Claim Processor jobs at ProMedica Toledo Hospital - 209 jobs

The Claims Examiner is responsible for accurately and consistently adjudicating claims in accordance with policies, procedures and guidelines as outlined by the company policy. Process claims according to all CMS and DMHC guidelines. Investigate and complete open or pended claims. Meet production and quality standards. Job Duties and Responsibilities: + Responsible for efficiency standards for number claims completed and for accuracy of entries. + Handles in a professional and confidential manner all correspondence. + Supports core values, policies, and procedures. + Acquires and adjudicates medical claims for processing; reviews scanned, EDI, or manual documents for pertinent data on claim for complete and accurate information. + Acquires daily workflow via reports or work queue and incoming phone calls. + Research claims for appropriate support documents. + Analyzes and adjusts data, determines appropriate codes, fees and ensures timely filing and contract rates are applied. + Responds and documents resolution of inquiries from internal departments. + Assists Finance with researching provider information to resolve outstanding or stale dated check issues. + Performs Provider Dispute Request (PDR) fulfillment process from the point of claim review through letter processing and records outcome in applicable tracking databases. **Qualifications** Experience: Three (3) years of medical claims processing for Medicare and Commercial products and provider dispute resolution processing in an IPA, HMO and Hospital related setting required. Three (3) years of experience with processing all types of specialty claims such as Chemotherapy, Dialysis, OB and drug and multiple surgery claims required. Three (3) years of experience on an automated claims processing system (Epic Tapestry preferred) preferred. **About Us** Cedars-Sinai is a leader in providing high-quality healthcare encompassing primary care, specialized medicine and research. Since 1902, Cedars-Sinai has evolved to meet the needs of one of the most diverse regions in the nation, setting standards in quality and innovative patient care, research, teaching and community service. Today, Cedars- Sinai is known for its national leadership in transforming healthcare for the benefit of patients. Cedars-Sinai impacts the future of healthcare by developing new approaches to treatment and educating tomorrow's health professionals. Additionally, Cedars-Sinai demonstrates a commitment to the community through programs that improve the health of its most vulnerable residents. **About the Team** With a growing number of primary urgent and specialty care locations across Southern California, Cedars-Sinai's medical network serves people near where they live. Delivering coordinated, compassionate healthcare you can join our network of clinicians and physicians to improve the healthcare people throughout Los Angeles and beyond. **Req ID** : 11588 **Working Title** : Claims Examiner - Managed Care **Department** : MNS Managed Care **Business Entity** : Cedars-Sinai Medical Center **Job Category** : Finance **Job Specialty** : Accounting **Overtime Status** : NONEXEMPT **Primary Shift** : Day **Shift Duration** : 8 hour **Base Pay** : $24 - $33 Cedars-Sinai is an EEO employer. Cedars-Sinai does not unlawfully discriminate on the basis of the race, religion, color, national origin, citizenship, ancestry, physical or mental disability, legally protected medical condition (cancer-related or genetic characteristics or any genetic information), marital status, sex, gender, sexual orientation, gender identity, gender expression, pregnancy, age (40 or older), military and/or veteran status or any other basis protected by federal or state law.

Park Nicollet is looking to hire a Claims Specialist to join our team! Come join us as a Partner for Good and help us make an impact on the care and experience that our patients and their families receive every day. This position ensures that insurance and other 3rd party claims are submitted and/or paid in a timely manner and are compliant with applicable regulations and payer requirements. Specific assignments may include pre-adjudication and/or follow-up, facility and/or professional claims, commercial and/or government payers. Effective performance of these functions helps the organization achieve strong cash flow and maximize patient satisfaction. Required Qualifications: Knowledge, Skills, and Abilities: Requires strong attention to detail and demonstrated problem resolution skills. Must be able to effectively communicate verbally and via written documents. Moderate personal computer proficiency with word processing, spreadsheets and email is required (preference for Microsoft Suite). Working knowledge of typical office equipment is expected. Preferred Qualifications: Education, Experience or Equivalent Combination: Experience in a health care revenue cycle environment preferred. Knowledge, Skills, and Abilities: Ability to acquire and retain complex knowledge of department/company processes, government policy/regulation, and payer requirements. Prior medical terminology and procedural/diagnostic coding (CPT, ICD) knowledge will be helpful. Proficiency with Health Information Systems (e.g., Epic) preferred. Benefits: Park Nicollet offers a competitive benefits package (for eligible positions) that includes medical insurance, dental insurance, a retirement program, time away from work, insurance options, tuition reimbursement, an employee assistance program, onsite clinic and much more!

Why is Health Advocate a great place to work? For starters, Health Advocate employees enjoy helping people every single day. Employees are given the training they need to do their jobs well, and they work with supervisors and staff who are supportive and friendly. Employees have room to grow, and many of Health Advocate's supervisors are promoted from within the company. Join our award winning team! 2025: Stevie Awards for Sales & Customer Service: Customer Service Department of the Year - Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner 2024: Excellence in Customer Service Awards: Organization of the Year (Small) Stevie Awards for Sales & Customer Service: Customer Service Department of the Year - Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner Best in Biz Awards: Most Customer-Friendly Company of the Year - Medium and large category (Silver) As part of Teleperformance in the US, we were also named #95 in the 2024 ‘Fortune 100 Best Companies to Work For ' in the USA by Great Places to Work (GPTW ) Join Us as a Claims Resolution Champion At Health Advocate, we're on a mission to simplify healthcare and empower our members to navigate their benefits confidently. If you're ready to make a meaningful impact by resolving complex claims and advocating for those who need support, this is your chance to transform lives. As a Claims Specialist, you'll go beyond solving billing issues-you'll serve as an advocate, educator, and problem-solver for our members. By leveraging your expertise in claims, benefits, and coordination of care, you'll ensure timely resolutions that ease stress and deliver value. In this role, you'll join a team that values collaboration, precision, and compassion. What You'll Do: Advocate, Resolve, Educate This role is more than answering questions-it's about being a trusted guide for our members. Here's how you'll make an impact: Resolve Complex Claims Issues: Investigate billing discrepancies, identify errors, and coordinate resolutions among members, carriers, and providers for timely claim processing. Coordinate Benefits Across Carriers: Manage cases involving Medicaid, Medicare, motor vehicle claims, and other benefit programs, ensuring proper coordination. Educate and Empower Members: Help members understand their benefit plans, educate them on coverage details, and guide them through challenging claims scenarios. Ensure Accuracy: Adhere to internal policies, procedures, and federal regulations to process claims in a precise and timely manner. Collaborate and Escalate: Partner with team members and escalate unresolved issues to supervisors or carriers when necessary. Support Team Growth: Mentor new team members, share best practices, and contribute to continuous process improvements. Who You Are: A Detail-Oriented Advocate We're looking for someone who's passionate about helping others, thrives on solving challenges, and brings technical expertise to the table. Experienced Professional: You have at least 2 years of experience in healthcare, customer service, or claims. Problem-Solver: You excel at analyzing claims, identifying root causes, and proposing practical solutions. Empathetic Communicator: You possess strong listening skills and the ability to guide members with care and patience, even in complex or emotionally charged situations. Knowledgeable and Resourceful: Familiarity with plan documents, ACA guidelines, Medicare, COBRA, and benefits such as dental, vision, and behavioral health is a plus. Tech-Savvy: You're proficient in MS Word and Excel and comfortable using internal databases to document and track cases. Why Health Advocate? At Health Advocate, we don't just resolve claims-we build trust and provide peace of mind. Here's what you'll gain by joining us: Purpose-Driven Work: Be a key player in simplifying healthcare for members and making a real difference in their lives. Competitive pay: Hourly pay rate starting at $20 per hour. Tools for Success: Access advanced systems, comprehensive training, and the support of a collaborative team. Comprehensive Benefits: Enjoy competitive pay, robust medical, dental, and vision coverage, 401(k) with company match, PTO, and more. A Culture of Care: Join a team that values empathy, innovation, and teamwork. Your Next Move Ready to transform challenges into resolutions and make healthcare easier for those we serve? Apply today and take the first step toward a rewarding career with Health Advocate! Company Overview Health Advocate is the nation's leading provider of health advocacy, navigation, well-being and integrated benefits programs. For 20 years, Health Advocate has provided expert support to help our members navigate the complexities of healthcare and achieve the best possible health and well-being. Our solutions leverage a unique combination of best-in-class, personalized support with powerful predictive data analytics and a proprietary technology platform to address nearly every clinical, administrative, wellness or behavioral health need. Whether facing common issues or an unprecedented challenge like COVID-19, our team of highly trained, compassionate experts work together to go above and beyond expectations, making healthcare easier for our members and ensuring they get the care they need. Learn more Health Advocate https://www.healthadvocate.com/site/ Facebook https://www.facebook.com/healthadvocateinc/ Video https://vimeo.com/386733264/eb447da080 Awards: 2025: Stevie Awards for Sales & Customer Service: Customer Service Department of the Year - Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner 2024: Excellence in Customer Service Awards: Organization of the Year (Small) Stevie Awards for Sales & Customer Service: Customer Service Department of the Year - Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner Best in Biz Awards: Most Customer-Friendly Company of the Year - Medium and large category (Silver) 2023: National Customer Service Association All-Stars Award: Service Organization of the Year. Stevie Awards for Sales & Customer Service: Customer Service Department of the Year - Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner 2022: Stevie Awards for Sales & Customer Service: Customer Service Department of the Year - Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner Excellence in Customer Service Awards: Organization of the Year (Small) Best in Biz Awards: Most Customer-Friendly Company of the Year - Medium and large category (Silver) 2021: Stevie Awards for Sales & Customer Service: Customer Service Department of the Year - Healthcare, Pharmaceuticals, and Related Industries, Silver Winner Stevie Awards for Sales & Customer Service: Most Valuable Response by a Customer Service Team (COVID-19). Bronze Winner Best in Biz Awards: Most Customer-Friendly Company of the Year - Medium and large category (Silver) 2020: National Customer Service Association All-Stars Award: Organizations of 100 or Greater, Runner-Up Communicator Award of Distinction: October 2019 Broker News MarCom Awards: Gold, COVID Staycation Ideas brochure MarCom Awards: Platinum, 2021 Well-being Calendar Best in Biz Awards: Most Customer-Friendly Company of the Year - Medium category (Silver) VEVRAA Federal Contractor requesting appropriate employment service delivery systems, such as state workforce agencies and local employment delivery systems, to provide priority referrals of protected veterans. PAY TRANSPARENCY NONDISCRIMINATION PROVISION The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-I.35(c)

This is a full-time temporary position. If selected, onboarding will be completed through a staffing agency. About us Kern Health Systems is dedicated to improving the health status of our members through an integrated managed health care delivery system. Essential Duties and Responsibilities Resolve system suspended claims for: PCPs Labs Radiology Less complicated specialists Physical Therapy Prepare claims that must be routed to other departments for further review. Review difficult claims with guidance from Claims Supervisor. Responsible for identifying billing errors and possible fraudulent claims submissions. Obtain eligibility verification and other health insurance coverage by Internet or POS. Responsible for correct manual calculation of benefits when applicable. Responsible for identifying possible CCS eligible claims for further investigation. Report overpayment refund requests on SharePoint log Maintain productivity and quality in accordance with established guideline. Perform other job-related duties as required. Regular Predictable attendance. Adheres to all company policies and procedures relative to employment and job responsibilities. Employment Standards: High School Diploma from an accredited school or equivalent. Minimum of one (1) year medical Claims Examiner processing experience. Individual must have good organizational skills and the ability to make good decisions.

The Claims Examiner is responsible for processing UB and CMS 1500 claims, performing data entry and claim pend issue resolution within the quality and production requirements. Responsibilities: * Adjudicate claims at a rate equal to 150 per normal workday. * Maintain statistical accuracy of 98%, and financial accuracy of 98%. * Correct DoD error report as needed, respond timely to all Customer Service, Provider Relations type questions. * Other duties as assigned by management. * Collaborate with and maintain open communication with all departments within CHRISTUS Health to ensure effective and efficient workflow and facilitate completion of tasks/goals. * Follow the CHRISTUS Guidelines related to the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI). Requirements: * High School Diploma required. Work Schedule: 8AM - 5PM Monday-Friday Work Type: Full Time

At Zotec Partners, our People make it happen. Transforming the healthcare industry isn't easy. But when you build a team like the one we have, that goal can become a reality. Our accomplishments can't happen without our extraordinary people - the men and women across the country who make up our diverse Zotec family and help make this company a best place to work. Over 25 years ago, we started Zotec with a clear vision, to partner with physicians to simplify the business of healthcare. Today we are more than 900 employees strong and we continue to use our incredible talent and energy to bring that vision to life. We are a team of Innovators, Collaborators and Doers. We're seeking a Central Claims Processor to join us. Note this is an on-site position in Carmel, IN. As a Central Claims Processor, you will be a key contributor within the Shared Services Department by accurately processing and managing insurance claims from various sources. What you'll do: Generate, review and match paper insurance claim forms and appeals with required supporting documentation Generate, organize, and maintain collection files to support claim follow-up and resolution Provide clear, professional email correspondence with internal and external stakeholders Support departmental operations by completing additional duties as assigned What you'll bring to Zotec: Willing to work on-site in Carmel, IN 1+ years' experience in an office environment, preferably a medical billing environment Familiarity with medical billing processes Proficient in Microsoft Windows and email Able to communicate effectively through emails and correspondence Demonstrate strong analytical, problem solving, organizational and priority management skills Ability to work independently and on projects with team members Strong relationship management and collaboration skills Must be able to multi-task, be flexible and embrace change At Zotec, you will enjoy a network of highly experienced professionals in an environment where you can operate with autonomy yet have the resources and backing of other professionals in a similar role. Entrepreneurial and enterprising is the spirit of our team. If you are an original thinker and opportunity seeker, we'd like to talk to you! Learn more about our organization, by visiting us at ********************* E-Verify and Equal Opportunity Employer

About Us Community health is about more than just vaccines and checkups. It's about giving people the resources they need to live their best lives. At Neighborhood, this is our vision. A community where everyone is healthy and happy. We're with you every step of the way, with the care you need for each of life's chapters. At Neighborhood, we are Better Together. Neighborhood Healthcare PACE is a managed medical plan built around surrounding participants with a team of physicians, nurses, social workers, therapists and care coordinators to help them maintain good health and a good quality of life. Our goal is to keep our seniors happy and healthy at home surrounded by their family and community. As a private, non-profit 501(C) (3) community health organization, we serve over 500k medical, dental, and behavioral health visits from more than 90k people annually. With two PACE centers located in Riverside County, our PACE program is positioned to serve over 650 senior participants. ROLE OVERVIEW and PURPOSE The PACE Claims Processor will review, analyze, and adjudicate all contracted claims for PACE participants to ensure timely and accurate payments are distributed. This position will use technology and data to identify and resolve root causes for claims and payment errors. Additionally, this role will work collaboratively with our third-party administrator (TPA), contracted providers, specialists, participants, and other departments to ensure timely resolution of invoices and claims. RESPONSIBILITIES Conducts claim audits daily to cross-references provider contracts and assure payment accuracy on all claims received, suspended, approved, denied, posted, and paid Adjudicates and processes claims to ensure claims are allowable and have proper authorizations, including correct payment amounts, contract alignment, and current Medicare rates Analyzes payment ACH requests from our TPA to ensure claims are paid timely and accurately according to contractual agreements Processes monthly eligibility for PACE enrolled participants with Centers for Medicare & Medicaid Services (CMS) and Department of Health Care Services (DHCS) Researches and responds to customer inquiries, concerns or requests for EOP's throughout the life of a claim in a timely manner to ensure customer satisfaction and retention Understands and interprets Medicare and Medi-Cal fee schedules Works collaboratively with TPA to ensure risk adjustments, encounter data submissions, and accounts receivables are completed in a timely manner Assists in maintaining and developing claim policies and procedures Works closely with PACE Accounting to ensure data accuracy for financial reporting Maintains professional working relationships with all levels of staff, clients, and the public Participates in accomplishing department goals and objectives Operates to instill confidence in our care and in our facilities for patients, fellow employees, and other stakeholders Impacts patient experience by demonstrating courteous and helpful behavior and a commitment to accuracy Contributes to the success of the organization by participating in quality improvement activities EDUCATION/EXPERIENCE High school diploma/GED required One-year medical billing or medical claims experience required; two years' experience preferred One-year electronic medical records system experience required; PACE preferred CPT, HCPCS and ICD-10 and revenue code experience preferred Experience with eligibility verification preferred Experience with revenue cycle processes in the healthcare setting required; examining/processing Medicare and Medicaid claims preferred ADDITIONAL QUALIFICATIONS (Knowledge, Skills and Abilities) Excellent verbal and written communication skills, including superior composition, typing and proofreading skills Ability to interpret a variety of instructions in written, oral, diagram, or schedule form Knowledgeable about third-party administrator systems Knowledgeable about and experience with using Microsoft Office Applications Knowledgeable about and experience with principles and practices of the health care industry and familiarity with Medi-Cal and Medicare payers Knowledgeable about and experience with medical office procedures and billing insurance carriers. Ability to successfully manage multiple tasks simultaneously Excellent planning and organizational ability Ability to work as part of a team as well as independently Ability to work with highly confidential information in a professional and ethical manner Physical Requirements Ability to lift/carry 25 lbs./weight Ability to stand or sit for long periods of time Neighborhood Healthcare offers a generous benefit plan that includes: Partially company paid Medical, Dental, and Vision Plans. Two plus weeks of vacation, Nine Holidays including two Floating Holidays of your choosing, Sick/Personal time, Volunteer Time Off (VTO), 403b Retirement plan (similar to a 401k), optional Health and Wellness events, and much more! Pay range: $24.95 - $34.93/hr hourly, depending on experience/qualifications.

Come to work with us at Community Health Services! We offer full-time benefits, 10 paid holidays, no weekend hours and so much more! We are looking for a full-time Claims Specialist to work in our Fremont office. CHS employs those who are eager to grow professionally, gain great experience, and work with a terrific team. The Claims Specialist will be responsible for performing general finance functions, entering encounters, processing and recording claims and all other duties as assigned. Hours for this position are: Mondays 7am-7pm, Tuesdays through Thursdays 8am-5pm, Fridays 8am-1pm Qualified candidates must have the following to be considered for employment: * Associate's degree from an accredited college or university * Experience in accounting/bookkeeping * Demonstrates ability to organize and implement general accounting and bookkeeping procedures for a healthcare organization * Ability to work with clinic personnel and patients in a courteous, cooperative manner * Ability to function as part of a team * Must have excellent customer service skills * Must have excellent multi-tasking, problem solving, and decision-making skills * Ability to follow instructions with attention to detail * Demonstrates professional relationship skills, and a strong work ethic * Prioritizes responsibilities, takes initiative, and possesses excellent organizational skills * Demonstrates effective communication skills * Ability to work with a culturally diverse group of people At CHS, we value our team and the critical role they play in patient care. If you're dependable, detail-oriented, and passionate about making a difference in your community, we'd love to hear from you. CHS is a drug-free/nicotine free organization. Candidates must pass a drug and nicotine screening upon employment offer.

The MSO Claims Examiner is responsible for the daily review, audit, examination, investigation and adjudication of hospital and professional claims. Must exceed qualitative standard and meet quantitative production standard. Responsible to prepare files and documents for the annual health plan delegation oversight audits, assist Claims Supervisor with MSO management reports, and other special projects as needed. ESSENTIAL JOB FUNCTIONS: Perform the daily examination, auditing and adjudication activities to submitted hospital and professional claims based on established utilization criteria, Medi-Cal and/or Medicare guidelines, member's Evidence of Benefit, and policies and procedures outlined in the MSO Claims Manual. Responsible for the daily review of complex pre-payment claims reports. Identify processing errors and make corrections prior to the weekly FFS payment cycle. Identify claims payment errors and perform claims revision/correct activities for repayment or deduction per Physician and/or Vendor Contract terms. Must meet quantitative production standard of 750 claims per week. Provides feedback on testing system upgrades and enhancements. Respond to complex provider inquiries related to claims adjudication, denial, and payment status and handle member billed issues when arise. Respond to first level provider inquiries related to claims adjudication, denial, and payment status and handle member billed issues when arise (when necessary). Responsible to prepare, review, and submit claims files and evidence documents for the annual delegation oversight audit(s) performed by Health Plan(s). Provide recommendations to Claims Manager on updating claims policies and procedures to meet turn-around-time and/or CMS/DHCS/MCP regulatory requirement. Assist in training the entry level Claims Examiner for claims auditing and adjudication activities, and other MSO staff with general claims information. Identify system configuration errors and flaws during day-to-day operation, report to department supervisor, manager and MSO System Configuration team to correct/resolve them. Identify auditing errors and/or training-related opportunities that will improve operational efficiencies and results. Provides information in response to the requests of patient, physician, insurance company or co-worker as appropriate. Prepares and interprets appropriate statistical reports. Performs other job duties as required by manager/supervisor and NEMS Management Team. Qualifications QUALIFICATIONS: Completion of a 2-year degree from an accredited University, may be substituted with relevant work experience in healthcare medical claims processing and examination field. Minimum 3-4 years of experience in health insurance claims processing, examination, adjudication, and auditing. Strong knowledge of managed care and/or healthcare claim reimbursement or medical billing in Medi-Cal and Medicare Advantage program required. Working knowledge of State/Federal healthcare compliance requirements (HIPAA, AB1455, and ICE standards), particularly DHCS/Medi-Cal and CMS/Medicare guidelines required. Working knowledge of medical terminology, standard code sets including CPT, HCPCS, ICD, POS, and claim forms. Strong English communication skills with strong analytical and problem solving skills. Ability to self-manage in a detail oriented environment. Ability to operate PC based software programs or automated database management systems preferred. Good organization and prioritization skills, outstanding in time management LANGUAGE: Must be able to fluently speak, read and write English. Fluent in other languages are an asset. STATUS: This is an FLSA NON-exempt position. This is not an OSHA high-risk position. This is a Full Time position. NEMS is proud to be an Equal Opportunity Employer welcoming diversity in our workforce. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. NEMS BENEFITS: Competitive benefits, including free medical, dental and vision insurance for employee, spouse and/or children; and company contribution to 401(k).

Job DescriptionDescription: Verda Health Plan of Texas has a contract with the Center of Medicaid and Medicare Services (CMS) and a state license with the Texas Department of Insurance for a Medicare Advantage Prescription Drug (MAPD) plan. We are committed to the idea that healthcare should be easily and equitably accessed by all. Our mission is to ensure that underserved communities have access to health and wellness services, and receive the support needed to live a healthy life that is free of worry and full of joy. We are looking for a Claims Examiner III to join our growing company with many internal opportunities. Are you ready to join a company that is changing the face of health care across the nation? Verda Healthcare health plan is looking for people like you who value excellence, integrity, care and innovation. As an employee, you'll join a team dedicated to improving the lives of our Medicare members. Our vision incorporates value-based health care that works. We value diversity. Align your career goals with Verda Healthcare, Inc. and we will support you all the way. Position Overview The Claims Examiner III performs advanced administrative, operational, and customer support duties that require independent initiative and sound judgment. This position is responsible for the analysis and adjudication of medical claims within a managed care environment. The role includes processing payment reconciliations and adjustments related to retroactive contract rates and fee schedule changes, as well as identifying root causes of claims payment errors and reporting them to management. The Claims Examiner III also manages provider inquiries and supports resolution efforts across departments. This position reports to: Claims Operations Manager. Responsibilities: · Analyze and adjudicate complex medical claims in compliance with CMS guidelines and health plan policies. · Review and apply appropriate fee schedules, contracts, and benefit plans. · Perform claim payment reconciliations and retroactive adjustments. · Identify patterns and root causes of payment discrepancies and escalate issues as needed. · Respond to provider inquiries and coordinate with internal teams for resolution. · Maintain documentation and track resolution outcomes. · Ensure compliance with regulatory, contractual, and internal policies. · Recommend process improvements based on claim trends and data analysis. · Support training initiatives for new staff and peers as subject matter experts. Requirements: Minimum Qualifications · High school diploma or GED required. Associate or bachelor's degree preferred. · Minimum of 3-5 years of experience in claims processing and adjudication, preferably within Medicare Advantage or managed care settings. · Knowledge of CPT, HCPCS, ICD-10 coding, and CMS regulations. · Strong analytical and problem-solving skills. · Proficient in claims systems (e.g., Plexis, Facets) and Microsoft Office tools. · Ability to handle confidential information in compliance with HIPAA. Professional Competencies · Strong attention to detail and accuracy · Excellent verbal and written communication · Customer service-oriented with a collaborative mindset · Ability to work independently and prioritize tasks · Commitment to continuous learning and quality improvement Verda cares deeply about the future, growth, and well-being of its employees. Join our team today! Job Type: Full-time Benefits: 401(k) Paid time off (vacation, holiday, sick leave) Health insurance Dental Insurance Vision insurance Life insurance Schedule: Full-time onsite (100% in-office) Hours of operations: 9am - 6pm Standard business hours Monday to Friday/weekends as needed Occasional travel may be required for meetings and training sessions. Ability to commute/relocate: Reliably commute or planning to relocate before starting work (Required) PHYSICAL DEMANDS Regularly sit/walk at a workstation in an office or cubicle setting. Must occasionally lift and/or move up to 25-50 pounds. * Other duties may be assigned in support of departmental goals.

Let's do great things, together! About Moda Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we're focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let's be better together. Position Summary Review claims to determine the reason the claim did not auto-adjudicate. Make corrections as necessary and process claims according to processing policies and contract provisions. This is a hybrid position based in Milwaukie Oregon. Pay Range $17.00 - $18.00 hourly (depending on experience) **Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range. Please fill out an application on our company page, linked below, to be considered for this position. ************************** GK=27770307&refresh=true Benefits: Medical, Dental, Vision, Pharmacy, Life, & Disability 401K- Matching FSA Employee Assistance Program PTO and Company Paid Holidays Required Skills, Experience & Education: High school diploma or equivalent. 10-key proficiency of 105 kspm net on a computer numeric keypad. Type a minimum of 35 wpm net on a computer keyboard. Ability to achieve and maintain quality and quantity standards. Possess legible handwriting. Knowledge of dental terminology, and ADA codes, preferred. Data Entry experience dealing with all types of plans/claims preferred. Good reading, verbal, and written communication skills. Ability to listen and communicate clearly and interact professionally, patiently, and courteously with co-workers and supervisor. Analytical, problem solving, and decision-making skills. Detail oriented and good memory retention with ability to shift priorities. Good organizational skills, ability to work well under pressure and ability to handle a variety of functions to meet timelines. Ability to interpret contracts and apply MODA Policies and Procedures to claims processing. Ability to come into work on time and on a daily basis. Ability to maintain confidentiality and project a professional business image. Primary Functions: Use contract notes and a processing manual to apply correct group specific and standard contract benefits to process pended claims. Know benefits provided by specific plans, how to determine eligibility, how to determine if claims qualify for benefits, how system should pay and how to enter information so correct benefits are paid. Document in a clear and concise manner and analyze and interpret existing file notes and documentation. Send clinical request and missing information letters. Ability to perform some manual calculation of benefits. Analyze pended claims to determine why the claim pended from auto-adjudication. Other duties as assigned Working Conditions & Contact with Others Office environment with extensive close PC and keyboard use, constant sitting, and frequent phone communication. Must be able to navigate multiple computer screens. A reliable, high-speed, hard-wired internet connection required to support remote or hybrid work. Must be comfortable being on camera for virtual training and meetings. Work in excess of standard workweek, including evenings and occasional weekends, to meet business need. Internally with Imaging Services, Claim Support, and Professional Relations. Together, we can be more. We can be better. Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training. For more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our ***************************** email.

Welcome! We're excited you're considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you'll find other important information about this position. Responsible for the process of patient account review, correction, adjustment, and filing to third party payers and/or patients. Works directly with patients and third party payers as it relates to information distribution. MINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. High school diploma or equivalent. 2. State criminal background check and Federal (if applicable), as required for regulated areas. PREFERRED QUALIFICATIONS: EXPERIENCE: 1. Previous hospital billing and/or credit and collection experience. CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned. 1. Performs claims processing to third party payer according to payer guidelines. 2. Reviews and corrects billing edits prior to submitting claims. 3. Reviews edits to ensure proper billing and verifies edits with the appropriate Department leaders, if needed. 4. Works denials thoroughly and timely with little back-log. 5. Performs follow up on account, working with third party payers, patient, employer, and physician office to resolve unpaid or underpaid accounts. Works follow-up reports thoroughly within the month. 6. Communicates problems hindering workflow to management in a timely manner. 7. Posts copays collected at Medical Offices to vouchers. Maintains unassigned payments. 8. Processes collections accounts. 9. Processes patient and insurance refund documentation. PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. Prolonged periods of sitting. 2. Manual dexterity required to operate standard office equipment. WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. Standard office environment. SKILLS AND ABILITIES: 1. Excellent oral and written communication skills. 2. Basic knowledge of medical terminology. 3. General knowledge of accounts receivable and collections procedures. Additional Job Description: Scheduled Weekly Hours: 20 Shift: Exempt/Non-Exempt: United States of America (Non-Exempt) Company: CCMC Camden Clark Medical Center Cost Center: 500 CCMC Administration Address: 800 Grand Central MallViennaWest Virginia Equal Opportunity Employer West Virginia University Health System and its subsidiaries (collectively "WVUHS") is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. WVUHS strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. All WVUHS employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.

Family Health Care is currently seeking applications for the position of Pharmacy 340B Claims Specialist! General Function: This position functions at the highest level (III) in the series of Pharmacy Technician roles within Family Health Care. The individual in this role is a “work-leader” serving as the expert on prescription claims reimbursement and performing self-auditing for the pharmacy department. This individual will ensure prescription claim integrity by having advanced knowledge of claim requirements for the various pharmacy benefit managers (PBM) and shall use that information to identify areas of improvement by performing targeted claim audits and will provide education to the pharmacy staff on billing requirements, when needed. Responsibilities: Acts as pharmacy claims auditor and will audit claims daily into order to track claims accuracy, trends, anomalies and other critical information to help BFHC ensuring appropriate reimbursement while mitigating organizational risk for claims remediations resulting from claim processing errors. Acts as pharmacy 340B claims auditor and audits claims on a scheduled basis into order to track 340B claims accuracy, trends, anomalies, and other critical information to help BFHC maintain 340B claim integrity while ensuring adherence to 340B policies, procedures, rules and regulations. Ensures timely and accurate billing/collections of all pharmacy charges and reimbursement activities through the use of reporting and reconciliation. Ensures integrity if financial reports and provides necessary reports to the finance department upon request. Assists the Chief Pharmacist and pharmacy staff in the research, development and implementation of new and existing pharmacy services. Location(s): White Cloud, MI Employment Type: Full Time Exempt/Non-Exempt: Non-Exempt Benefits: Competitive wage and excellent benefits package. FHC is an eligible organization for State and Federal Loan Repayment Programs. Family Health Care is an Equal Opportunity Employer.

What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! Under the direction of the Covered California Claims (CCA) Manager, the CCA Claims Specialist is responsible for analyzing, managing, and investigating complex and high-dollar healthcare claims that require in-depth research to determine accuracy and mitigate payment errors. The Claims Specialist is also responsible for adjusting first-pass and post-pay claims that result in overpayment or underpayment due to claim processing system issues, contract amendments, processing errors, or other issues. This position collaborates with internal stakeholders, assists with claim audits (internal and regulatory) and utilizes strong analytical skills and independent judgement skills to make effective and accurate decisions. This position will also be responsible for responding to inquiries from the Provider Payment Resolution team on claims that may have been paid incorrectly. Commitment to Quality: The IEHP Team is committed to incorporate IEHP's Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Additional Benefits Perks IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more. Competitive salary Telecommute schedule State of the art fitness center on-site Medical Insurance with Dental and Vision Life, short-term, and long-term disability options Career advancement opportunities and professional development Wellness programs that promote a healthy work-life balance Flexible Spending Account - Health Care/Childcare CalPERS retirement 457(b) option with a contribution match Paid life insurance for employees Pet care insurance Key Responsibilities Work effectively with other departments (i.e., Special Investigation Unit, Provider Payment Resolution team, and other departments/stakeholders) to investigate and identify fraud, respond to escalated provider inquiries timely, and support the claims process. Investigate and process complex and high-dollar claims determining accuracy and making timely decisions. Advise leadership and internal business units (as applicable) of findings and outcomes on identified claim issues. Research and analyze medical claims adjustment requests along with related documentation to determine payment accuracy and adjust/adjudicate as needed in the Health Rules Processing system and other platforms. Research claims that may have been paid incorrectly and communicate findings for adjustment. Adjust claims based on findings (i.e., correct coding, rates of reimbursement, authorizations, contracted amounts, etc.) ensuring that all relevant information is considered. Assist with internal and regulatory claim audits, reviewing claim accuracy. Identify trends and recommend improvements to IEHP's claim processing system. Analyze and investigate insurance claims to discover or prevent fraud. Be an active participant in the Claims Department's initiatives and participate in Claims Huddles, etc. Remain current with all claim processing changes/updates (i.e. internal processes, regulatory guidelines). Perform any other duties as required to ensure Health Plan operations and department business needs are successful. Qualifications Education & Requirements Three (3) years of experience in examining and processing complex and high-dollar institutional and professional claims Experience in a managed care environment helpful. Commercial, Exchange, and Medicare preferred High school diploma or GED required Associate's degree from an accredited institution preferred Key Qualifications ICD-9/ ICD-10 and CPT coding and general practices of claims processing CMS/DMHC and Affordable Care Act regulations and guidelines Commercial line of business specifically Covered California/Exchange Excellent communication and interpersonal skills Excellent analytical, critical thinking, customer service, and organizational skills Ability to think critically with the capacity to work independently All IEHP positions approved for telecommute work locations may periodically be required to report to IEHP's main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership Start your journey towards a thriving future with IEHP and apply TODAY! Work Model Location Telecommute (All IEHP positions approved for telecommute work locations may periodically be required to report to IEHP's main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership) Pay Range USD $25.90 - USD $33.02 /Hr.

Full-time Description Claims Specialist - Job Description Jurupa Valley, CA - Onsite Who We Are Mountain Valley Express (MVE) is a leading LTL Carrier and 3PL Services provider with locations across California, Arizona, and Nevada. With years of experience, a dedicated team, and cutting-edge technology, MVE offers a broad range of services, including less-than-truckload (LTL), full truckload, custom invoicing and auditing, optimization, warehousing and distribution, engineering solutions, and packaging and shipping supplies. Our deep understanding of the market, along with strong carrier partnerships, allows us to deliver highly tailored services that meet the unique needs of our customers. Benefits · Comprehensive medical, dental, and vision insurance. · 401(k) plan with company match. · Company-paid Life and AD&D Insurance policies. · Paid vacation, sick leave, and holidays. The Opportunity We are seeking a Claims Specialist to join our team. In this role, you will be responsible for managing the end-to-end freight claims process, including receipt, investigation, documentation, and resolution. This position is integral to maintaining MVE's reputation for accuracy, transparency, and customer service excellence. You will work closely with the Operations, Customer Service, and Accounting teams to ensure claims are resolved efficiently and in compliance with company policies and federal regulations. Essential Duties and Responsibilities • Claims Management: Receive, review, and process freight loss and damage claims in accordance with company policies and industry regulations. • Investigation and Documentation: Collect all supporting documentation, including photos, inspection reports, and terminal or driver statements, to thoroughly evaluate each claim. • Communication and Resolution: Maintain clear and professional communication with customers, internal departments, and third parties throughout the claims process. • Reporting and Analysis: Track claim data, analyze trends, and identify areas for process improvement or risk mitigation. • Compliance and Recordkeeping: Ensure all claims are handled in compliance with applicable laws and carrier liability rules while maintaining accurate digital records within the TMS system. • Collaboration: Partner with operations and leadership teams to recommend corrective actions that prevent recurring claim issues. Skills & Attributes • Strong analytical and investigative skills with excellent attention to detail. • Exceptional written and verbal communication skills. • Ability to manage multiple priorities in a fast-paced environment. • Proficiency in Microsoft Office Suite (Excel, Word, Outlook); experience with TMS or claims software preferred. • Knowledge of LTL operations, NMFC classifications, and cargo liability principles is highly desirable. • Strong organizational and problem-solving abilities with a customer service mindset. Requirements Minimum Requirements · Education: High school diploma or equivalent required; Associate's or Bachelor's degree in Business, Logistics, or a related field preferred. · Experience: Minimum of 2 years of experience in freight claims, transportation, logistics, or a related administrative role. Compensation · Compensation: $20.00 - $24.00 per hour, based on experience and location. · Classification: Non-Exempt, subject to all applicable state and federal laws. Work Environment This is a full-time, at-will position with typical work hours scheduled from Monday to Friday, 8:00 a.m. to 5:00 p.m. Physical Requirements: · Prolonged periods of sitting at a desk and working on a computer · Frequent walking throughout the facility and between departments as part of daily operational tasks · Ability to lift and/or move up to 20-25 pounds. · Ability to navigate each department and the company's facilities as needed. Equal Opportunity Employer Mountain Valley Express is an at-will and equal opportunity employer. We are committed to employing and assigning the best-qualified candidates without discrimination based on race, color, religion, gender, marital status, age, national origin, physical or mental disability, sexual orientation, veteran/reserve and National Guard status, or any other status or characteristic protected by law. Salary Description $20.00 - $24.00

Description:Claims Specialist - Job Description Jurupa Valley, CA - Onsite Who We Are Mountain Valley Express (MVE) is a leading LTL Carrier and 3PL Services provider with locations across California, Arizona, and Nevada. With years of experience, a dedicated team, and cutting-edge technology, MVE offers a broad range of services, including less-than-truckload (LTL), full truckload, custom invoicing and auditing, optimization, warehousing and distribution, engineering solutions, and packaging and shipping supplies. Our deep understanding of the market, along with strong carrier partnerships, allows us to deliver highly tailored services that meet the unique needs of our customers. Benefits · Comprehensive medical, dental, and vision insurance. · 401(k) plan with company match. · Company-paid Life and AD&D Insurance policies. · Paid vacation, sick leave, and holidays. The Opportunity We are seeking a Claims Specialist to join our team. In this role, you will be responsible for managing the end-to-end freight claims process, including receipt, investigation, documentation, and resolution. This position is integral to maintaining MVE's reputation for accuracy, transparency, and customer service excellence. You will work closely with the Operations, Customer Service, and Accounting teams to ensure claims are resolved efficiently and in compliance with company policies and federal regulations. Essential Duties and Responsibilities • Claims Management: Receive, review, and process freight loss and damage claims in accordance with company policies and industry regulations. • Investigation and Documentation: Collect all supporting documentation, including photos, inspection reports, and terminal or driver statements, to thoroughly evaluate each claim. • Communication and Resolution: Maintain clear and professional communication with customers, internal departments, and third parties throughout the claims process. • Reporting and Analysis: Track claim data, analyze trends, and identify areas for process improvement or risk mitigation. • Compliance and Recordkeeping: Ensure all claims are handled in compliance with applicable laws and carrier liability rules while maintaining accurate digital records within the TMS system. • Collaboration: Partner with operations and leadership teams to recommend corrective actions that prevent recurring claim issues. Skills & Attributes • Strong analytical and investigative skills with excellent attention to detail. • Exceptional written and verbal communication skills. • Ability to manage multiple priorities in a fast-paced environment. • Proficiency in Microsoft Office Suite (Excel, Word, Outlook); experience with TMS or claims software preferred. • Knowledge of LTL operations, NMFC classifications, and cargo liability principles is highly desirable. • Strong organizational and problem-solving abilities with a customer service mindset. Requirements:Minimum Requirements · Education: High school diploma or equivalent required; Associate's or Bachelor's degree in Business, Logistics, or a related field preferred. · Experience: Minimum of 2 years of experience in freight claims, transportation, logistics, or a related administrative role. Compensation · Compensation: $20.00 - $24.00 per hour, based on experience and location. · Classification: Non-Exempt, subject to all applicable state and federal laws. Work Environment This is a full-time, at-will position with typical work hours scheduled from Monday to Friday, 8:00 a.m. to 5:00 p.m. Physical Requirements: · Prolonged periods of sitting at a desk and working on a computer · Frequent walking throughout the facility and between departments as part of daily operational tasks · Ability to lift and/or move up to 20-25 pounds. · Ability to navigate each department and the company's facilities as needed. Equal Opportunity Employer Mountain Valley Express is an at-will and equal opportunity employer. We are committed to employing and assigning the best-qualified candidates without discrimination based on race, color, religion, gender, marital status, age, national origin, physical or mental disability, sexual orientation, veteran/reserve and National Guard status, or any other status or characteristic protected by law.

Let's do great things, together! About Moda Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we're focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let's be better together. Position Summary Responsible for utilizing resources efficiently for the accurate and timely entry, review, and resolution of simple to moderately complex medical claims in accordance with policies, procedures, and guidelines as outlined by the company. This is a FT WFH role. Pay Range $17.00 - $19.03 hourly, DOE. *Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range. Please fill out an application on our company page, linked below, to be considered for this position. ************************** GK=27768550&refresh=true Benefits: Medical, Dental, Vision, Pharmacy, Life, & Disability 401K- Matching FSA Employee Assistance Program PTO and Company Paid Holidays Required Skills, Experience & Education: High School diploma or equivalent 6-12 months data entry or medical office experience preferred 10-key proficiency of 135 spm Type a minimum of 35 wpm Knowledge of medical terminology, CPT codes and ICD-9/10 codes preferred Demonstrates work habits that include punctuality, organization, and flexibility Ability to maintain balanced performance in areas of production and quality Analytical reasoning and flexibility Professional and effective written and verbal communication skills Experience with Facets platform a plus Identify all the duties and responsibilities Primary Functions: Enters claims data into system while interpreting coding and understanding medical terminology in relation to diagnosis and procedures. Review, analyze, and resolve claims through the utilization of available resources for moderately complex claims. Analyze and apply plan concepts to claims that include deductible, coinsurance, copay, out of pocket, etc. Examines claims to determine if further investigation is needed from other departments and routes claims appropriately through the system. Adjudication of claims to achieve quality and production standards applicable to this position. Release claims by deadline to meet company, state regulations, contractual agreements, and group performance guarantee standards. Reviews Policies and Procedures (P&P'S) for process instructions to ensure accurate and efficient claims processing as well as providing suggestions for potential process improvements. Performs all job functions with a high degree of discretion and confidentiality in compliance with federal, state, and departmental confidentiality guidelines. Flexible schedule that may include working 5 hours of overtime on pre-determined Saturdays to meet business needs. Moda's standard workweek is a 37.5 hour work week. Working Conditions & Contact with Others: Office environment with extensive close PC and keyboard work with constant sitting. Must be able to navigate multiple screens. Flexible schedule that may include working 5 hours of overtime on pre-determined Saturdays to meet business needs. Moda's standard workweek is a 37.5 hour work week. Works internally with the customer service, membership accounting, and appeals departments. Works externally to support client needs. Together, we can be more. We can be better. Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training. For more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our ***************************** email.

Full-time Description Claims Specialist - Job Description Manteca, CA - Onsite Who We Are Mountain Valley Express (MVE) is a leading LTL Carrier and 3PL Services provider with locations across California, Arizona, and Nevada. With years of experience, a dedicated team, and cutting-edge technology, MVE offers a broad range of services, including less-than-truckload (LTL), full truckload, custom invoicing and auditing, optimization, warehousing and distribution, engineering solutions, and packaging and shipping supplies. Our deep understanding of the market, along with strong carrier partnerships, allows us to deliver highly tailored services that meet the unique needs of our customers. Benefits · Comprehensive medical, dental, and vision insurance. · 401(k) plan with company match. · Company-paid Life and AD&D Insurance policies. · Paid vacation, sick leave, and holidays. The Opportunity We are seeking a Claims Specialist to join our team. In this role, you will be responsible for managing the end-to-end freight claims process, including receipt, investigation, documentation, and resolution. This position is integral to maintaining MVE's reputation for accuracy, transparency, and customer service excellence. You will work closely with the Operations, Customer Service, and Accounting teams to ensure claims are resolved efficiently and in compliance with company policies and federal regulations. Essential Duties and Responsibilities • Claims Management: Receive, review, and process freight loss and damage claims in accordance with company policies and industry regulations. • Investigation and Documentation: Collect all supporting documentation, including photos, inspection reports, and terminal or driver statements, to thoroughly evaluate each claim. • Communication and Resolution: Maintain clear and professional communication with customers, internal departments, and third parties throughout the claims process. • Reporting and Analysis: Track claim data, analyze trends, and identify areas for process improvement or risk mitigation. • Compliance and Recordkeeping: Ensure all claims are handled in compliance with applicable laws and carrier liability rules while maintaining accurate digital records within the TMS system. • Collaboration: Partner with operations and leadership teams to recommend corrective actions that prevent recurring claim issues. Skills & Attributes • Strong analytical and investigative skills with excellent attention to detail. • Exceptional written and verbal communication skills. • Ability to manage multiple priorities in a fast-paced environment. • Proficiency in Microsoft Office Suite (Excel, Word, Outlook); experience with TMS or claims software preferred. • Knowledge of LTL operations, NMFC classifications, and cargo liability principles is highly desirable. • Strong organizational and problem-solving abilities with a customer service mindset. Requirements Minimum Requirements · Education: High school diploma or equivalent required; Associate's or Bachelor's degree in Business, Logistics, or a related field preferred. · Experience: Minimum of 2 years of experience in freight claims, transportation, logistics, or a related administrative role. Compensation · Compensation: $20.00 - $24.00 per hour, based on experience and location. · Classification: Non-Exempt, subject to all applicable state and federal laws. Work Environment This is a full-time, at-will position with typical work hours scheduled from Monday to Friday, 8:00 a.m. to 5:00 p.m. Physical Requirements: · Prolonged periods of sitting at a desk and working on a computer · Frequent walking throughout the facility and between departments as part of daily operational tasks · Ability to lift and/or move up to 20-25 pounds. · Ability to navigate each department and the company's facilities as needed. Equal Opportunity Employer Mountain Valley Express is an at-will and equal opportunity employer. We are committed to employing and assigning the best-qualified candidates without discrimination based on race, color, religion, gender, marital status, age, national origin, physical or mental disability, sexual orientation, veteran/reserve and National Guard status, or any other status or characteristic protected by law. Salary Description $20.00 - $24.00

Peach Tree Dental - Monroe, West Monroe, Ruston, Jonesboro Insurance Claims Specialist Job Details: Salary: Starting from $16.00-$20.00/hourly Pay is based on experience, qualifications, and desired location. **Incentives after training vary and are based on performance Job Type: Full-time Qualifications For Insurance Claims Specialists: High school or equivalent (Required). Takes initiative. Has excellent verbal and written skills. Ability to manage all public dealings in a professional manner. Ability to recognize problems and problem solve. Ability to accept feedback and willingness to improve. Ability to set goals, create plans, and convert plans into action. Is a Brand Ambassador, both in and outside of the facility. Benefits Offered For Full-Time Insurance Claims Specialists: Medical, Dental, Vision Benefits Dependent Care & Healthcare Flexible Spending Account Simple IRA With Employer Match Basic Life, AD&D & Supplemental Life Insurance Short-term & Long-term Disability Perks & Rewards For Full-Time Insurance Claims Specialists: Competitive pay + bonus Paid Time Off & Sick time 6 paid Holidays a year Full Job Description: With our hearts, minds, and hands, we build better smiles, better relationships, and better lives. Living this purpose over the last 25 years has allowed us to create a world-class dental organization that continues to grow. At every turn, you will see our continued investment in leadership, the community, and advanced technologies. Do you want to be a part of developing one of the leading models of dental care in Louisiana? Do you thrive in a fast-paced, progressive environment? The role of the Insurance Claims Specialist could be for you! Please go to WWW.PEACHTREEDENTAL.COM to complete your online application and assessments or use the following URL: **********************************************