Billing Specialist jobs at Res-Care Premier

ENT and Allergy Associates, LLP and Hümi is seeking a self-motivated, people-friendly full time EMC Biller for our Corporate office located in Tarrytown NY. Review, correct, and bill encounters for submission to the clearinghouse, ensuring compliance with timely filing deadlines using RCx Rules, Waystar, and the NextGen reporting system Hourly: 22.00/ph Essential responsibilities Include but are not limited to the following: RCx Rules, Waystar and/or the NextGen systems are used to review all encounters that need updating and corrections entered with accurate information Run edits against all charges from previous day Run pre-bill reports and verify charges entered for billing/coding specifics Verify doctor participation for all insurances and active location billing Address errors and questions to the office via email and NextGen tasking system After automated billing and EDI file creation by NextGen address any claim production status errors and task situations Submit all EDI files to clearinghouse, Waystar Primary, Secondary, Sleep Study, Hearing Aid, any additional files Secondary claim files updated with primary EOB information through NG Secondary Portal and Waystar EDI files are reviewed daily by 9 m. Verify EDI files have been received for processing at clearinghouse Work rejections immediately upon receipt as received through clearinghouse Updating Provider Master File in file maintenance with all referring physician requests from offices within 48 hour period Billing corrects Data Integrity Non-History reports Create clean claims, void and correct charges manually as per requested internally from collections Work tasks sent to us by all offices within Nextgen system Personal Attributes Ability to focus and work efficiently Excellent attention to detail Ability to organize and prioritize work and manage multiple priorities Qualifications Experience with medical billing systems Familiarity with Insurance and Billing Procedures Familiarity with Electronic Data Interchange (EDI) Other Duties Please note this job description is not designed to cover or contain a completely comprehensive listing of activities, duties, or responsibilities that are required for this position. Duties, responsibilities, and activities may change at any time, with or without notice. The ENT & Allergy Associates Network: ENT & Allergy Associates (ENTA) is the largest ENT, Allergy, and Audiology practice in the country, with over 475 clinicians who practice in over 80 clinical locations throughout New York, New Jersey, Pennsylvania, and Texas. Each ENTA clinical office is comprised of world-class physicians who are specialists and sub-specialists in their respective fields, providing the highest level of expertise and care. With a wide range of services including Adult and Pediatric ENT and Allergy, Voice and Swallowing, Advanced Sinus and Skull Base Surgery, Facial Plastics and Reconstructive Surgery, Treatment of Disorders of the Inner Ear and Dizziness, Asthma-related services, Diagnostic Audiology, Hearing Aid Dispensing, Sleep and CT Services, ENTA Is able to meet the needs of patients of all ages. ENTA is also affiliated with some of the most prestigious medical institutions in the world. Each year ENTA physicians are voted ‘Top Doctor' by Castle Connolly, a true testament to the exceptional care and service they provide to their patients. HÜMI: Backed by over 25 years of experience, Hümi (formerly Quality Medical Management Services USA, LLC, or QMMS USA) specializes in healthcare management and consultancy across practice operations and management, technology, revenue cycle, compliance, HR management, and business applications. With a seasoned team and a commitment to excellence, Hümi delivers cutting-edge healthcare business management solutions. By implementing best practices at every step, Hümi ensures measurable success for its clients. At its core, Hümi represents the human side of healthcare, where operational excellence meets a people-first philosophy. ENT and Allergy Associates is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

CarepathRx transforms hospital pharmacy from a cost center into an active revenue generator through a powerful combination of technology, market-leading pharmacy services and wrap-around services. Job Details: The Collections Specialist is responsible for managing third-party billing and collections, ensuring timely and accurate payment of claims, and processing payer appeals. This role involves investigating denials, processing rejections, and identifying root causes of payment issues, with the goal of resolving discrepancies and maximizing reimbursement. The ideal candidate will have knowledge of home infusion, medical billing practices, and payer reimbursement guidelines, as well as strong communication and problem-solving skills. The position requires attention to detail, the ability to work independently, and proficiency with Microsoft 365. Experience with ICD-10, CPT-4, HCPCS, and Medicare billing is preferred. Responsibilities Understand Third Party Billing and Collection Guidelines. Identify root cause of issues and demonstrate recommendations for corrective action steps to eliminate future occurrences of denials. Meet quality assurance, benchmark standards, and maintain productivity levels as defined by management. Contact payer, or patient as appropriate. Documents all collections activity in patient collections notes. Documents work performed/action taken on AR Reports. Process all Payer appeal requests within the time frame required by the Payer. Reviews claim processing to determine proper payment has been issued. Request and process all approved adjustments. Processes rejections and denials to determine if the claim needs to be refiled or submitted for an appeal with the payer. Reviews patient information in appropriate system to determine why the claim is unpaid, if an adjustment is valid, and whether additional approval is required. Ability to identify errors, correct claims and reprocess for reimbursement. Ability to read and interpret an EOB for accurate understanding of claim processing. Knowledge of claims investigation and reviewing payer contracts for reimbursement. Performs other duties as assigned. Skills & Abilities Ability to communicate with patients, payors, outside agencies, and public through telephone, electronic and written correspondence. Helpful, knowledgeable, and polite while maintaining a positive attitude. Interpret a variety of instructions in a variety of communication mediums. Knowledge of Home Infusion. Knowledge of insurance policies, reimbursement practices, as well as claim processing requirements. Knowledge of medical billing practices and of medical billing reimbursement. Maintain confidentiality and practice discretion and caution when handling sensitive information Multi-task along with attention to detail. Ability to accurately perform simple mathematical calculations using addition, subtraction, multiplication, and division. Self-motivation, organized, time-management and deductive problem-solving skills. Work independently and as part of a team. Collections or medical billing experience with basic understanding of ICD10, CPT4, HCPCS, and medical terminology is preferred. Familiarity with third party payor guidelines and reimbursement practices and available financial resources for payment of balances due is beneficial. Medicare knowledge of billing requirements specific to DMEMAC. HCN360 and CPR+ knowledge preferred. Knowledge of Microsoft 365 products, including but not limited to Outlook, Teams and Excel. Strong customer service skills. Requirements High school graduate or equivalent. Excellent interpersonal, organizational, communication and effective problem-solving skills are necessary. CarepathRx offers a comprehensive benefit package for full-time employees that includes medical/dental/vision, flexible spending, company-paid life insurance and short-term disability as well as voluntary benefits, 401(k), Paid Time Off and paid holidays. Medical, dental and vision coverage are effective 1st of the month following date of hire . CarepathRx provides equal employment opportunity to all qualified applicants regardless of race, color, religion, national origin, sex, sexual orientation, gender identity, age, disability, genetic information, or veteran status, or other legally protected classification in the state in which a person is seeking employment. Applicants encouraged to confidentially self-identify when applying. Local applicants are encouraged to apply. We maintain a drug-free work environment. Applicants must be eligible to work in this country.

Salary: $23-$30 Billing Specialist The Billing Specialist will play a vital role in the financial operations of our ophthalmology practice, ensuring that claims are processed efficiently and patient billing inquiries are handled with care. The role encompasses a range of tasks within the billing department, including medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, reimbursement management, and authorization management. Reports to:Revenue Cycle Manager Key Responsibilities: Claims Management: Work on accounts receivable (A/R), process rejected claims, and perform necessary follow-up to ensure successful claim processing. Follow up on claims using various systems, including Nextech EHR, TriZetto clearinghouse, and others. Prepare and submit clean claims to insurance companies electronically or by paper. Correct and resubmit claims to third-party payers when needed. Mail appropriate patient contact letters to resolve outstanding claims. Billing Operations: Maintain contact with other departments to obtain and analyze patient information for accurate billing documentation. Respond to patient inquiries and billing concerns via phone, email, and messaging portals. Perform follow-up calls and written correspondence to patients and payers as needed. Prepare, review, and send patient statements as necessary. Authorization Management: Obtain and verify insurance authorizations and pre-certifications for procedures and services. Ensure all necessary authorizations are secured prior to patient appointments and procedures. Track authorization expirations and follow up on renewals as needed. Communicate with patients and insurance companies to resolve authorization issues or delays. Customer Service & Compliance: Identify and resolve patient billing complaints in a timely manner. Adhere to policies regarding safety, confidentiality, and HIPAA guidelines. Establish and maintain effective working relationships with office staff and doctors, ensuring a collaborative work environment. Qualifications and Requirements: Minimum of 2+ years of experience in ophthalmology billing. Knowledge of medical terminology specific to ophthalmology. Proficiency in CPT, HCPCS, and ICD codes related to ophthalmology. High school diploma required; an associate degree is preferred. Skills: Ability to work independently with minimal supervision. Strong organizational and time management skills. Detail-oriented with the ability to manage multiple tasks and meet deadlines. Strong communication skills, with the ability to effectively interact with patients and office staff. Resourceful, result-driven, and a team player. Work Environment: Hybrid position with the ability to be on-site for meetings, training, or other work-related functions. The position may also require on-site job responsibilities that require being in the office once a week. Monday through Friday, 8:00 AM to 5:00 PM. Compensation Range:$23.00-$30.00 Note: The content of this job description is intended to provide a general overview of the job's key responsibilities and qualifications. Additional responsibilities may be assigned to meet practice needs. Job Type: Full-time Pay: $23.00 - $30.00 per hour Expected hours: 40 per week Benefits: 401(k) 401(k) matching Dental insurance Employee assistance program Health insurance Life insurance Paid time off Tuition reimbursement Vision insurance Schedule: 8 hour shift Day shift Monday to Friday Experience: ICD-10: 2 years (Required) Ability to Commute: Poway, CA (Required) Work Location: Hybrid

Billing Specialist The Billing Specialist will play a vital role in the financial operations of our ophthalmology practice, ensuring that claims are processed efficiently and patient billing inquiries are handled with care. The role encompasses a range of tasks within the billing department, including medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, reimbursement management, and authorization management. Reports to: Revenue Cycle Manager Key Responsibilities: Claims Management: Work on accounts receivable (A/R), process rejected claims, and perform necessary follow-up to ensure successful claim processing. Follow up on claims using various systems, including Nextech EHR, TriZetto clearinghouse, and others. Prepare and submit clean claims to insurance companies electronically or by paper. Correct and resubmit claims to third-party payers when needed. Mail appropriate patient contact letters to resolve outstanding claims. Billing Operations: Maintain contact with other departments to obtain and analyze patient information for accurate billing documentation. Respond to patient inquiries and billing concerns via phone, email, and messaging portals. Perform follow-up calls and written correspondence to patients and payers as needed. Prepare, review, and send patient statements as necessary. Authorization Management: Obtain and verify insurance authorizations and pre-certifications for procedures and services. Ensure all necessary authorizations are secured prior to patient appointments and procedures. Track authorization expirations and follow up on renewals as needed. Communicate with patients and insurance companies to resolve authorization issues or delays. Customer Service & Compliance: Identify and resolve patient billing complaints in a timely manner. Adhere to policies regarding safety, confidentiality, and HIPAA guidelines. Establish and maintain effective working relationships with office staff and doctors, ensuring a collaborative work environment. Qualifications and Requirements: Minimum of 2+ years of experience in ophthalmology billing. Knowledge of medical terminology specific to ophthalmology. Proficiency in CPT, HCPCS, and ICD codes related to ophthalmology. High school diploma required; an associate degree is preferred. Skills: Ability to work independently with minimal supervision. Strong organizational and time management skills. Detail-oriented with the ability to manage multiple tasks and meet deadlines. Strong communication skills, with the ability to effectively interact with patients and office staff. Resourceful, result-driven, and a team player. Work Environment: Hybrid position with the ability to be on-site for meetings, training, or other work-related functions. The position may also require on-site job responsibilities that require being in the office once a week. Monday through Friday, 8:00 AM to 5:00 PM. Compensation Range: $23.00-$30.00 Note: The content of this job description is intended to provide a general overview of the job's key responsibilities and qualifications. Additional responsibilities may be assigned to meet practice needs. Job Type: Full-time Pay: $23.00 - $30.00 per hour Expected hours: 40 per week Benefits: 401(k) 401(k) matching Dental insurance Employee assistance program Health insurance Life insurance Paid time off Tuition reimbursement Vision insurance Schedule: 8 hour shift Day shift Monday to Friday Experience: ICD-10: 2 years (Required) Ability to Commute: Poway, CA (Required) Work Location: Hybrid

Retina Consultants, LLC is Hiring a Skilled Billing Specialist We are seeking a driven and knowledgeable candidate -someone who can advocate for best practices, conduct in-depth research, and investigate current industry-standard billing policies and procedures. The ideal candidate will stay current with evolving billing practices to ensure ongoing accuracy, efficiency, and compliance. This position is on-site only with no remote work available. Key Responsibilities: Accurately submit claims to insurance companies, Medicare, and Medicaid. Review and correct claim denials, rejections, and underpayments. Follow up on outstanding claims and ensure timely reimbursement. Post payments and adjustments to patient accounts. Verify patient insurance eligibility and benefits. Communicate with insurance companies, patients, and providers to resolve billing inquiries. Maintain compliance with HIPAA, payer policies, and industry regulations. Assist with month-end reconciliation and reporting as needed. Qualifications & Skills: Minimum 5 years of medical billing experience (retina/ophthalmology experience a plus). Certified Coder/Biller preferred Knowledge of ICD-10, CPT, and HCPCS coding. Familiarity with EHR/PM systems. Strong understanding of insurance guidelines, including Medicare, Medicaid, and commercial payers. Proficiency in Microsoft Office (Excel, Word, Outlook). Excellent communication and problem-solving skills. Ability to work independently and as part of a team. Benefits: Competitive salary based on experience. Health, dental, and vision insurance. 401(k). Paid time off and holidays. Professional development opportunities. Location: Retina Consultants, LLC We look forward to meeting you! Work schedule 10 hour shift Benefits Paid time off Health insurance Dental insurance Vision insurance 401(k) Paid training

FULL-TIME Applicants must be located in Northeast OH. The Billing Specialist is responsible for ensuring that all providers are enrolled and active w/multiple payers to ensure timely billing of services. The role is responsible for processing, verification, and preparation of all commercial claims for insurance clients. The position maintains records of payments and handles administrative detail and follow-up. Essential Functions and Duties: Support the creation and implementation of a streamlined provider credentialing process to ensure appropriate enrollment of clinical staff, ensuring service delivery coincides with efficient and timely billing. Manage and update provider credentialing tools and processes to ensure there are no lapses in service delivery due to the inability to bill for services. Daily posting of Insurance payments and electronic remittance adviser (ERA) files (a.k.a. 835 transactions). Provide insurance verification and prior authorization for clients. Daily posting of Explanation of Benefits (EOB) and Explanation of Payments (EOP) for non-payments; management of denials and rebill/ Coordination of Benefits (COB) issues. Weekly compile and transmit claims Upload EOB into scanning solution (eBridge). Assists with prior authorization/benefit coordination and rebill claims, as needed. Assists with weekly submission of Centers for Medicare & Medicaid Services (CMS) claims Identify and assists in resolution of errors for all Insurance claims Performs regular review and investigates unpaid claims and other accounts receivable management projects. Assist clients in accessing and trouble shooting our Payment Hub, an online payment system. Fixes and Reversal of Payment issues on the Ohio MITS portal Maintain orderly, current, and up-to-date records of client insurance coverage to ensure accurate client files Assist other staff with general inquires and requests, as needed Unique responsibilities as assigned by supervisor or Management Qualifications: Associate degree or equivalent education from a two-year college or technical school with major in Medical Billing/Coding and/or Accounts/Receivable, plus 3-5 yrs. billing experience. Knowledge, Skills and Abilities: Excellent and proven attention to detail Strong computer/software management skills Excellent math skills. Ability to work well within a team environment Ability to work with a diverse group of people Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act (ADA) of 1990 and the Americans with Disabilities Amendments Act (ADAA) of 2008. While performing this job, the employee is regularly required to sit, talk, and hear. This job requires filing, opening, and closing of file cabinets, and the ability to bend and/or stand as necessary. This job is frequently required to use hands; handle, feel and reach with hands and arms; and may occasionally lift and/or move files and other related materials up to 20 pounds. The position requires regular use of a computer, calculator, and telephone. Work Environment: This job operates in a professional office environment and in the community. While performing the duties of this position in the office this role routinely uses standard office equipment such as computers, phones, photocopiers, and filing cabinets. The employee will occasionally travel by automobile and is exposed to changing weather conditions. The employee may be required to drive daily to nearby locations for meetings or visits to assigned work sites. This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines. EEO Statement Red Oak is proud to be an equal opportunity workplace. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, or disability status.

Job DescriptionDescription: FULL-TIME Applicants must be located in Northeast OH. The Billing Specialist is responsible for ensuring that all providers are enrolled and active w/multiple payers to ensure timely billing of services. The role is responsible for processing, verification, and preparation of all commercial claims for insurance clients. The position maintains records of payments and handles administrative detail and follow-up. Essential Functions and Duties: Support the creation and implementation of a streamlined provider credentialing process to ensure appropriate enrollment of clinical staff, ensuring service delivery coincides with efficient and timely billing. Manage and update provider credentialing tools and processes to ensure there are no lapses in service delivery due to the inability to bill for services. Daily posting of Insurance payments and electronic remittance adviser (ERA) files (a.k.a. 835 transactions). Provide insurance verification and prior authorization for clients. Daily posting of Explanation of Benefits (EOB) and Explanation of Payments (EOP) for non-payments; management of denials and rebill/ Coordination of Benefits (COB) issues. Weekly compile and transmit claims Upload EOB into scanning solution (eBridge). Assists with prior authorization/benefit coordination and rebill claims, as needed. Assists with weekly submission of Centers for Medicare & Medicaid Services (CMS) claims Identify and assists in resolution of errors for all Insurance claims Performs regular review and investigates unpaid claims and other accounts receivable management projects. Assist clients in accessing and trouble shooting our Payment Hub, an online payment system. Fixes and Reversal of Payment issues on the Ohio MITS portal Maintain orderly, current, and up-to-date records of client insurance coverage to ensure accurate client files Assist other staff with general inquires and requests, as needed Unique responsibilities as assigned by supervisor or Management Qualifications: Associate degree or equivalent education from a two-year college or technical school with major in Medical Billing/Coding and/or Accounts/Receivable, plus 3-5 yrs. billing experience. Knowledge, Skills and Abilities: Excellent and proven attention to detail Strong computer/software management skills Excellent math skills. Ability to work well within a team environment Ability to work with a diverse group of people Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act (ADA) of 1990 and the Americans with Disabilities Amendments Act (ADAA) of 2008. While performing this job, the employee is regularly required to sit, talk, and hear. This job requires filing, opening, and closing of file cabinets, and the ability to bend and/or stand as necessary. This job is frequently required to use hands; handle, feel and reach with hands and arms; and may occasionally lift and/or move files and other related materials up to 20 pounds. The position requires regular use of a computer, calculator, and telephone. Work Environment: This job operates in a professional office environment and in the community. While performing the duties of this position in the office this role routinely uses standard office equipment such as computers, phones, photocopiers, and filing cabinets. The employee will occasionally travel by automobile and is exposed to changing weather conditions. The employee may be required to drive daily to nearby locations for meetings or visits to assigned work sites. This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines. EEO Statement Red Oak is proud to be an equal opportunity workplace. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, or disability status. Requirements:

This is a full-time hourly (non-exempt) position. Overall goal is accurate charge entry and timely collection of monies due from various carriers and patients for medical, dental and behavioral health claims. Essential Functions: Post encounters as assigned and verify all Insurance Carriers Audit and chart review in a timely and accurate manner for coding and billing compliance, review all posted encounters for assigned pay codes. Make sure assigned codes meet all federal, legal and insurance regulations. File secondary claims and follow through. Submit all approved tickets electronically to the clearinghouse and retrieve and process reports from them or print them on paper, if necessary. Post payments received from third party payers manually, or if electronic posting is enabled for payer, review for oddities and make corrections when needed. Resubmit denied claims after review and corrections are made. Run aging detail and monitor old claims for payment status and correct as necessary monthly. Ensure all measures are exhausted to collect from Insurance carrier before claim is submitted to Revenue Cycle Manager for approval to write off. Inform the Manager of any issues that arise. Provide training for the front desk staff on insurance carriers on an as needed basis. Assist providers or procedure entry staff with coding for encounters and/or hospital billing Monitor regulatory changes pertaining to Medicare, Medicaid, and Commercial insurance. Credentialing duties as assigned providers with all insurance carriers. Work on special billing/financial projects and train new employees as requested. Attends billing seminars and workshops as needed. Working knowledge ICD-10, current procedural coding. Other duties as assigned. Knowledge, Skills and Abilities : Excellent communication skills; active listening as well as written and oral comprehension/communication skills; Gives full attention to what individuals are saying, understands the point being made, asks appropriate questions to gain better knowledge of situation(s) and repeats information to ensure understanding; public speaking skills necessary; bilingual (English/Spanish) language skills helpful Excellent customer service skills actively seek ways to assist internal and external customers within the scope of assigned duties Good basic mathematical skills use a calculator or other means to accurately assist in financial matters Good computer skills; Outlook, Windows, Microsoft Office, Excel applications. Good time management skills self-evaluate the use of time and understands how others may be affected Cultural diversity awareness and skills; respects all people regardless of race, nationality or social standing Ability to work independently (self-motivating) and as a team member Ability to develop a collaborative therapeutic alliance with individuals and make accurate professional judgments Ability to build and maintain effective working relationships with co-workers, providers, managers, patients, agency resource personnel and community members in general Familiarity with local community resources for patients with chronic disease Knowledge of the health and human services infrastructure, health insurance programs and public coverage options Problem sensitivity skills; empathetic/understanding Deductive reasoning and problem-solving skills Organized and detail-oriented Familiar with Prior authorizations and referrals as needed for claims. Education, Experience and Licensure: High school diploma or equivalent (GED) required Degree or Certificate in Billing/Coding preferred Certified in Medical and/or Dental coding preferred Two years' experience required Computer knowledge required; Windows, Microsoft Office applications and Practice Management Systems Prior experience in professional office environment preferred Physical Demands: May sit and/or stand for long periods of time Must be able to see and hear within normal range with or without correction device(s) Dexterity and hand-to-eye coordination as normally associated with operating office equipment, computers and telephone Working Conditions: Professional, fast-paced office environment

This is a full-time hourly (non-exempt) position. Overall goal is accurate charge entry and timely collection of monies due from various carriers and patients for medical, dental and behavioral health claims. Essential Functions: * Post encounters as assigned and verify all Insurance Carriers * Audit and chart review in a timely and accurate manner for coding and billing compliance, review all posted encounters for assigned pay codes. * Make sure assigned codes meet all federal, legal and insurance regulations. * File secondary claims and follow through. * Submit all approved tickets electronically to the clearinghouse and retrieve and process reports from them or print them on paper, if necessary. * Post payments received from third party payers manually, or if electronic posting is enabled for payer, review for oddities and make corrections when needed. * Resubmit denied claims after review and corrections are made. * Run aging detail and monitor old claims for payment status and correct as necessary monthly. * Ensure all measures are exhausted to collect from Insurance carrier before claim is submitted to Revenue Cycle Manager for approval to write off. * Inform the Manager of any issues that arise. * Provide training for the front desk staff on insurance carriers on an as needed basis. * Assist providers or procedure entry staff with coding for encounters and/or hospital billing * Monitor regulatory changes pertaining to Medicare, Medicaid, and Commercial insurance. * Credentialing duties as assigned providers with all insurance carriers. * Work on special billing/financial projects and train new employees as requested. * Attends billing seminars and workshops as needed. * Working knowledge ICD-10, current procedural coding. * Other duties as assigned. Knowledge, Skills and Abilities: * Excellent communication skills; active listening as well as written and oral comprehension/communication skills; Gives full attention to what individuals are saying, understands the point being made, asks appropriate questions to gain better knowledge of situation(s) and repeats information to ensure understanding; public speaking skills necessary; bilingual (English/Spanish) language skills helpful * Excellent customer service skills actively seek ways to assist internal and external customers within the scope of assigned duties * Good basic mathematical skills use a calculator or other means to accurately assist in financial matters * Good computer skills; Outlook, Windows, Microsoft Office, Excel applications. * Good time management skills self-evaluate the use of time and understands how others may be affected * Cultural diversity awareness and skills; respects all people regardless of race, nationality or social standing * Ability to work independently (self-motivating) and as a team member * Ability to develop a collaborative therapeutic alliance with individuals and make accurate professional judgments * Ability to build and maintain effective working relationships with co-workers, providers, managers, patients, agency resource personnel and community members in general * Familiarity with local community resources for patients with chronic disease * Knowledge of the health and human services infrastructure, health insurance programs and public coverage options * Problem sensitivity skills; empathetic/understanding * Deductive reasoning and problem-solving skills * Organized and detail-oriented * Familiar with Prior authorizations and referrals as needed for claims. Education, Experience and Licensure: * High school diploma or equivalent (GED) required * Degree or Certificate in Billing/Coding preferred * Certified in Medical and/or Dental coding preferred * Two years' experience required * Computer knowledge required; Windows, Microsoft Office applications and Practice Management Systems * Prior experience in professional office environment preferred Physical Demands: * May sit and/or stand for long periods of time * Must be able to see and hear within normal range with or without correction device(s) * Dexterity and hand-to-eye coordination as normally associated with operating office equipment, computers and telephone Working Conditions: Professional, fast-paced office environment

Job Description The ADRC serves elders aged 65 or older, adults aged 18-64 with a disability, and their caregivers. Staff support informed decision making, provide Medicaid eligibility assistance for the Statewide Medicaid Managed Care Long-term Care Program (SMMCLTCP), and provide the following duties and responsibilities through customer service that is streamlined, efficient, and consumer-friendly. Duties and Responsibilities: Medicaid Outreach and LTCPE, including: Counsel individuals on the Statewide Medicaid Managed Care Long-term Care Program (SMMCLTCP), available services, eligibility requirements, the application process, and additional information sources. Provide outreach that is standardized and consistent statewide to ensure public awareness of Medicaid programs and services and how to access them. Build relationships with and educate service providers and other professionals to facilitate referrals and increase awareness of Medicaid resources. Medicaid Eligibility Screening and Pre-enrollment (APCL/Waitlist) Placement, including: Accept referrals from the ADRC Helpline and other sources for screening utilizing the DOEA approved 701S screening instrument. Determine the individual's needs and enroll on the pre-enrollment list (APCL/waitlist). Ensure accurate data entry into eCIRTS, and SharePoint. Inform individuals or individual's representatives about potential eligibility for the Medicaid programs, including their rights and responsibilities. Re-evaluate individuals on the pre-enrollment list (APCL/waitlist) using the standardized screening instrument as required or as requested due to a significant change. Enrollment Management System (EMS), including: Provide the duties outlined in the most recent DOEA EMS release procedure. Contact individuals on the release verbally and in writing. Verify an individual's current Medicaid eligibility status. Assist the client to pursue the eligibility process with meeting SMMCLTCP financial and medical eligibility. Work with client to obtain the Physician Referral form (3008). Coordinate with CARES (Comprehensive Assessment and Review for Long Term Care Services) staff for determination of medical eligibility. Track Medicaid applications through the eligibility process. Act as a consumer advocate by coordinating with CARES and DCF/ESS staff to resolve in a timely manner any eligibility issues that arise during the Medicaid eligibility determination process. Assist clients who have lost Medicaid to regain their active status in SMMCLTCP. Grievances and Complaints, including: Provide assistance to SMMCLTCP enrollees, concerning how to file grievances and complaints with the long-term care plans. Provide information concerning Medicaid Fair Hearings. Maintain a record of such complaints, in accordance with statewide procedures. Quality Assurance, including: Assist with quality assurance reviews of 701S and long-term care education contacts by ADRC staff. Assist with insuring eCIRTS data integrity. Assist with tracking and reviews of EMS processing to ensure contractual compliance. Education: Possess a bachelor's degree from an accredited college or university; or Have an Associate of Arts Degree from an accredited college or university and a minimum of one year experience as a caseworker, case manager, intake specialist, or experience in performing human services related work; or Have a high school diploma or GED and two years' experience as a caseworker, case manager, intake specialist, or experience in performing human services related work. Skills/Qualifications: Knowledge of computer applications to perform the functions of the position, including word processing, database, and spreadsheet applications. The ability to work independently and with minimal supervision. Knowledge of available ADRC administered programs and available Medicaid programs. The ability to work with disabled adults, elders, caregivers, stakeholders, and community partners in a knowledgeable, engaged, and compassionate manner. The ability to set and track personal performance goals to efficiently manage workload. Special Requirements: Must pass DOEA Level II criminal background screening; must sign Medicaid Attestation Payroll Form per Department of Elder Affairs/AAAPP requirements. Must sign SMMCLTC Program - Prohibited Activities. Equal Opportunity Employer: At AAAPP, we take pride in providing equal employment opportunities to everyone regardless of their race, ethnicity, beliefs, religion, marital status, gender, citizenship status, age, veteran status, or disability. Accordingly, the purpose of this policy is to reinforce our commitment to the creation and maintenance of a diverse workplace where equality, respect, and consideration for one another are the norm. *Excellent Benefits* No phone calls. DF/SF WP EOE Job Type: Full-time Salary: $21.00 per hour Benefits: 401(k) 401(k) matching Dental insurance Flexible spending account Health insurance Life insurance Paid time off Vision insurance Schedule: Monday to Friday Education: High school or equivalent (Required) Experience: Case management: 1 year (Required) Work Location: Hybrid remote in Saint Petersburg, FL 33702

Join CareSouth as a Full-Time Patient Engagement Representative and be the welcoming face that guides our patients through their healthcare journey! Located in Plaquemine, this onsite position allows you to engage directly with individuals seeking assistance, making a significant impact in their lives while showcasing your problem-solving skills. You'll thrive in a relaxed, yet high-performance environment that values empathy and innovation. At a competitive pay rate of $13.60 per hour, you'll find fulfillment in helping others in a professional setting surrounded by a forward-thinking team. If you're an office professional eager to contribute to a safe and supportive medical clinic atmosphere, this is the perfect opportunity for you. You can get great benefits such as Medical, Dental, Vision, 401(k), Life Insurance, Flexible Spending Account, and Paid Time Off. Take the first step in your rewarding career today by applying! What does a Patient Engagement Representative do? As a Patient Engagement Representative at CareSouth, you will play a vital role in delivering high-quality, efficient service to our patients. Your commitment to accuracy and completeness in inputting patient information will directly impact the care we provide. This position requires you to engage customers with compassion and empathy, ensuring that every interaction is characterized by a warm smile and attentive service. By actively working to create and maintain a professional and positive patient experience, you will not only enhance patient satisfaction but also foster trust and rapport within our clinic. Join us in making a difference in the lives of those we serve! Does this sound like you? To excel as a Patient Engagement Representative at CareSouth, you must possess a unique blend of skills that ensure seamless interactions with patients. Strong computer skills are essential for efficiently managing patient information and utilizing healthcare software. Excellent verbal and written communication skills will enable you to convey vital information with clarity and compassion. A friendly and welcoming demeanor is crucial, as you will be the first point of contact for our patients. Additionally, exceptional interpersonal communication skills will help you build rapport and trust. The ability to effectively resolve conflicts with empathy and professionalism will ensure a positive experience for all patients. These skills will empower you to thrive in a high-performance environment dedicated to innovative healthcare solutions. Knowledge and skills required for the position are: Must have strong computer skills. Excellent verbal and written communication skills. Be friendly, welcoming and compassionate. Exceptional interpersonal communication skills Must be able to effectively resolve conflicts Get started with our team! If you have these qualities and meet the basic job requirements, we'd love to have you on our team. Apply now using our online application!

About Us Neuronetics, Inc. is a leading mental health company dedicated to transforming lives through innovative treatments. Now joined with Greenbrook Mental Wellness Centers, we offer FDA-cleared NeuroStar TMS and Spravato therapies for major depressive disorder and treatment-resistant depression across 95+ clinics nationwide. Together, we're expanding access to life-changing care-combining cutting-edge technology with clinical expertise to make a real impact in the mental health space. Transform Lives: Join Greenbrook Mental Wellness Centers as an Insurance Benefits Specialist in Delray, Florida! Are you passionate about making sure everyone has access to the mental health care they need? Do you have an eye for detail and enjoy navigating complex insurance systems? If so, join our dedicated team at Greenbrook Mental Wellness Centers. We're seeking an Insurance Verification Specialist to play a vital role in ensuring our patients can use their health insurance benefits to get the mental health services they need. This role is responsible for identifying and reporting patient eligibility, helping to remove financial barriers to care. This is a full-time position located at our corporate offices in Delray, Florida. Work hours will vary between 8 a.m. and 6 p.m. EST. Why Greenbrook? * Meaningful Impact: Directly contribute to improving lives by helping patients access crucial mental health treatments. * Competitive Compensation: Earn between $18-$20/hour (commensurate with education and prior experience). * Comprehensive Benefits: Enjoy a generous benefits package, including a 401(k) with company match, paid time off, and comprehensive medical, dental, and vision coverage. * Collaborative Environment: Work alongside a supportive team committed to patient care and mental health advocacy. Your Role: * Verify Patient Coverage: Review and verify insurance coverage and mental health benefits, including in-network providers, coverage details, and pre-authorization requirements. * Secure Coverage: Collaborate with insurance companies to secure coverage quotes for patients' treatment plans. * Maintain Records: Conduct thorough insurance research to identify the most cost-effective options for patients and maintain accurate, up-to-date patient insurance records in our electronic health record (EHR) system. * Provide Documentation: Clearly and concisely document insurance payer plans, including patient coverage, cost share, access, and provider options. * Collaborate and Report: Identify and report trends or delays with reimbursements and collaborate with management and clinical teams to find solutions to potential insurance barriers. What We're Looking For: * Experience: A minimum of two (2) years of experience in healthcare insurance is required, with a focus on mental health benefits being a plus. * Knowledge: A strong understanding of medical billing and coding practices. * Skills: Excellent communication and interpersonal skills, with a patient-centered approach. Proficiency in Microsoft Office Suite (Word, Excel) and electronic health record (EHR) systems is required. * Attributes: You must be able to work independently and as part of a team in a fast-paced environment and possess strong analytical and problem-solving skills. * Passion: A passion for mental health advocacy and a commitment to reducing healthcare disparities. Over 16 million Americans are affected by depression. Greenbrook TMS is changing the way that depression is treated, and YOU can be part of making a positive difference in the lives of patients by joining our amazing team! Who we are: To learn our WHY: *********************** FftT0 | Patient stories on HOW we transform lives: ********************************************* * Applicants must be authorized to work for any employer in the US. We are unable to sponsor or assume responsibility for employment visa/work authorization at this time. Greenbrook, a subsidiary of Neuronetics, is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy or any other protected characteristic as outlined by federal, state, or local laws. This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and apprenticeship. Greenbrook makes hiring decisions based solely on qualifications, merit, and/or business needs at the time. We are committed to providing equal employment opportunities to individuals with disabilities and protected veterans. GBSP25

Revenue Cycle Management Specialist I Revenue Cycle Management Specialist I, can work in all facets of the revenue cycle department. This role is focused on claims processing, managing accounts receivable, and ensuring proper collection is made on account within the best practice timeframe. Problem solving skills are required as the specialist must be able to use various tools, analyze the situation, research data, and resolve and/or formulate a decision. Who We Are: JAG Physical Therapy's care-first model of rehabilitation may be the change you are looking for! JAG Physical Therapy, a comprehensive outpatient, orthopedic physical therapy company with 100 facilities throughout Pennsylvania, New Jersey, and New York, is seeking compassionate and motivated individuals to join our winning team! JAG has been honored by the area's top publications as the best in the business based on growth and outcomes and is considered the Gold Standard for physical therapy care by the Metro area's largest healthcare systems and insurance providers. What You'll Love About Us: Competitive pay Health, Dental, & Vision Benefits HSA Options including dependent care, medical, and commuter benefits $10,000.00 Term Life Insurance benefit at NO cost to employees up to 3 weeks PTO 401(k) with company match Yearly review for growth opportunities Tuition discounts for employees and their families TicketsAtWork and LifeMart company perks Our workplace fosters a close-knit and supportive environment where individuals genuinely care for and uplift one another, creating a strong sense of unity and camaraderie What You'll Need: High School or GED 2 to 3 years related work experience with Physical Therapy experience preferred Experience in EMRs and other medical billing software Knowledge of billing requirements and regulations of major payers Problem solving skills with attention to detail Strong verbal and written communication skills Excellent Customer service Proficient computer skills and knowledge of Microsoft Office Ability to prioritize and manage multiple tasks What You'll Do: Identify trends and root causes related to RCM processes Responsible for clean claim billing, claim adjudication, denial management, payment posting, underpayments, patient liability, and other revenue cycle processes Completing daily worklist as assigned by leadership Identify challenges and opportunities for improvement Educate patients, staff, and/or providers regarding best practices Responsible for entering data in an accurate manner Documenting best practices and creating new workflows Provide excellent customer service to our patients and internal teams Other duties as assigned Important Disclaimer Notice: The above statements are only intended to represent the essential job functions and general nature of the work being performed and are not exhaustive of the tasks that an Employee may be required to perform. The employer reserves the right to revise this at any time and to require Employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or the work environment change. This job description is not a guarantee of employment. What you'll love about us section is based on full time employment with the company and is not guaranteed based on employment type.

As a Revenue Cycle Management Specialist within our Medical Payment Posting team, you will be expected to adopt a strategic approach to ensure the accurate recording and reconciliation of all financial transactions by specified deadlines. Your responsibilities will include managing credit balances, negotiating insurance underpayments, and overseeing the distribution of patient statements. This role is vital in maintaining the financial accuracy and integrity of the medical billing process. You will collaborate closely with the billing and collections teams to reconcile accounts and address any discrepancies. Who We Are: JAG Physical Therapy's care-first model of rehabilitation may be the change you are looking for! JAG Physical Therapy, a comprehensive outpatient, orthopedic physical therapy company with 100 facilities throughout Pennsylvania, New Jersey, and New York, is seeking compassionate and motivated individuals to join our winning team! JAG has been honored by the area's top publications as the best in the business based on growth and outcomes and is considered the Gold Standard for physical therapy care by the Metro area's largest healthcare systems and insurance providers. What You'll Love About Us: Competitive pay Health, Dental, & Vision Benefits HSA Options including dependent care, medical, and commuter benefits $10,000.00 Term Life Insurance benefit at NO cost to employees up to 3 weeks PTO 401(k) with company match Yearly review for growth opportunities Tuition discounts for employees and their families TicketsAtWork and LifeMart company perks Our workplace fosters a close-knit and supportive environment where individuals genuinely care for and uplift one another, creating a strong sense of unity and camaraderie What You'll Need: High School or GED 2 to 3 years related work experience with Physical Therapy experience preferred Experience in EMRs and other medical billing software Knowledge of billing requirements and regulations of major payers Problem solving skills with attention to detail Strong verbal and written communication skills Excellent Customer service Proficient computer skills and knowledge of Microsoft Office Ability to prioritize and manage multiple tasks What You'll Do: Payment Posting: Accurately post payments from patients and insurance companies to patient accounts. Ensure all payments are posted in a timely manner. Reconciliation: Reconcile daily deposits and payments with patient accounts. Identify and resolve any discrepancies in payment postings. Insurance Payments: Post insurance payments and adjustments according to Explanation of Benefits (EOBs). Verify the accuracy of insurance payments and follow up on any discrepancies. Patient Payments: Post patient payments received via mail, online, or in-person. Ensure patient payments are applied correctly to outstanding balances. Communication: Communicate with the billing and collections teams to address any payment issues. Provide support to patients and insurance companies regarding payment inquiries. Reporting: Generate and review payment reports to ensure accuracy. Assist in preparing financial reports as needed. Compliance: Adhere to all company policies and regulatory requirements. Maintain confidentiality of patient information. Important Disclaimer Notice: The above statements are only intended to represent the essential job functions and general nature of the work being performed and are not exhaustive of the tasks that an Employee may be required to perform. The employer reserves the right to revise this at any time and to require Employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or the work environment change. This job description is not a guarantee of employment. What you will love about our section is based on full-time employment with the company and is not guaranteed based on employment type.

As a part of our Billing Support Team, within the Revenue Cycle Management department, your primary responsibility is to assist patients with understanding their medical bills and resolving any billing issues. This includes explaining various billing components such as deductibles, coinsurance, out-of-pocket expenses, copays, and denials. Additionally, you will process credit card payments, communicate with other departments to address discrepancies, and ensure the accuracy of patient statements. Who We Are: JAG Physical Therapy's care-first model of rehabilitation may be the change you are looking for! JAG Physical Therapy, a comprehensive outpatient, orthopedic physical therapy company with 100 facilities throughout Pennsylvania, New Jersey, and New York, is seeking compassionate and motivated individuals to join our winning team! JAG has been honored by the area's top publications as the best in the business based on growth and outcomes and is considered the Gold Standard for physical therapy care by the Metro area's largest healthcare systems and insurance providers. What You'll Love About Us: Competitive pay Health, Dental, & Vision Benefits HSA Options including dependent care, medical, and commuter benefits $10,000.00 Term Life Insurance benefit at NO cost to employees up to 3 weeks PTO 401(k) with company match Yearly review for growth opportunities Tuition discounts for employees and their families TicketsAtWork and LifeMart company perks Our workplace fosters a close-knit and supportive environment where individuals genuinely care for and uplift one another, creating a strong sense of unity and camaraderie What You'll Need: High School or GED 2 to 3 years related work experience with Physical Therapy experience preferred Experience in EMRs and other medical billing software Knowledge of billing requirements and regulations of major payers Problem solving skills with attention to detail Strong verbal and written communication skills Excellent Customer service Proficient computer skills and knowledge of Microsoft Office Ability to prioritize and manage multiple tasks What You'll Do: Answer patient calls and provide clear explanations of their medical statements. Help patients understand billing terms such as deductibles, coinsurance, out-of-pocket expenses, copays, and denials. Address patient inquiries and concerns with empathy and professionalism. Billing and Payments: Process credit card payments securely and efficiently. Assist patients with setting up payment plans if needed. Communication and Coordination: Collaborate with other departments to review and resolve billing discrepancies. Ensure accurate and timely updates to patient accounts. Monthly Statement Runs: Prepare and send out monthly statements to patients. Ensure all statements are sent by the end of the month. Accuracy and Compliance: Verify the accuracy of patient statements and billing information. Adhere to company policies and regulatory requirements Important Disclaimer Notice: The above statements are only intended to represent the essential job functions and general nature of the work being performed and are not exhaustive of the tasks that an Employee may be required to perform. The employer reserves the right to revise this at any time and to require Employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or the work environment change. This job description is not a guarantee of employment. What you will love about our section is based on full-time employment with the company is not guaranteed based on employment type.

Pharmacy Medical Biller We're looking for a Pharmacy Medical Biller who can help keep our billing operations accurate, timely, and running smoothly. This role is ideal for someone who understands pharmacy billing systems, likes solving problems, and cares about supporting a team that delivers strong patient outcomes. What You'll Do You'll process insurance claims, review denials and rejections, and make sure everything is submitted accurately to Medicare, Medicaid, and commercial payers. You'll work closely with pharmacists and technicians to resolve billing issues, verify insurance, manage prior authorizations, and maintain organized billing records. You'll also respond to patient questions about billing or copays, reconcile daily claims, and help ensure compliance with HIPAA and pharmacy billing regulations. Your work directly supports the financial health of the pharmacy and helps patients receive the medications and services they rely on. What We're Looking For High school diploma or equivalent 1-2 years of billing experience (pharmacy billing strongly preferred) Familiarity with pharmacy benefit managers, insurance plans, and third-party billing Experience with PioneerRx is strongly preferred Solid understanding of reimbursement guidelines and payer policies Strong attention to detail and problem-solving skills Comfortable working with Microsoft Office and general computer systems Ability to manage multiple tasks while staying accurate and compliant Why Join Us You'll be part of a mission-driven pharmacy that focuses on patient care, access, and community impact. This role offers steady, meaningful work in a supportive environment, with opportunities to grow your skills and contribute to a team that makes a real difference. If you enjoy detailed work, take pride in accuracy, and want to support a pharmacy committed to exceptional service, we'd love to talk with you.

Job Description A billing specialist prepares and issues invoices, posts payments, and manages client accounts, ensuring financial data is accurate and consistent. Key duties include reviewing billing documents, tracking accounts receivable, reconciling payments, and communicating with clients about deadlines and discrepancies. This role often requires strong attention to detail, financial analysis skills, and proficiency with billing software.

How will you make an impact & Requirements Compensation: $18.00 to $22.50

Job Details Main Office - Bridgeville, PADescription Chartiers Center is a private, non-profit corporation funded by state, county, third party insurances and private funds. Services include intake, referral, outpatient therapy, psychiatric assessment, service coordination, substance abuse treatment, training and social rehabilitative services, crisis intervention, partial hospitalization, community outreach, day, and recreational services for adults with intellectual disabilities, homeless outreach, and housing program. As a Part-Time Front Desk/Registration Specialist with Chartiers Center at our Bridgeville Office. Responsibilities include: Phone Support Checking in clients for appointments Processing co-pays for visits (credit cards and cash payments) Ensuring drivers license and insurance cards are scanned into the system. Uploading new consumer photos to the system Evening shifts require closing the front desk station and locking the building. Valued skills: Active Listening, multitasking, problem solving, ability to maintain confidentiality and calmness in stressful situations. Previous experience in medical setting or social service agency a plus. Hours would vary and could be anytime from Mon-Thursday 8:00 AM - 7:30 PM and Friday 8:00 AM-5:00 PM At Chartiers Center we offer the following benefits: Competitive Hourly Rate Monday-Friday- Daylight/Evenings Medical, Dental and Vision Short- and Long-Term Disability Retirement Plan 8 Paid Holidays Generous PTO (Pro-Rated Paid Time Off) Tuition Reimbursement Positive and fulfilling work environment! Minimum Qualifications: High School Diploma or Equivalent One (1) year related experience Diversity and Inclusion- Each of our clients/individuals is uniquely different and so are we. We hire great people from a wide variety of backgrounds, cultures and experiences. Not just because it's the right thing to do, but because it makes Chartiers Center stronger and our clients/individuals healthier. If you share our values and our enthusiasm for our mission, we will be stronger together. EOE