay will be determined on an individualized basis and will be impacted by location, experience, expertise, internal pay equity, and other relevant business considerations. Further, cash compensation is only part of the total compensation package, which, depending on the position, may include stock options and other Charlie Health-sponsored benefits. Please note that this role is not available to candidates in Alaska, Maine, Washington DC, New Jersey, California, New York, Massachusetts, Connecticut, Colorado, Washington State, Oregon, or Minnesota. Li-RemoteOur Values Connection: Care deeply & inspire hope. Congruence: Stay curious & heed the evidence. Commitment: Act with urgency & don't give up. Please do not call our public clinical admissions line in regard to this or any other job posting. Please be cautious of potential recruitment fraud. If you are interested in exploring opportunities at Charlie Health, please go directly to our Careers Page: ******************************************************* Charlie Health will never ask you to pay a fee or download software as part of the interview process with our company. In addition, Charlie Health will not ask for your personal banking information until you have signed an offer of employment and completed onboarding paperwork that is provided by our People Operations team. All communications with Charlie Health Talent and People Operations professionals will only be sent *********************** email addresses. Legitimate emails will never originate from gmail.com, yahoo.com, or other commercial email services. Recruiting agencies, please do not submit unsolicited referrals for this or any open role. We have a roster of agencies with whom we partner, and we will not pay any fee associated with unsolicited referrals. At Charlie Health, we value being an Equal Opportunity Employer. We strive to cultivate an environment where individuals can be their authentic selves. Being an Equal Opportunity Employer means every member of our team feels as though they are supported and belong. We value diverse perspectives to help us provide essential mental health and substance use disorder treatments to all young people. Charlie Health applicants are assessed solely on their qualifications for the role, without regard to disability or need for accommodation. By submitting your application, you agree to receive SMS messages from Charlie Health regarding your application. Message and data rates may apply. Message frequency varies. You can reply STOP to opt out at any time. For help, reply HELP.
    $44k-60k yearly Auto-Apply 60d+ ago
  • Health Plan Request Bench Release of Information Specialist II - Remote

    Verisma Systems Inc. 3.9company rating

    Remote medicare specialist job

    Health Plan Request Bench Release of Information Specialist II The Health Plan Request (HPR) Bench Release of Information Specialist (ROIS) II processes release of information (ROI) requests related to health plan audits with accuracy, efficiency, and compliance across multiple client accounts. This role requires a high level of proficiency in various electronic medical record (EMR) systems, adherence to HIPAA regulations and uphold strict confidentiality standards. The HPR Bench ROIS III independently prioritizes tasks, troubleshoots requests, and collaborates effectively with internal teams while adapting to evolving workflows and compliance requirements, as well as ensuring they can fulfill all client-specific onboarding and access requirements. Duties & Responsibilities: Process medical ROI requests related to health plan audits quickly and accurately, ensuring compliance with HIPAA and client requirements Utilize Verisma software applications to input, manage, and track medical records Organize and retrieve records within multiple EMR systems, ensuring all documentation is properly structured and complete Interpret medical records, forms, and authorizations to correspond to specific audit measures Maintain high standards of production, efficiency, and accuracy meeting company standards and performance metrics Prioritize workload effectively and work independently while meeting productivity goals Communicate effectively within the HPR team and in a cross-functional manner, as necessary Attain a solid understanding of client-specific expectations across multiple accounts while ensuring compliance with HIPAA, HITECH, state regulations, and company policies Utilize Verisma's reference materials and compliance guidelines to maintain confidentiality and accuracy in all tasks Assist with training and mentoring new associates, as needed, ensuring knowledge transfer and consistency in processes Attend and actively participate in training sessions, workflow updates and team meetings, as required Maintain all necessary background checks, drug screenings, health screenings and access requirements to serve on the Bench Perform other related duties, as assigned, to support the effective operation of the department and the company Live by and promote Verisma Core Values Minimum Qualifications: High school diploma or equivalent required; some college preferred RHIT certification preferred 3+ years of experience in medical records, Release of Information (ROI), or Health Information Management (HIM), with expertise in supporting multiple clients and processing audit requests Knowledge of HIPAA and state regulations related to the release of protected health information Must be able to maintain all necessary background checks, drug screenings, health screenings and access requirements to serve on the Bench Clerical or office experience with data entry, document management and proficiency in using general office equipment Proficient in Microsoft Office Suite and multiple EMR systems, with the ability to troubleshoot and adapt to new technologies Strong problem-solving, organizational and time management skills with keen attention to detail Strong ability to work independently while meeting high productivity expectations Ability to effectively multi-task or change projects, as needed Prior remote experience, preferred
    $34k-53k yearly est. 3d ago
  • Insurance Verification Specialist

    Dental Office

    Remote medicare specialist job

    We are seeking an experienced, highly skilled individual with close attention to detail for the position of Insurance Verification Specialist. All full-time team members work four, 8-to 10-hour days per week, Monday through Friday. Along with being a helpful and positive team member, you will handle the following tasks: Handle patient inquiries regarding their insurance coverage Contact insurance companies regarding past due balances, credits, preauthorizations, appeals, denials, and questions on EOB's Submit insurance appeals Help with last-minute insurance verifications Follow up on aging claims with insurance companies and patients Good interpersonal skills are essential when interacting with patients and fellow employees. The ability to adapt to new procedures is crucial, as we continually strive to enhance our employee workflow and patient care. 1 year of experience verifying dental insurance. Pay: $22.00 - $27.00 per hour Job Type: Full-time Benefits: 401(k) Dental insurance Employee discount Flexible spending account Health insurance Health savings account Life insurance Paid time off Retirement plan Vision insurance Schedule: 10-hour shift 8-hour shift Monday to Friday Supplemental Pay (after 90 days of continuous employment): Bonus opportunities Experience: Dental insurance/billing: 1 year (Required) Working knowledge of Open Dental preferred Work Location: In person. THIS IS NOT A REMOTE POSITION. INDHRFO01
    $22-27 hourly Auto-Apply 37d ago
  • Health Information Specialist I

    Datavant

    Remote medicare specialist job

    Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. Datavant is a data platform company for healthcare whose products and solutions enable organizations to move and connect data securely. Datavant has a network of networks consisting of thousands of organizations, more than 70,000 hospitals and clinics, 70% of the 100 largest health systems, and an ecosystem of 500+ real-world data partners. By joining Datavant today, you're stepping onto a highly collaborative, remote-first team that is passionate about creating transformative change in healthcare. We invest in our people and believe in hiring for high-potential and humble individuals who can rapidly grow their responsibilities as the company scales. Datavant is a distributed, remote-first team, and we empower Datavanters to shape their working environment in a way that suits their needs. This is an entry level position responsible for processing all release of information (ROI), specifically medical record requests, in a timely and efficient manner ensuring accuracy and providing customers with the highest quality product and customer service. Associates must at all times safeguard and protect the patient's right to privacy by ensuring that only authorized individuals have access to the patient's medical information and that all releases of information are in compliance with the request, authorization, company policy and HIPAA regulations. Position Highlights: Full-Time: Monday-Friday 8:30-5:00 PM OR 8:00-4:30pm EST Location: This role will be performed - Remote - WFH Processing medical records along with by taking calls from patients, insurance companies, and attorneys to provide medical records status Documenting information on multiple platforms using two computer monitors. Preferred Customer Service and Data Entry and Release of Information experience Full Benefits: PTO, Health, Vision, and Dental Insurance and 401k Savings Plan with matching contributions & Tuition Reimbursement You will: Receive and process requests for patient health information in accordance with Company and Facility policies and procedures. Maintain confidentiality and security with all privileged information. Maintain working knowledge of Company and facility software. Adhere to the Company's and Customer facilities Code of Conduct and policies. Inform manager of work, site difficulties, and/or fluctuating volumes. Assist with additional work duties or responsibilities as evident or required. Consistent application of medical privacy regulations to guard against unauthorized disclosure. Responsible for managing patient health records. Responsible for safeguarding patient records and ensuring compliance with HIPAA standards. Prepares new patient charts, gathering documents and information from paper sources and/or electronic health records. Ensures medical records are assembled in standard order and are accurate and complete. Creates digital images of paperwork to be stored in the electronic medical record. Responds to requests for patient records, both within the facility and by external sources, retrieving them and transmitting them appropriately. Answering of inbound/outbound calls. May assist with patient walk-ins. May assist with administrative duties such as handling faxes, opening mail, and data entry. Must meet productivity expectations as outlined at a specific site. May schedules pick-ups. Other duties as assigned. What you will bring to the table: High School Diploma or GED. Ability to commute between locations as needed. Able to work overtime during peak seasons when required. Basic computer proficiency. Comfortable utilizing phones, fax machines, printers, and other general office equipment on a regular basis. Professional verbal and written communication skills in the English language. Detail and quality oriented as it relates to accurate and compliant information for medical records. Strong data entry skills. Must be able to work with minimum supervision responding to changing priorities and role needs. Ability to organize and manage multiple tasks. Able to respond to requests in a fast-paced environment. Bonus points if: Experience in a healthcare environment. Previous production/metric-based work experience. In-person customer service experience. Ability to build relationships with on-site clients and customers. Comfortable bringing new ideas, process improvement suggestions, and feedback to internal stakeholders. We are committed to building a diverse team of Datavanters who are all responsible for stewarding a high-performance culture in which all Datavanters belong and thrive. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status. At the end of this application, you will find a set of voluntary demographic questions. If you choose to respond, your responses will be anonymous and used to help us identify areas of improvement in our recruitment process. ( We can only see aggregate responses, not individual responses. In fact, we aren't even able to see if you've responded or not .) Responding is your choice and it will not be used in any way in our hiring process . Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role. The estimated base pay range per hour for this role is:$15-$18.32 USD To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc. Any requests to be exempted from these requirements will be reviewed by Datavant Human Resources and determined on a case-by-case basis. Depending on the state in which you will be working, exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its components, pregnancy or pregnancy-related medical conditions, and/or religion. This job is not eligible for employment sponsorship. Datavant is committed to a work environment free from job discrimination. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status. To learn more about our commitment, please review our EEO Commitment Statement here. Know Your Rights, explore the resources available through the EEOC for more information regarding your legal rights and protections. In addition, Datavant does not and will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay. At the end of this application, you will find a set of voluntary demographic questions. If you choose to respond, your answers will be anonymous and will help us identify areas for improvement in our recruitment process. (We can only see aggregate responses, not individual ones. In fact, we aren't even able to see whether you've responded.) Responding is entirely optional and will not affect your application or hiring process in any way. Datavant is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need an accommodation while seeking employment, please request it here, by selecting the ‘Interview Accommodation Request' category. You will need your requisition ID when submitting your request, you can find instructions for locating it here. Requests for reasonable accommodations will be reviewed on a case-by-case basis. For more information about how we collect and use your data, please review our Privacy Policy.
    $15-18.3 hourly Auto-Apply 3d ago
  • Billing & Revenue Specialist

    Thrive Pet Healthcare

    Remote medicare specialist job

    at Thrive Pet Healthcare Vetspire is a leading provider of AI driven innovative practice management software tailored for veterinary professionals. We empower independent clinics, university veterinary colleges, corporate groups, and all types of hospitals (including GP, urgent care, emergency, and specialty practices) with seamless tools for operations, patient care, and growth. As we expand our footprint in the veterinary SaaS market, we're seeking a detail-oriented Billing & Revenue Specialist to join our team and ensure flawless revenue management. Role SummaryThe Billing & Revenue Specialist will play a pivotal role in our revenue operations, overseeing the end-to-end billing process for our subscription-based SaaS products. This position requires a proactive individual who thrives in a fast-paced environment, collaborating with sales, customer success, and finance teams to drive accurate invoicing, timely collections, and revenue optimization. Success in this role will be measured by reduced days sales outstanding (DSO), high billing accuracy, and proactive support for our multi-channel customer base. ESSENTIAL JOB FUNCTIONS Manage the full revenue cycle, including invoice generation, payment processing, cash application, and reconciliations for SaaS subscriptions, renewals, upsells, and one-time services across independent, university, and corporate channels. Prepare and issue accurate, compliant invoices using tools like ERP systems, ensuring alignment with contract terms for various hospital types (e.g., recurring fees for Vet practices, volume-based billing etc). Monitor accounts receivable (AR) aging reports, follow up on overdue payments, and execute collections strategies to minimize bad debt while maintaining strong customer relationships. Conduct revenue recognition analysis and deferred revenue tracking for multi-year contracts. Collaborate with sales and account managers to resolve billing disputes, process credits/debits, and support deal closures by providing billing forecasts and projections. Generate monthly/quarterly revenue reports, KPIs (e.g., ARR growth, churn impact), and ad-hoc analyses to inform executive decision-making. Identify process improvements, such as automation opportunities in billing workflows, to enhance efficiency in our growing SaaS portfolio. You understand and have experience with web technology and SaaS Software You are proactive You are persuasive in setting up meetings with decision makers You are experienced in forecasting sales targets and ensuring they are met You know how to present to and consult with senior level management on business trends with a view to developing new services and sales channels You will have monthly meetings with senior level management and report out on sales targets and metrics Innovation & Strategy Provide thought leadership to product development and operational excellence for Pathway deployments Effective communication of Operation's directions, capabilities, initiatives, and innovations to the other members of the leadership team Provide guidance on new processes, approaches, methods, and features Assist in the development of business case justifications and cost/benefit analyses for initiatives Budget/Financial P&L / Contractual negotiation responsibilities Be involved in or coordinate discussions/negotiations with third party suppliers as dictated by deliverable requirements. Assist with developing yearly budgets/sales targets within the Operations department Aid in the development of productivity measures and costing strategies. Be involved in or co-ordinate discussions/negotiations with third party suppliers as dictated by deliverable requirements. ESSENTIAL SKILLS High energy, flexible, innovative and the ability to manage responsibilities and priorities in a fast-paced and time-critical environment May be required to work early morning, evening or even weekend shifts May be required to work in a mobile capacity Associate's or Bachelor's degree in Accounting, Finance, Business Administration, or a related field. Experience: 2+ years in billing, revenue operations, or accounts receivable within a SaaS, software, or healthcare environment; experience with subscription billing models preferred. Skills: Proficiency in ERP/CRM systems and Microsoft Excel (advanced functions, pivot tables). Strong understanding of revenue recognition principles and AR best practices. Excellent analytical skills with attention to detail and the ability to handle high-volume transactions. Outstanding communication and customer service skills for cross-functional collaboration and dispute resolution. Attributes: Highly organized, proactive problem-solver with a customer-centric mindset; ability to adapt to evolving priorities in a startup-like SaaS environment Work independently High aptitude in problem solving and customer service excellence Interpersonal skills to interact with owners and clinic members Highly organized and able to multitask under time constraints Ability to balance and prioritize work A self-motivated team player
    $35k-57k yearly est. Auto-Apply 60d+ ago
  • Part-Time Insurance Verification Specialist (Remote)

    Globe Life Family of Companies 4.6company rating

    Remote medicare specialist job

    At Globe Life we are committed to empowering our employees with the support and opportunities they need to succeed at every stage of their career. We take pride in fostering a caring and innovative culture that enables us to collectively grow and overcome challenges in a connected, collaborative, and mutually respectful environment that calls us to Make Tomorrow Better. Role Overview: Could you be our next Part-Time Insurance Verification Specialist? Globe Life is looking for a Part-Time Insurance Verification Specialist to join the team! In this role, you will verify life and health insurance applications directly with potential customers. This is a vital part of our Company's New Business and Underwriting process. The information you verify and gather directly affects whether the Company will decline or issue a policy. This is a remote / work-from-home position. What You Will Do: Make outbound calls to potential customers to verify and document required information to finalize applications for underwriting assessment. Use the Quality Assurance database and conduct appropriate assessments on what additional customer information or verification is needed. Clearly explain the application process to potential customers. Accurately complete additional paperwork as needed. Maintain appropriate levels of communication with management regarding actions taken within the Quality Assurance database. Transfer calls to the appropriate department as needed. Successfully meet the minimum expectation for departmental key performance indicators (K.P.I's). Be enlisted in special projects that encompass making numerous outbound calls, recording activities requested by/from customers, etc. What You Can Bring: Minimum typing requirement of 35 wpm. Bilingual English and Spanish preferred Superior customer service skills required - friendly, efficient, good listener. Proficient use of the computer, keyboard functions, and Microsoft Office. Ability to multitask and work under pressure. Knowledge of medical terminology and spelling is a plus. Excellent organization and time management skills. Must be detail-oriented. Have a desire to learn and grow within the Company. Applicable To All Employees of Globe Life Family of Companies: Reliable and predictable attendance of your assigned shift. Ability to work full-time and/or part-time based on the position specifications.
    $28k-31k yearly est. 60d+ ago
  • Revenue Cycle Specialist

    Cardioone

    Remote medicare specialist job

    About the Company CardioOne partners with independent cardiologists to provide innovative solutions that improve patient outcomes and reduce costs. Our platform helps our physician partners thrive in today's fee-for-service environment and prepare for success in value-based care. In February 2024, we partnered with WindRose Health Investors as well as top physician services and payor executives to grow our team and invest in our next phase of growth. Join us in our mission to positively impact US cardiology. About the Job We are seeking a detail-oriented and seasoned Revenue Cycle Specialist to join our growing team! The ideal candidate will have a demonstrated knowledge of medical billing, preferably in cardiology services. We seek an organized critical thinker with billing knowledge and who is comfortable working with providers, insurance companies, and in a fast-paced environment. This role offers an exciting opportunity to dive into the heart of healthcare finance, where you'll play a crucial part in our practice's success while developing valuable skills for your future career growth. What you'll do: Ensure that insurance information is entered correctly for successful claim submission and payment. Communicate with Patients to ensure understanding of patient balance, billing concerns, projected out of pocket expenses and correct insurance information is on file, Work in multiple computer systems to obtain and organize information to support billing Resolve claims that require pre-bill resolution Resolve payment denials Oversee billing-related inventories in multiple systems, ensuring inventory volume and aging remains within thresholds Conduct reconciliation processes, ensuring no charge goes uncaptured Manage communications between practice and vendor staff and organizations Reports status of various revenue cycle metrics and escalates issues for resolution. Assists in preparation of reports to share with payers when discrepancies are uncovered. What you'll need: High school diploma or GED preferred 3+ years experience in the industry required Cardiology or diagnostic imaging experience preferred including prior authorization requirements/processes Certified Professional Coder preferred Strong understanding of Insurance products and claim processing Knowledge of claim formatting and transmission guidelines Detailed understanding of EOB/ERA data and impact on financial responsibility. A passion and proficiency for patient advocacy. Knowledge of ICD-10 and CPT codes, and modifiers Experience with medical office procedures and medical collections Comfort with electronic medical records systems (Athena Collector knowledge is preferred, Hybrid Chart familiarity is the cherry on top) Strong attention to detail and accuracy in data entry Intermediate knowledge of Microsoft Word and Excel Excellent communication skills, both written and verbal, to interact with patients, insurance companies, and healthcare providers Work Location: Remote: Colorado (Denver preferred), Delaware, Florida, New Hampshire, New Jersey, Pennsylvania, Texas. Additional Information Full-time base hourly rate of $20.00 to $24.00 per hour plus medical, dental, and vision. Pay is negotiable depending on certifications.
    $20-24 hourly Auto-Apply 8d ago
  • Revenue Cycle Specialist

    National Youth Advocate Program 3.9company rating

    Medicare specialist job in Columbus, OH

    We are looking for a full-time Revenue Cycle Specialist to join our NYAP team! This is an in-person role to start. Schedule- Monday-Friday 9a-5p Compensation: Starts at $40,000/yr. based on degree and experience. Working At NYAP NYAP's commitment to doing what is best for children, youth and their families is a core value and one that we look for in our newest team members. Excellent training and continuing education and development opportunities offered on topics such as: PCIT, NMT, TF-CBT, BFST, CSAYC, TBRI, FFT and many, many more! Student Loan Repayment assistance, up to $1,200 per year! Medical, Dental, and Vision insurance for you and your family! 22 Days Off Each Year! Plus 11 Paid Holidays Per Year! Competitive salaries and benefits including a 401(k) Summer Hours Off (Friday afternoons off). Tuition Assistance Work Anniversary Trips! Peace leave Paternity leave Position Overview To ensure timely and accurate invoicing/follow up to maximize payments for all services rendered and to coordinate and assist with internal and external controls/audits for any special contracts. To initiate paybacks in a timely manner in order to maintain good relationships with our special contract vendors. Responsibilities The Revenue Cycle Contracts Specialist will perform duties including, but not limited to: Perform all work in a manner consistent with the National Youth Advocate Program's mission, values, and philosophies. Submit timely invoices to contract payers in accordance set forth in each contract. Review and process foster parent pay. Develop and maintain process for tracking invoice status and payments. Review with Revenue Cycle Supervisor and/or Manager any issues pertaining to special contracts that may need immediate attention. Actively participate in special contract audits and assist with any corrections or paybacks that may be required. Submit adjustment request for any services deemed uncollectible to Revenue Cycle Supervisor and/or Manager. Maintain list of point of contacts for billing questions for each contract. Other duties as assigned. Minimum Qualifications High School Diploma or Equivalent. 2 years' experience in same or related field. Basic knowledge of Microsoft Office and Outlook. Understanding of Insurance Billing and practices. Billing and reconciliation experience. Ability to communicate with internal and external clients. Proficient use of desktop and laptop computers, smart phones and tablets, printers, fax machines and photocopiers as well as software including word processing, spreadsheet and database programs. Other Skills Excellent customer service and communication skills Works well independently and as a team member Multi-task efficiently and be flexible in all situations If this describes YOU, please apply today! www.nyap.org/employment NYAP also requires all of our employees, regardless of your title/position, to hold and maintain automobile liability insurance coverage of $100,000/$300,000. Please contact our HR department with questions, 614-487-3888 or hr@nyap.org The person in this position needs to follow a team concept and support both agency goals and co-workers. Employees must be able to effectively work with and be respectful and sensitive to persons from various cultures, socioeconomic, ethnic, religious, and racial backgrounds. Benefits listed are for eligible employees as outlined by our benefit policy. Qualifications We have been serving communities and clients since 1978. We continue to expand and develop new and innovative programs for our communities and families. We offer unique and personalized services for families and individuals in four different areas: Prevention/Intervention, Positive Youth Development, Out-of-Home-Placement and Reunification/Permanency. If YOU can envision it; WE can DO it! The possibilities are endless! We know you are compassionate and dedicated to serving your clients and communities and we are dedicated, as your employer to provide you with support to do just that. We look for individuals that are ready to make a direct impact and are excited to be an instrument in supporting the needs of our children, youth and families. An Equal Opportunity Employer, including disability/veterans.
    $40k yearly 5d ago
  • Insurance Verification Specialist

    Recora, Inc.

    Remote medicare specialist job

    Job Title: Insurance Verification Specialist Classification: Part Time/1099 Contractor Work Structure: Fully Remote Schedule/Shift: Monday-Friday; 10-40 hours/week (between hours of 9a-6p ET) Team: Clinical Operations Reporting to: Pulmonary Rehab Manager Location: United States Compensation: $19-$20 per hour Job Summary: The Insurance Verification Specialist will review patient insurance information and verify in advance the treatments that their policies will cover. They then call insurance companies and send the proper documentation to verify authorizations for procedures which require them. Essential Job Functions and Responsibilities: * Enter data and validate patient information. * Researches and corrects invalid or incorrect patient demographic information such as invalid insurance policy number to ensure proper billing. * Determines member benefit coverage. * Monitor and verify insurance information for individual patient visits and procedures. * Communicate with patients about co-pays, benefits, coverage, and care authorization. * Contacts providers with authorization, denial, and appeals process information. * Assists in educating and acts as a resource to scheduling department. * Works and assists with the billing department in researching and resolving rejected, incorrectly paid, and denied claims as requested. * Responds professionally to all inquiries from patients, staff, and payors in a timely manner. * Accurately documents patient accounts of all actions taken Qualifications: The ideal candidate must be a rigorous analytical thinker and problem solver with the following professional attributes: * Strong work ethic and sound judgment * Proven written and verbal communication skills * Natural curiosity to pursue issues and increase expertise * Demonstrated knowledge of insurances * Two to four years related experience and/or training in insurance verification * Two to four years of experience in medical billing * Two to four years of experience in authorizations * Knowledge of CPT and ICD10 codes. * Excellent computer, multi-tasking and phone skills. * The ability to work well under pressure (most of the paperwork is time * sensitive). * Must successfully pass a background check. Additional Information In accordance with HIPAA, this position must maintain the confidentiality of the patient in all circumstances as well as company confidentiality. Ensures the confidentiality of data collected and stored is maintained. This description is intended to provide basic guidelines for meeting job requirements. Responsibilities, knowledge, skills abilities, and working conditions may change as needs evolve. * Note: This is a 1099 contractor position
    $19-20 hourly Auto-Apply 17d ago
  • Revenue Cycle Specialist

    Choice Healthcare Services 3.8company rating

    Remote medicare specialist job

    Dental Revenue Cycle Specialist Summary:The Dental Revenue Cycle Specialist is responsible for ensuring accurate and timely billing of accounts, accuracy of account balances and coordinating with other billing team members to ensure billing accuracy. This is a remote position and we are seeking candidates who live in Pacific and Mountain time zones, as we are a West Coast based organzation. Pay Range: $18.00-23.00/hour (based on experience) At CHOICE Healthcare Services, our mission is to provide everyone access to the healthcare they need. CHOICE is the largest provider of pediatric dental care in the Southwest United States, and we pride ourselves on delivering high quality care to children in our communities. What we provide to you as a CHOICE teammate: Care for your wellbeing and work-life balance Professional and personal growth Experienced leadership support Fun and supportive team dynamic with events and celebrations Comprehensive benefit package Responsibilities Essential Duties and Responsibilities: include the following. Other duties may be assigned. Ensure daily billing and adjustments are accurate and timely Ability to read insurance benefits and explanation of benefits (EOB) Process pre-authorizations with HMO insurances & Denti-Cal Review outstanding claims, follow up on aging for both patient and insurance balances Send statements with outstanding balances to patient Process appeals/denials with insurances Assists front office staff at practices with insurance and account questions as needed Verify insurance eligibility and benefits for patients Cross trained in other aspects of the department as assigned Ability to work in fast paced environment Willingness to cover other duties as assigned Regular, predictable attendance is required Ability to get along and work effectively with others Qualifications Education/Experience: High school diploma or equivalent Medical Billing & Coding Certificate, preferred Minimum of 2 years of experience working in medical collections and accounts receivables Experience working in a dental or orthodontics billing practice or similar environment Experience working with EOBs and healthcare accounts receivables
    $18-23 hourly Auto-Apply 4d ago
  • Care Inbound Revenue Specialist - (Remote)

    It Works 3.7company rating

    Remote medicare specialist job

    Welcome to the intersection of energy and home services. At NRG, we're driven by our passion to create a smarter, cleaner and more connected future. Vivint Smart Home, an NRG owned company, is a leading smart home company in the United States, dedicated to redefining the home experience with intelligent products and services. We find purpose in proactively protecting and keeping our customers connected to home, no matter where they are. Join the Smart Home team to create smarter, safer and more sustainable homes. Welcome to the intersection of energy and home services. At NRG, we're driven by our passion to create a smarter, cleaner and more connected future. Vivint Smart Home, an NRG owned company, is a leading smart home company in the United States, dedicated to redefining the home experience with intelligent products and services. We find purpose in proactively protecting and keeping our customers connected to home, no matter where they are. Join the Smart Home team to create smarter, safer and more sustainable homes. Who We Are: Our Inbound Service & Sales team within our Customer Solutions organization provides peace of mind through seamless security solution integrations. We are searching for passionate individuals to help us redefine home security. With a proven service-to-sales process, our team ensures every customer experiences the ultimate protection and peace of mind. We prioritize providing world-class customer service and savings for families through our proactive retention efforts. The Role: Inbound Service & Sales Specialists excel in offering equipment and plan upgrades, tailored system relocation packages to retain loyal customers, and educate clients on opportunities to save money and optimize their Smart Home experience. This role combines customer support with consultative sales. You'll begin every interaction by delivering exceptional service, listening carefully, resolving concerns, and building trust. Once the customer feels supported, you'll transition seamlessly into proactively uncovering needs and presenting individualized solutions that enhance their security and lifestyle. In this role you will earn the opportunity to sell by prioritizing solutions that ensure our customers' systems and accounts are taken care of while presenting equipment and offers that will enhance their experience with our products. Day to Day: You will master our internal troubleshooting processes and adopt a consultative sales approach that prioritizes customer needs. Strong communication and interpersonal skills are key to thriving in a fast-paced, dynamic environment. A passion for sales, delivering professional customer service, and a problem-solving mindset will enable you to achieve your monthly goals. You'll join a supportive, high-energy team that values collaboration and shared success. As an Inbound Service & Sales Specialist, you'll work closely with leaders across departments, your direct supervisor and performance coach, as well as upper management, to ensure success for you, the customer, and Vivint. Expectations for Success: • Drive and Adaptability: Must demonstrate strong determination and flexibility toovercome challenges. Success in this role means handling rejection with confidence and pushing through obstacles to identify and enact appropriate solutions. • Achieving Steady Sales Performance: Must consistently meet or exceed monthly and quarterly targets, showcasing a proven ability to deliver results and drive Vivint's continued revenue growth. • Clear and Compelling Communication: Must be able to simplify complex product offerings and present them in an enticing way, ensuring customers understand the value of their new system and how it meets their unique needs. • Commitment to Continuous Learning: Must stay current on evolving products, services, industry trends, and sales strategies. Curiosity and innovation are key to maintaining success in a dynamic market. Qualifications Needed: • Must be at least 18 years old • Must obtain a Burglar Alarm License (paid for by Vivint) • Proven experience in sales or a customer-facing role, preferably in a customer upgrade or sales specialist capacity • Proficient with computer functions and ability to utilize software, databases, scripts, and other resources • Must be able to type a minimum of 40 wpm • Cannot be located in CA, CO, CT, DC, KY, ME, NJ, NY, or WA. Education: • High School diploma / GED Equivalent Working Conditions: • Work-from-home employees cannot be the primary caregivers for children, other people, or pets while on shift • Have a quiet and private location from which to work • Must be able to provide your own equipment; requirements will be verified upon hire and are as follows: • A computer (laptop or desktop) that runs Windows 10 (Please note our remote-based software does NOT work with Apple/Mac products, tablets, or Chromebooks) • Computer must have at least 16 GB RAM • Computer must have a functional webcam • A USB wired headset equipped with a microphone • Must have reliable internet: 10 MBPS download and 10 MBPS upload speeds • Must have a wired internet connection • A second monitor is strongly recommended if a laptop is being used • An external mouse (if using a laptop) Pay: $17.75/hr. + Uncapped Commissions Training: Paid & Mandatory Training (6 weeks) Schedule: 9:00 am - 5:30 pm MT Monday - Friday (NO WEEKENDS) Why You'll Love It Here • Clear career pathing throughout our Customer Care organization • Paid holidays and flexible paid time away • Employee/Friends/Family Discounts • Medical/dental/vision/life coverage & 24/7 Medical Hotline • 401(k) + Employer Match • Employee Resource Groups Safety: Vivint enforces a safety culture whereby all employees have the responsibility for continuously developing and maintaining a safe working environment. Each new employee is responsible for completing all training requirements. Additionally, the employee must accept they have responsibility for maintaining the safety of themselves, their co-workers,and the public. Employees must adhere to all written and verbal instructions, promptly report and correct all hazards or unsafe conditions, question non-standard operations or unmitigated hazards, and provide feedback to management on all safety issues. Our compensation reflects the cost of labor across several US geographic markets. The base pay for this position is $17.75. Pay is based on a number of factors including market location and may vary depending on job-related knowledge, skills, and experience. NRG Energy is committed to a drug and alcohol-free workplace. To the extent permitted by law and any applicable collective bargaining agreement, employees are subject to periodic random drug testing, and post-accident and reasonable suspicion drug and alcohol testing. EOE AA M/F/Protected Veteran Status/Disability. Level, Title and/or Salary may be adjusted based on the applicant's experience or skills. EEO is the Law Poster (The poster can be found at ************************************************************************ Official description on file with Talent.
    $17.8 hourly 10d ago
  • Specialist, Revenue Cycle - Managed Care

    Cardinal Health 4.4company rating

    Medicare specialist job in Columbus, OH

    **Remote Hours: M-F 8:30-5:00 pm EST (or based on business needs)** **_What Contract and Billing contributes to Cardinal Health_** Contracts and Billing is responsible for finance related activities such as customer and vendor contract administration, customer and vendor pricing, rebates, billing (including drop-ships), processing charge backs and vendor invoices, developing and negotiating customer and group purchasing contracts. + Demonstrates knowledge of financial processes, systems, controls, and work streams. + Demonstrates experience working collaboratively in a finance environment coupled with strong internal controls. + Possesses understanding of service level goals and objectives when providing customer support. + Demonstrates ability to respond to non-standard requests from vendors and customers. + Possesses strong organizational skills and prioritizes getting the right things done. **_Responsibilities_** + Working unpaid or denied claims to ensure timely filing guidelines are meet. + Submitting medical documentation/billing data to Commercial (MCO) and government (Medicare/Medicaid) providers + Denials resolution for unpaid and rejected claims + Preparing, reviewing and billing claims via electronic software and paper claim processing + Insurance claims follow up regarding discrepancies in payment. **_Qualifications_** + Bachelor's degree in business related field preferred, or equivalent work experience preferred + 1+ years experience as a Medical Biller or Denials Specialist preferred + Strong knowledge of Microsoft excel + Ability to work independently and collaboratively within team environment + Able to multi-task and meet tight deadlines + Excellent problem solving skills + Strong communication skills + Familiarity with ICD-10 coding + Competent with computer systems, software and 10 key calculators + Knowledge of medical terminology **_What is expected of you and others at this level_** + Applies basic concepts, principles, and technical capabilities to perform routine tasks + Works on projects of limited scope and complexity + Follows established procedures to resolve readily identifiable technical problems + Works under direct supervision and receives detailed instructions + Develops competence by performing structured work assignments **Anticipated hourly range:** $22.30 per hour - $28.80 per hour **Bonus eligible:** No **Benefits:** Cardinal Health offers a wide variety of benefits and programs to support health and well-being. + Medical, dental and vision coverage + Paid time off plan + Health savings account (HSA) + 401k savings plan + Access to wages before pay day with my FlexPay + Flexible spending accounts (FSAs) + Short- and long-term disability coverage + Work-Life resources + Paid parental leave + Healthy lifestyle programs **Application window anticipated to close:** 2/12/2026 *if interested in opportunity, please submit application as soon as possible. The hourly range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate's geographical location, relevant education, experience and skills and an evaluation of internal pay equity. _All internal applicants must meet the following criteria:_ + _Rating of "Meets Expectations" or higher during last performance review_ + _Have been in their current position for at least a year_ + _Informed their current supervisor/manager prior to applying_ + _No written disciplinary action in the last year_ _Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply._ _Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal_ _Opportunity/Affirmative_ _Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law._ _To read and review this privacy notice click_ here (***************************************************************************************************************************
    $22.3-28.8 hourly 4d ago
  • Intermediate Insurance Verification Specialist (Physical Therapy, Remote)

    Snapscale

    Remote medicare specialist job

    About Us: At Snapscale, we partner with growing healthcare providers to deliver scalable back-office support. We're seeking an experienced Insurance Verification Specialist to join our remote team, focusing on Physical Therapy practices. This role is critical to ensuring accurate insurance verification and benefit coordination to keep patient care and billing flowing smoothly. Key Responsibilities:Empty heading Verify insurance benefits, eligibility, and prior authorization requirements for Physical Therapy services. Confirm coverage details by communicating with insurance carriers and documenting outcomes clearly in the EHR. Identify and flag limitations, deductibles, copays, coinsurance, and authorization needs. Collaborate with intake, billing, and clinical teams to ensure a seamless patient onboarding process. Maintain accurate records in compliance with HIPAA and company documentation standards. Stay up-to-date with payer rules, coverage trends, and authorization workflows specific to PT practices. Proactively resolve discrepancies and escalate coverage issues when necessary. Required Qualifications: 4+ years of insurance verification experience, including 2+ years in a Physical Therapy or Rehab setting. Solid grasp of PT-specific billing and authorization workflows. Familiarity with EHRs and verification platforms like Availity, Navinet, or payer portals. Excellent written and verbal communication skills. Strong attention to detail, with the ability to problem-solve and work independently. Comfortable working in a remote, fast-paced environment and meeting daily verification targets. Knowledge of HIPAA regulations and a commitment to compliance. Preferred Qualifications: Experience supporting multiple PT clinics or multi-location practices. Prior work with US-based clients or BPO healthcare firms. Familiarity with Medicare and commercial insurance plans common in PT.
    $30k-35k yearly est. 60d+ ago
  • Collection Specialist / Medical - Remote

    Brightspring Health Services

    Remote medicare specialist job

    Our Company Amerita Amerita, Inc. is a leading provider in home Infusion therapy. We are looking for a Collection Specialist to join our Revenue Cycle Management (RCM) team as we grow to be one of the top home infusion providers in the country. As a core member of the Collection team, you will be responsible for a broad range of collection processes related to medical account receivable in support of a single or multiple site locations. The Collection Specialist will report to the Collection Manager and work from home. Schedule: Monday - Friday Hours vary We Offer: • Competitive Pay • Health, Dental, Vision & Life Insurance • Company-Paid Short & Long-Term Disability • Flexible Schedules & Paid Time Off • Tuition Reimbursement • Employee Discount Program & DailyPay • 401k • Pet Insurance Responsibilities As a Collection Specialist, you will... Ensure daily accomplishments work towards company goals for cash collections and Account Receivable over 90 days. Understand and adhere to state and federal regulations and company policies regarding compliance, integrity, patient privacy and ethical billing and collection practices. Research outstanding balances and take necessary collection action to resolve in a timely manner; recommend necessary demographic changes to patient accounts to ensure future collections. Research assigned correspondence; take necessary action to resolve requested information in a timely manner; establish appropriate follow up. Resubmit accurate and timely claims in formats including, but not limited to, CMS-1500 and electronic 837. Utilize the mose efficient resources to secure timely payment of open claims or invoices, giving priority to electronic solutions. Negotiate payment plans with patients in accordance with company collection policies. Identify patterns of short-payment or non-payment and bring them to the attention of appropriate supervisory personnel. Review insurance remittance advices for accuracy. Identify billing errors, short-payments, overpayments and unpaid claims and resolve accordingly, communicating any needed system changes. Review residual account balances after payments are applied and generate necessary adjustments (within eligible guidelines), overpayment notifications, refund requests and secondary billing. Interact with third party collection agencies. Communicate consistently and professionally with other Amerita employees. Work within specified deadlines and stressful situations. Work overtime when necessary to meet department goals and objectives. Qualifications High School Diploma/GED or equivalent required; some college a plus A minimum of one (1) year of experience in medical collections with a working knowledge of managed care, commercial insurance, Medicare and Medicaid reimbursement; home infusion experience a plus Working knowledge of automated billing systems; experience with CPR+ preferred Working knowledge and application of metric measurements, basic accounting practices, ICD-9, CPT and HCPCS coding Solid Microsoft Office skills required, including Word, Excel and Outlook Ability to type 40 wpm and proficiency with 10-key calculator Ability to independently obtain and interpret information Strong verbal and written communication skills About our Line of Business Amerita, an affiliate of BrightSpring Health Services, is a specialty infusion company focused on providing complex pharmaceutical products and clinical services to patients outside of the hospital. Committed to excellent service, our vision is to combine the administrative efficiencies of a large organization with the flexibility, responsiveness, and entrepreneurial spirit of a local provider. For more information, please visit ****************** Follow us on Facebook, LinkedIn, and X. Salary Range USD $20.00 - $22.00 / Hour
    $20-22 hourly Auto-Apply 1d ago
  • Insurance Verification Specialist

    Evident Id

    Remote medicare specialist job

    The world's largest organizations rely on Evident to help them protect their business and brand from third-party risk. Our game-changing technology - which enables the secure exchange of risk data like proof of insurance, identity, business registration, and other information - helps our customers verify that their partners have all of the required credentials to do business. In today's new remote-first, ever-changing regulatory environment, our secure, privacy-first enterprise platform, accessible via web portal or API, provides a highly scalable and configurable solution to manage communications, storage, decisioning, and ongoing monitoring of credentials. Evident is a VC-backed technology startup, headquartered in Atlanta, GA. Learn more at evidentid.com. Job Description Evident ID is hiring an Insurance Verification Specialist. We are seeking an Insurance Verification Specialist for our business insurance field. The role involves verifying information via phone calls to ensure accuracy and compliance with insurance policies. Working hours are from 9 am to 5 pm ET, and the position can be fully remote. The total working hours for this position are 32 hours per week, to be determined based on the specific working days. Offered salary is $15 per hour.Responsibilities Conducting phone calls to verify information provided by clients or other relevant parties, ensuring accuracy and compliance with insurance policies Establishing and nurturing long-term working relationships with insurance agencies, brokers, and other stakeholders to facilitate smooth information verification processes Performing data entry tasks accurately and efficiently to record verified information into databases or management systems Providing reports to managers regarding the progress of verification tasks, highlighting any discrepancies or issues encountered during the process Taking ownership of assigned verification projects while collaborating effectively with team members to ensure seamless workflow and achievement of team goals Maintaining a high level of professionalism during phone interactions to uphold the company's reputation and foster positive relationships with clients and partners The Insurance Verification Specialist will report to the Team Lead or Manager within the Business Insurance Department Requirements Minimum 3 year of experience in business insurance, insurance agent license preferred Familiarity with Certificates of Insurance (COI) At least 2 years of experience in phone verification or customer service roles, ensuring effective issue resolution Proficiency in English communication with a strong emphasis on clarity and professionalism Additional fluency in another language is desirable, enhancing customer interaction capabilities Knowledge of Zendesk is advantageous for efficient support management Adaptability to evolving industry standards and a proactive approach to continuous learning are expected for optimal performance Demonstrating reliability and consistency in attendance to ensure coverage during designated working hours and contribute to the team's overall efficiency. Why Evident? • Our team solves a crucial problem with huge business potential together, and we are able to see exactly how our contribution affects customers!• Recently named one of Atlanta's Coolest Companies & 50 on Fire by Atlanta Inno• Recently named one of the Top 10 Fastest Growing Companies in Atlanta & one of the Best Places to Work in Atlanta by Atlanta Business Chronicle
    $15 hourly Auto-Apply 60d+ ago
  • Health Insurance Verification Specialist (Remote-Wisconsin)

    Atos Medical, Inc. 3.5company rating

    Remote medicare specialist job

    Health Insurance Verification Specialist | Atos Medical-US | New Berlin, WI This position is remote but requires you to be commutable to New Berlin, WI for orientation and training/employee events as needed. Join a growing company with a strong purpose! Do you want to make a difference for people breathing, speaking and living with a neck stoma? At Atos Medical, our people are the strength and key to our on-going success. We create the best customer experience and thereby successful business through our 1200 skilled and engaged employees worldwide. About Atos Medical Atos Medical is a specialized medical device company and the clear market and technology leader for voice and pulmonary rehabilitation for cancer patients who have lost their voice box. We design, manufacture, and sell our entire core portfolio directly to leading institutions, health care professionals and patients. We believe everyone should have the right to speak, also after their cancer. That's why we are committed to giving a voice to people who breathe through a stoma, with design solutions and technologies built on decades of experience and a deep understanding of our users. Atos Medical has an immediate opening for a Health Insurance Verification Specialist in the Insurance Department. Summary The Health Insurance Verification Specialist will support Atos Medical's mission to provide a better quality of life for laryngectomy customers by assisting with the attainment of our products through the insurance verification process and reimbursement cycle. A successful Health Insurance Verification Specialist in our company uses client information and insurance management knowledge to perform insurance verifications, authorizations, pre-certifications, and negotiations. The Health Insurance Verification Specialist will analyze and offer advice to our customers regarding insurance matters to ensure a smooth order process workflow. They will also interact and advise our internal team members on schedules, decisions, and potential issues from the Insurance payers. Essential Functions Act as an advocate for our customers in relation to insurance benefit verification. Obtain and secure authorization, or pre-certifications required for patients to acquire Atos Medical products. Verifies the accuracy and completeness of patient account information. Ensures information obtained is complete and accurate, applying acquired knowledge of Medicare, Medicaid, and third party payer requirements/on-line eligibility systems. Contacts insurance carriers to obtain benefit coverage, policy limitations, authorization/notification, and pre-certifications for customers. Follows up with physician offices, customers and third-party payers to complete the pre-certification process. Requests medical documentation from providers not limited to nurse case reviewers and clinical staff to build on claims for medical necessity. Collaborates with internal departments to provide account status updates, coordinate the resolution of issues, and appeal denied authorizations. Answer incoming calls from insurance companies and customers and about the insurance verification process using appropriate customer service skills and in a professional, knowledgeable, and courteous manner. Educates customers, staff and providers regarding referral and authorization requirements, payer coverage, eligibility guidelines, documentation requirements, and insurance related changes or trends. Verifies that all products that require prior authorizations are complete. Updates customers and customer support team on status. Assists in coordinating peer to peer if required by insurance payer. Notifies patient accounts staff/patients of insurance coverage lapses, and self-pay patient status. May notify customer support team if authorization/certification is denied. Maintains knowledge of and reference materials of the following: Medicare, Medicaid and third-party payer requirements, guidelines and policies, insurance plans requiring pre-authorization and a list of current accepted insurance plans. Inquire about gap exception waiver from out of network insurance payers. Educate medical case reviewers at Insurance Companies about diagnosis and medical necessity of Atos Medical products. Obtaining single case agreements when requesting an initial authorization with out of network providers. This process may entail the negotiation of pricing and fees and will require knowledge of internal fee schedules, out of network benefits, and claims information. Complete all Insurance Escalation requests as assigned and within department guidelines for turn around time. Maintains reference materials for Medicare, Medicaid and third-party payer requirements, guidelines and policies, insurance plans requiring pre-authorization and a list of current accepted insurance plans. Other duties as assigned by the management team. Basic Qualifications High School Diploma or G.E.D Experience in customer service in a health care related industry. Preferred Qualifications 2+ years of experience with medical insurance verification background Licenses/Certifications: Medical coding and billing certifications preferred Experience with following software preferred: Salesforce, SAP, Brightree, Adobe Acrobat Knowledge Medicare, Medicaid and third-party payer requirements, guidelines and policies, insurance plans requiring pre-authorization and a list of current accepted insurance plans. Additional Benefits Flexible work schedules with summer hours Market-aligned pay 401k dollar-for-dollar matching up to 6% with immediate vesting Comprehensive benefit plan offers Flexible Spending Account (FSA) Health Savings Account (HSA) with employer contributions Life Insurance, Short-term and Long-term Disability Paid Paternity Leave Volunteer time off Employee Assistance Program Wellness Resources Training and Development Tuition Reimbursement Atos Medical, Inc. is an Equal Opportunity/Affirmative Action Employer. Our Affirmative Action Plan is available upon request at ************. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status. Equal Opportunity Employer Veterans/Disabled. To request reasonable accommodation to participate in the job application, please contact ************. Founded in 1986, Atos Medical is the global leader in laryngectomy care as well as a leading developer and manufacturer of tracheostomy products. We are passionate about making life easier for people living with a neck stoma, and we achieve this by providing personalized care and innovative solutions through our brands Provox , Provox Life™ and Tracoe. We know that great customer experience involves more than first-rate product development, which is why clinical research and education of both professionals and patients are integral parts of our business. Our roots are Swedish but today we are a global organization made up of about 1400 dedicated employees and our products are distributed to more than 90 countries. As we continue to grow, we remain committed to our purpose of improving the lives of people living with a neck stoma. Since 2021, Atos Medical is the Voice and Respiratory Care division of Coloplast A/S 56326 #LI-AT
    $30k-35k yearly est. 60d+ ago
  • Insurance Verification Specialist

    Insight Global

    Remote medicare specialist job

    Interviews each patient or representative in order to obtain complete and accurate demographic. Financial and insurance information and accurately enters all patient information into the registration system. Reads physicians orders to determine services requested and to assure order validity. Obtains new medical record numbers for all new patients. Obtains all necessary signatures and is knowledgeable regarding any special forms that may be required by patients third-party payor. Documents thorough explanatory notes on patient accounts, concerning any non-routine circumstances clarifying special billing processes. Re-verifies all information at time of registration process. Understands and applies company philosophy and objectives and Rehab and PAS policies and procedures, as related to assigned duties. Understands the outpatient registration processes. Works with IT/ EMR on troubleshooting Registration interface errors. Maintains a working knowledge of the process to verify insurance coverage and benefits. Assist in verifying benefits as needed and all patients end of year. Professional and knowledgeable communication to patient regarding benefits. Completes all revenue collection efforts according to company and PAS policy. Contacts patients prior to initial visit to discuss co-pay and/or self-pay arrangements. Collects the co-pay amount at each visit and provides a receipt to the patient. Balances collection log and receipts at end of each business We are a company committed to creating inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity employer that believes everyone matters. Qualified candidates will receive consideration for employment opportunities without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, disability, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to Human Resources Request Form (****************************************** Og4IQS1J6dRiMo) . The EEOC "Know Your Rights" Poster is available here (*********************************************************************************************** . To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: *************************************************** . Skills and Requirements Insurance verification and Patient registration experience. Must be able to work 100% remote. If team member has any technical issues which may prevent from completing their daily tasks, he/she will be required to report onsite. Customer Service experience. Epic experience. Handle high call volume. Personal equipment for the first month.
    $26k-30k yearly est. 60d+ ago

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