Managed Care Specialist Job at MJHS (New York)

Managed Care Billing Specialist

Location

United States , Los Angeles

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

At least 3 years of experience in medical insurance collections, insurance follow-up, or healthcare accounts receivable
Prior hospital-based billing or collections experience is required
Hands-on experience working with UB04 claims in a hospital environment
Strong understanding of payer guidelines, reimbursement practices, and insurance follow-up procedures
Background in denial resolution, appeals processing, and correction of claim-related issues
Ability to manage a high-volume workload with strong accuracy, organization, and attention to detail
Effective written and verbal communication skills with solid analytical and problem-solving ability
Familiarity with hospital billing systems and electronic medical records is preferred

Job Responsibility

Perform insurance collections follow-up on outstanding hospital claims with a focus on Medicare and Managed Care payers
Review and work hospital UB04 claims to ensure accurate billing and proper reimbursement
Investigate and resolve claim denials, rejections, underpayments, and payment delays
Submit corrected claims, supporting documentation, and appeals as needed to facilitate payment resolution
Follow up on aged accounts receivable and maintain productivity in line with departmental goals
Document all collection activity, account updates, and payer communications in the billing system
Collaborate with billing, coding, and patient financial services teams to resolve claim discrepancies and improve reimbursement outcomes
Monitor payer trends and escalate recurring issues impacting collections

What we offer

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

Fulltime

Managed Care Medical Billing Specialist

A leading hospital in Los Angeles is seeking a detail-oriented Managed Care Medi...

Location

United States , Los Angeles

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

At least 3 years of experience in medical billing, managed care billing, or hospital revenue cycle operations
Working knowledge of payer rules, claim submission workflows, denial resolution, and accounts receivable follow-up practices
Understanding of medical terminology, insurance eligibility review, authorization requirements, and coding-related billing accuracy
Experience handling hospital billing forms and claim types, including UB04 and UB92
Familiarity with electronic billing platforms and claims tools, including experience with EPACES or similar systems
Strong analytical skills with close attention to detail and the ability to identify and resolve billing discrepancies
Ability to manage a high-volume workload, meet deadlines, and communicate effectively with internal and external stakeholders

Job Responsibility

Demonstrate the ability to determine the accuracy of pertinent medical, coding, eligibility, authorization, demographic, and financial information, and make any required corrections
Determine payer documentation requirements for payment and ensure all necessary supporting documentation is available for claim submission
Transmit and submit clean claims to payers within three working days of receipt, while maintaining a productivity standard of 200 claims per day
Update the computer system to reflect claim submission and transmission activity
Review payer correspondence and provide corrections and/or additional documentation within three working days
Review payment data for suspensions, underpayments, and denials, and submit appropriate responses, including corrected insurance forms and rebills as needed
Review bi-monthly accounts receivable reports to identify claims that have been submitted but remain unresolved or unacknowledged, as well as claims that have not yet been submitted, and take appropriate action to ensure timely resolution
Prepare adjustments needed to ensure account balances reflect payable amounts and forward them to management for review and authorization

What we offer

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

Fulltime

Medicare Managed Care Medical Collections Specialist

A hospital in Los Angeles is seeking a Medicare Managed Care Medical Collections...

Location

United States , Los Angeles

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Previous experience in medical collections, insurance follow-up, or healthcare accounts receivable required
Experience with Medicare managed care collections in a hospital or healthcare setting preferred
Strong knowledge of insurance appeals, denial management, and insurance AR follow-up
Familiarity with medical billing processes, payer guidelines, and reimbursement practices
Strong communication, negotiation, and problem-solving skills
Ability to organize and prioritize a high-volume workload in a fast-paced environment
Proficiency with hospital billing systems and electronic medical or revenue cycle platforms preferred
At least 3 years of experience in medical collections, insurance follow-up, or healthcare accounts receivable
Background in Medicare managed care or Medicare Advantage collections within a hospital or healthcare setting is preferred
Working knowledge of denial management, insurance appeals, and payer follow-up practices

Job Responsibility

Call insurance companies, payers, and/or patients to secure payment on unpaid claims
Perform timely follow-up on outstanding insurance accounts receivable to ensure appropriate reimbursement
Manage and prioritize daily workload to maximize collection efforts and minimize delays in payment resolution
Submit and track insurance appeals related to denied or underpaid claims
Review denials, determine root cause, and take corrective action to support claim resolution
Gather and provide required documentation to payers to support payment or appeal requests
Work closely with internal departments to resolve billing discrepancies and improve claim turnaround times
Maintain accurate account notes and update billing systems with collection and follow-up activity
Monitor unpaid claims to ensure timely escalation and resolution

What we offer

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

Fulltime

New

Customer Care Specialist

Serve as the point of contact for customers and communicate with them by email, ...

Location

United States , Anaheim

Salary:

30.40 USD / Hour

Marriott Bonvoy

Expiration Date

Until further notice

Requirements

High School diploma or G.E.D. equivalent
3 years related experience
No supervisory experience
None

Job Responsibility

Serve as the point of contact for customers and communicate with them by email, letter, or phone
Respond to questions and requests within the designated turnaround time
Clarify and resolve any issues to provide a timely and satisfactory outcome to the customer’s inquiry
Enter and retrieve information contained in computer databases to update records, files, and answer inquiries from guests
Operate standard office equipment other than computers
Prepare letters, memos, and other documents using a computer, mail, fax machine, including proofreading and editing written information to verify accuracy and completeness
Communicate with guests via the social media channels such as TripAdvisor, Twitter and Facebook
Enter and locate work-related information using computers
Provide excellent customer service to all customers and fellow STARS
Support the efforts of other STARS to provide excellent customer service

Fulltime

Customer Care Specialist with German

Are you passionate about helping others? Do you like to work in an international...

Location

Spain , Barcelona

Salary:

28000.00 - 33000.00 EUR / Year

Babel Profiles

Expiration Date

Until further notice

Requirements

+3 years of experience in Customer Service, Customer Care, or Order Management, ideally in a B2B environment
Strong experience in back-office customer service, including order management, issue resolution, and logistics coordination
Strong problem-solving and solution-oriented mindset
Highly proactive, autonomous, and able to ramp up quickly
Adaptable and comfortable working in a dynamic, fast-paced environment
Hands-on experience with SAP is essential, along with strong proficiency in Microsoft Office
Strong collaboration skills and ability to work effectively across departments
Thinking in solutions, have an innovative mindset

Job Responsibility

Act as the main contact for customers and consumers in coordination with the Call Center, handling inquiries on orders, products, usage, and digital platforms
Manage inbound and outbound customer communications in areas without sales coverage across all channels
Coordinate daily operations with logistics providers, ensuring correct product intake and order processing
Oversee end-to-end order management, from entry through to shipment and delivery
Manage returns, claims, and invoice incidents, ensuring timely resolution
Maintain and update customer and product master data across internal systems and logistics partners

What we offer

Bonus
Hybrid working model (1 day at home)
Private health and life insurance
Ticket Restaurant
Yoga, pilates, and barre classes

Fulltime

Customer Care Specialist

As a Customer Care Specialist (Tier 1), you will be responsible for handling inb...

Location

Philippines , Metro Manila

Salary:

Not provided

NTT DATA

Expiration Date

Until further notice

Requirements

Excellent communication skills, both verbal and written
Fluent in English
Demonstrated analytical and problem-solving skills
Demonstrated ability to work within time constraints
Working knowledge of PCs and strong keyboarding skills (min 25 wpm with an accuracy of 95%)
Positive attitude and demonstrated ability to perform in a team-based environment
Professional and pleasant telephone manner
Must have flexibility and willingness to work rotational shifts, including overnights and weekends
Experience working in a call center environment specifically in a customer service role
Previous Financial Services experience would be considered an asset

Job Responsibility

Manage inbound customer calls regarding standard credit card inquiries, transactions, account maintenance and Tier 1 online support
Respond to customer inquiries in a pleasant, courteous, professional, and well-informed manner
In conjunction with on-screen customer information, identify customer needs through customer contact while simultaneously reading/updating customer information on the system
Analyze information presented by the customer and action next steps accordingly based on the nature of the inquiry
Adhere to established escalation procedures when mitigating complaints/escalations on the first contact
Remain current on program information and business initiatives, as well as corporate products and processes
Achieve quality service by accurately assessing and responding to customer needs, using sound judgment and flexibility when recommending appropriate options/solutions
Fulfill customer brand expectations in a manner that complies with policies, practices, and procedures
Accurately complete appropriate documentation for each transaction
End each call by completing all required activity in order to fulfill customer requests

Fulltime

Animal Care Specialist

As a Companion Animal Specialist, you are the primary expert and advocate for th...

Location

United States , Ewa Beach

Salary:

17.00 - 25.00 USD / Hour

Petco Animal Supplies Stores, Inc

Expiration Date

Until further notice

Requirements

Minimum of 1 year of experience working with or caring for companion animals and aquatic life
Strong knowledge of animal care, husbandry, and maintenance practices
Demonstrated ability to educate others and communicate effectively
Strong customer service mindset with an aptitude for selling behaviors
Basic business, math, and inventory management skills
Strong organizational, interpersonal, and communication skills
High school diploma or GED preferred
Completion and ongoing maintenance of the Petco Animal Care Certification Program required
Ability to safely lift and move merchandise, supplies, or animals weighing up to 50 pounds
Must be able to work in proximity to animals, including exposure to animal dander, odors, noises, and cleaning chemicals

Job Responsibility

Ensure the health, safety, and proper care of all companion animals and aquatic life in accordance with Petco standards, policies, and procedures
Complete and verify required animal care tasks, including hourly animal health checks, wellness documentation, maintenance logs, and incident reports
Ensure proper handling, documentation, and care of relinquished and adoption animals
Serve as the primary resource for animal care education for customers and PCC partners
Adhere to and promote all safety, animal welfare, and loss prevention procedures
Deliver knowledgeable, compassionate, and solution-focused service to customers
Actively support customer interactions using Petco’s selling model
Promote a culture of teamwork, inclusion, and collaboration across the PCC
Mentor and educate partners on animal care standards, maintenance routines, and best practices
Maintain professional, clean, and well-presented animal habitats and aquatic areas

What we offer

Health and financial benefits
401K
Incentives
PTO

Parttime

Animal Care Specialist

As a Companion Animal Specialist, you are the primary expert and advocate for th...

Location

United States , Chicago

Salary:

17.00 - 25.00 USD / Hour

Petco Animal Supplies Stores, Inc

Expiration Date

Until further notice

Requirements

Minimum of 1 year of experience working with or caring for companion animals and aquatic life
Strong knowledge of animal care, husbandry, and maintenance practices
Demonstrated ability to educate others and communicate effectively
Strong customer service mindset with an aptitude for selling behaviors
Basic business, math, and inventory management skills
Strong organizational, interpersonal, and communication skills
High school diploma or GED preferred
Completion and ongoing maintenance of the Petco Animal Care Certification Program required

Job Responsibility

Ensure the health, safety, and proper care of all companion animals and aquatic life in accordance with Petco standards, policies, and procedures
Complete and verify required animal care tasks, including hourly animal health checks, wellness documentation, maintenance logs, and incident reports
Ensure proper handling, documentation, and care of relinquished and adoption animals
Serve as the primary resource for animal care education for customers and PCC partners
Adhere to and promote all safety, animal welfare, and loss prevention procedures
Deliver knowledgeable, compassionate, and solution-focused service to customers
Actively support customer interactions using Petco’s selling model
Promote a culture of teamwork, inclusion, and collaboration across the PCC
Mentor and educate partners on animal care standards, maintenance routines, and best practices
Maintain professional, clean, and well-presented animal habitats and aquatic areas

What we offer

Purpose-driven work that makes a difference for pets and people
A welcoming, inclusive team environment
Opportunities to learn, grow, and explore career paths
A fun, fast-paced role where no two days are the same
401K
PTO

Parttime

Select Country

Managed Care Specialist

Job Description

Job Responsibility

Requirements

What we offer

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