Claims Billing Specialist Job at Robert Half (Philadelphia)

Medical Billing Specialist

Location

United States , Dothan

Salary:

Not provided

RealTime (AL)

Expiration Date

Until further notice

Requirements

Medical Billing Experience
Perform posting charges
Perform completion of claims to payers
Conduct duties in a professional and timely fashion
Submit billing data to the appropriate insurance providers
Process claims
Resolve denial instances
Perform claim follow-up
Achieve maximum reimbursement for services provided
Deploy, maintain and report on various programs

Job Responsibility

Medical billers play a vital role in the connection between health care providers, patients, and insurance companies. At RealTime, we provide excellent Revenue Cycle Management to medical practices across the Southeast and through the Midwest.

What we offer

Training
Competitive pay
Phone allowance
Generous PTO
401(k) with company match
Health & Wellness Benefits including medical, dental, and vision
Company-sponsored events for fun and fellowship

Fulltime

Billing Specialist

Location

United States

Salary:

Not provided

Pafford EMS

Expiration Date

Until further notice

Requirements

Proficient with a PC
Knowledge of Health Insurance Portability and Accountability Act (HIPAA)
Knowledge of procedure and diagnostic codes (HCPCS and ICD-10 codes)
Knowledge of medical terminology
Knowledge of Medical Billing
Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and commercial payers
Customer service skills for interacting with patients regarding medical claims and payments
Problem-solving skills to research and resolve discrepancies, denials, appeals, and collections
Ability to work independently and with a group
Working knowledge of MS Word, Excel

Job Responsibility

Obtain referrals and pre/post-authorizations for ambulance services
Check eligibility and benefits verification
Review insurance and facility claims for accuracy and completeness
Prepare, review, and transmit claims using billing software, clearinghouse, and payer websites
Following up on unpaid claims within standard billing cycle timeframe
Reviewing underpaid claims for appropriate escalation steps to ensure appropriate reimbursement for services
Calling insurance companies regarding any payment discrepancies
Identifying and billing secondary or tertiary insurance
Processing incoming mail and taking appropriate follow up actions to resolve accounts
Researching and appealing denied claims

Medicaid Billing Specialist

Pafford Medical Services is seeking a detail-oriented and experienced Medicaid B...

Location

United States

Salary:

Not provided

Pafford EMS

Expiration Date

Until further notice

Requirements

Minimum of 2-3 years of experience in medical billing, with a focus on Medicaid billing and follow-up
In-depth knowledge of Medicaid regulations, coding (ICD-10, CPT), and billing procedures
Experience with medical billing software and electronic health records (EHR) systems
Strong analytical and problem-solving abilities
Excellent attention to detail and accuracy
Effective communication and interpersonal skills
Ability to work independently and manage multiple tasks
Proficiency in Microsoft Office Suite (Word, Excel)
High School Diploma or GED
Minimum of 2-3 years revenue cycle management experience

Job Responsibility

Accurately prepare and submit Medicaid claims for services rendered by Pafford EMS
Ensure all claims are coded correctly and comply with Medicaid regulations and guidelines
Monitor and verify patient eligibility and insurance coverage
Conduct follow-up on outstanding claims and ensure timely resolution of billing issues
Communicate with Medicaid offices, patients, and other relevant parties to resolve claim discrepancies, denials, or rejections
Review and appeal denied claims, providing necessary documentation and information
Maintain accurate and up-to-date records of billing activities, payments, and follow-ups
Generate regular reports on billing status, outstanding claims, and payment trends
Stay informed about changes in Medicaid regulations and billing procedures
Participate in training and development opportunities to enhance knowledge and skills

Fulltime

Claims Resolution Representative III

The Claims Resolution Representative III is responsible for working across the p...

Location

United States of America , Albany

Salary:

19.62 - 26.49 USD / Hour

University of Rochester

Expiration Date

Until further notice

Requirements

Associate degree and 2 years of related relevant experience
or equivalent combination of education and/or experience
Excellent problem-solving skills
Excellent communication skills
Excellent customer service skills

Job Responsibility

Follows department policies and procedures and maintains and exercises comprehensive knowledge of insurance company billing requirements and regulations to research and resolve unpaid accounts receivable
Follows up on multi-faceted denials through review of remittances (EOBs), insurance correspondence, rejections
Research claims, identify problems, and takes appropriate action to assure claim resolution
Responds to all billing-related inquiries from colleagues, departments, patients, and payors in a timely and professional manner
Keeps management informed of changes in billing requirements and rejection or denial codes
Collaborates with Claim Edit Specialists and Patient Medical Billing Specialists

Fulltime

Billing Specialist, Revenue Cycle, FT

Responsible for working/editing daily download of assigned Managed Care/HOM clai...

Location

United States , Boca Raton

Salary:

16.04 - 19.41 USD / Hour

Baptist Health

Expiration Date

Until further notice

Requirements

Degrees: High School,Cert,GED,Trn,Exper.
AA preferred or equivalent
Managed Care/HMO contract billing experience required
3-5 years prior experience in Billing of claims
Understanding of all required fields on a 1500 and/or UB for hospitals and diagnostic facilities is required
Background in coding or coding certification (CPC, CPC-H, CCS, or RMC) a plus
Exp in other related Business Office Functions including Federal Programs, such as: Collections, refunds, review and adjudication of claims a plus
Knowledge and understanding of: Medical terminology, Correct Coding Initiative, Revenue Codes, DRG Guidelines, ICD-9/10, CPT-4, Modifiers & HCPCS codes, HIPAA regulations, statutory regulations, On-line verifications (DDE)
Internet savvy
knowledge of Microsoft Suite a must

Job Responsibility

Working/editing daily download of assigned Managed Care/HOM claims
Optimizing the timely transmittal of accurate and clean claims daily
Identifying and obtaining invalid/missing claim data by communicating with other depts. to secure and/or correct the data which prevents claim transmission
Protecting payer filing deadlines by utilizing all available resources to resolve held claims
Assuring all known regulatory, contractual, compliance, and BHSF guidelines are adhered to
Taking on additional queues as back up to billing all carriers
Utilizing available system resources to resolve claim issues when appropriate
Reporting any billing system issues to Billing management
Assisting other Billing Specialists with claim resolution or other projects as assigned

What we offer

Career growth and development opportunities
Comprehensive health and wellness resources
Wellness program that can help employees eliminate their medical plan deductible
Tuition reimbursement

Fulltime

Patient Financial Specialist

The associate is responsible for the duties and services that are of a support n...

Location

United States , Irving

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

HS Diploma or equivalent years of experience required
Post HS education preferred
1-3 years of experience preferred
Experience working within a multi-facility hospital business office environment preferred
College education, previous Insurance Company claims experience, and/or health care billing trade school education may be considered in lieu of formal hospital experience
Experience working with inpatient and outpatient billing requirements of UB-04 and HCFA 1500 billing forms preferred
Experience with Medicare & Medicaid billing processes and regulations preferred
Understanding of Medicare language
Knowledge in locating and referencing CMS and/or Medicare Regulations preferred

Job Responsibility

Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders
Performs Revenue Cycle functions in a manner that meets or exceeds CHRISTUS Health's key performance metrics
Ensures PFS departmental quality and productivity standards are met
Collects and provides patient and payor information to facilitate account resolution
Maintains an active working knowledge of all Government Mandated Regulations as it pertains to claims submission
Responsible to perform the necessary research in order to determine proper governmental requirements prior to claims submission
Responds to all types of account inquires through written, verbal, or electronic correspondence
Maintains payor-specific knowledge of insurance and self-pay billing and follow-up guidelines and regulations for third-party payers
Maintains working knowledge of all functions within the Revenue Cycle
Responsible for professional and effective written and verbal communication with both internal and external customers in order to resolve outstanding questions for account resolution

Fulltime

Claims Resolution Representative III

The Claims Resolution Representative III is responsible for working across the p...

Location

United States of America , Rochester

Salary:

19.62 - 26.49 USD / Hour

University of Rochester

Expiration Date

Until further notice

Requirements

Associate degree and 2 years of related relevant experience
or equivalent combination of education and/or experience
Excellent problem-solving skills
Excellent communication skills
Excellent customer service skills

Job Responsibility

Follows department policies and procedures and maintains and exercises comprehensive knowledge of insurance company billing requirements and regulations to research and resolve unpaid accounts receivable
Follows up on multi-faceted denials through review of remittances (EOBs), insurance correspondence, rejections
Research claims, identify problems, and take appropriate action to assure claim resolution
Responds to all billing-related inquiries from colleagues, departments, patients, and payors in a timely and professional manner
Communicates any missing/incomplete information to providers and department administrative support staff to ensure accurate billing
Communicates with insurance representatives through telephone calls, payer website, and written communication to ensure accurate processing of claims
Collaborate with appropriate departments to generate a detailed rational for appeals and grievances to the insurance companies
Keeps management informed of changes in billing requirements and rejection or denial codes as they pertain to claim processing and coding
Escalates system issues preventing claims submission and follow-up for review and resolution
Collaborates with Claim Edit Specialists and Patient Medical Billing Specialists assigned to pre claim WQ’s to identify opportunities for improvement in clean claims rate

Fulltime

Medical Billing Specialist

Location

United States , Lantana

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Prior experience in medical billing within a nursing home, long-term care, or skilled nursing facility environment is required.
Working knowledge of medical claims processing, billing follow-up, collections, and payment resolution.
Familiarity with healthcare billing systems such as Matrix, Change Healthcare, and Inovalon
experience with additional related platforms is a plus.
Understanding of medical coding fundamentals and their impact on clean claim submission and reimbursement.
Experience using tools such as DDE and ePaces for claim inquiry, eligibility, or billing support is preferred.
Ability to work independently in a fully remote Monday through Friday schedule while maintaining accuracy and productivity.
Strong attention to detail, problem-solving ability, and organizational skills in a deadline-driven billing environment.

Job Responsibility

Prepare, review, and submit medical claims for skilled nursing and long-term care services with close attention to accuracy and payer requirements.
Investigate billing discrepancies, correct claim errors, and follow through on denied or rejected submissions to improve reimbursement outcomes.
Manage account follow-up activities, including collections work, payment research, and resolution of outstanding balances.
Use billing platforms and clearinghouse tools to process claims and monitor claim status.
Verify coding and claim details before submission to help reduce delays, underpayments, and avoidable denials.
Coordinate with internal teams to gather documentation, clarify billing questions, and support complete and compliant claim processing.
Track remittance activity, post payment information as needed, and reconcile billing records to maintain organized account data.
Support electronic billing workflows involving systems when required for payer communication and claim review.

What we offer

medical
vision
dental
life and disability insurance
401(k) plan

Fulltime

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Claims Billing Specialist

Job Description

Job Responsibility

Requirements

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