Medical Claims Representative Job at Robert Half (Lincolnwood)

Patient Access Services Representative

The TMCOne Pulmonary specializes in Pulmonary and Sleep Medicine where each pati...

Location

United States , Tucson

Salary:

Not provided

Tucson Medical Center

Expiration Date

Until further notice

Requirements

High School diploma or General Education Degree (GED)
completion of vocational medical office training desired, or an equivalent combination of relevant education and experience
preferred one (1) year of medical office and/or hospital experience to include healthcare eligibility and benefit analysis or scheduling experience for diagnostic testing and/or surgery
some positions may require certification as a Medical Assistant (CMA)
knowledge of office management practices, including billing and scheduling within healthcare
knowledge of basic computer familiarity and experience and the ability to operate basic office equipment
knowledge of patient care protocols and practices
knowledge of general patient care practice, methods and regulations
skill in evaluating patient’s needs or following up with a care-giver and then providing follow up support to patients
skill in scheduling appointments and referrals

Job Responsibility

Assists medical care givers with patient management, tracking and monitoring requirements
answers phones, pre-screens using appropriate triage skills, within allowable parameters calls in prescription re-fills, calls patients with test results and schedules patients for next appointments
perform extensive centralized scheduling, insurance verification, referral, billing and payment posting responsibilities
exhibits excellence in customer service through appropriate attitude and interaction with all patients, visitors and staff
collects deposits or deductibles and advises patient or guarantor of insurance benefits and anticipated cost estimates
ensures completion of financial documentation in accordance with TMCH’s credit and collection policies
explains all necessary compliance forms and obtains patient signature as required for regulatory agencies
performs medical necessity screening and ensures compliance with system requirements
interacts with physicians and/or physicians’ office staff to secure diagnosis, procedure details or authorizations and information for denials as needed
uses medical terminology and scheduling knowledge to select correct procedure when scheduling and coordinates information with other departments as needed

Fulltime

Claims Adjuster

Location

United States , Charlotte

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

High School Diploma, Minimum of two years college
Claims experience, 1+ years desired
Adjuster’s License for the State of North Carolina
Ability to work independently or in a team environment
excellent verbal and written communication skills
effective organizational skills
accuracy and neatness in work
pitch in when needed on other tasks
ability to work under pressure
proficient in MS Office (Excel, Word, Outlook, etc.)

Job Responsibility

Handle workers’ compensation claims caseload from inception to final settlement
Original set up of claim
Perform a factual investigation of claim
Set reserves and determine compensability
Communicate daily with claimants, medical personnel, and representatives from housing authorities for updates
Pay weekly lost time claims and medical bills
Assign rehabilitation referrals and legal representation as needed
Coordinate with nurse case managers, vocational counselors, attorneys, and professional surveillance services to bring claims to a conclusion
Update claims information into Riskmaster Claim’s System to include medical notes and daily activity
Transmit medical bills to bill review vendor, scan, and attach medical bills to claim

What we offer

medical
vision
dental
life and disability insurance
eligible to enroll in company 401(k) plan

Clinic Patient Representative Senior

Greets, instructs, directs and schedules patients and visitors. Serves as a liai...

Location

United States , Tyler

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

High school diploma or equivalent
Knowledge of managed care preferred
Ability to operate 10 key calculator by touch, telephone, computer, copier, and fax machine
Excellent interpersonal and communication skills and good math knowledge essential
Some College Preferred
Three or more years of experience in a health care organization
ICD9 and CPT coding (advanced skills) Preferred
Experience with charge posting or collections Preferred

Job Responsibility

Maintains flow of patient check-in, verifies demographic and insurance information and enters into computer database
Assures that information in patient account is accurate
Assists with answering phones, taking messages and assisting with patient and staff inquiries
Responds to CBO requests for patient account corrections and/or maintenance, in a timely manner
Schedules appointments for patients in accordance with physician guidelines
Collects time of service payment amounts
collects prior balance amounts and/or arranging payment plans as requested
Checks in patients, verifies and updates necessary information in the medical record
Assists patients with completing all necessary forms
Scheduled appoints according to clinician template and follows office scheduling policies

Parttime

New

Medical Billing Specialist

We are looking for a detail-oriented Medical Billing Specialist to join our team...

Location

United States , Baton Rouge

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Certification in medical billing and/or medical coding is required
Demonstrated experience with medical billing, coding, claims processing, and collections
Working knowledge of insurance claim submission, payment posting, and denial resolution procedures
Familiarity with payer guidelines, billing compliance standards, and current coding practices
Ability to review account details carefully and maintain a high level of accuracy in documentation
Strong communication skills for working with insurance representatives, patients, and internal teams
Comfortable managing multiple priorities in a deadline-driven healthcare billing environment

Job Responsibility

Assign appropriate billing and coding details to patient accounts based on documented diagnoses, treatments, and services provided
Prepare and submit insurance claims accurately, then monitor their progress to support prompt payment and correct posting of reimbursements
Research denied, rejected, or outstanding claims and coordinate with payers, patients, and internal staff to resolve discrepancies
Confirm insurance coverage and eligibility information before billing and assist in addressing patient account and payment-related questions
Reconcile billing records and account activity to help maintain accurate financial information across the revenue cycle
Document billing actions thoroughly and preserve organized records to support audit readiness and operational accuracy
Stay current on payer policies, coding standards, and healthcare billing regulations to promote compliant claim submission
Identify recurring billing issues and recommend process improvements that strengthen collections and overall revenue cycle performance

What we offer

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

Clinic Patient Representative Senior - Eye Care

Greets, instructs, directs and schedules patients and visitors. Serves as a liai...

Location

United States , Longview

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

High school diploma or equivalent
Knowledge of managed care preferred
Ability to operate 10 key calculator by touch, telephone, computer, copier, and fax machine
Excellent interpersonal and communication skills and good math knowledge essential
Some College Preferred
Three or more years of experience in a health care organization
ICD9 and CPT coding (advanced skills) Preferred
Experience with charge posting or collections Preferred

Job Responsibility

Maintains flow of patient check-in, verifies demographic and insurance information and enters into computer database
Assures that information in patient account is accurate
Assists with answering phones, taking messages and assisting with patient and staff inquiries
Responds to CBO requests for patient account corrections and/or maintenance, in a timely manner
Schedules appointments for patients in accordance with physician guidelines
Collects time of service payment amounts
collects prior balance amounts and/or arranging payment plans as requested
Checks in patients, verifies and updates necessary information in the medical record
Assists patients with completing all necessary forms
Scheduled appoints according to clinician template and follows office scheduling policies

Fulltime

Medical Billing Specialist

We are looking for a detail-oriented Medical Billing Specialist to join our team...

Location

United States , Boardman, Ohio

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Previous experience in medical billing within a healthcare setting
Proficiency in handling Medicaid, CareSource, and other insurance billing processes
Strong knowledge of medical billing terminology and insurance practices
Advanced computer skills, including data entry and billing software applications
Exceptional attention to detail and organizational abilities
Excellent communication skills with a detail-oriented and customer-focused approach
Ability to work onsite during scheduled hours in Boardman, Ohio
Familiarity with tools and processes related to medical coding, claims, and collections

Job Responsibility

Prepare and submit medical claims accurately to insurance providers, including Medicaid and CareSource
Investigate and resolve unpaid or denied claims by communicating effectively with insurance companies
Review patient bills for completeness and correctness, obtaining additional information when necessary
Ensure compliance with healthcare regulations and maintain patient confidentiality at all times
Collaborate with healthcare professionals and insurance representatives to secure timely reimbursements
Process payments and adjustments in billing systems with precision
Address inquiries from patients and insurance providers promptly and professionally
Maintain organized records of billing activities and follow established protocols

What we offer

medical, vision, dental, and life and disability insurance
eligible to enroll in our company 401(k) plan

Clinic Patient Representative Senior - Specialty Cardiology

Greets, instructs, directs, and schedules patients and visitors. Serves as a lia...

Location

United States , Longview

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

High school diploma or equivalent
Knowledge of managed care preferred
Ability to operate 10 key calculator by touch, telephone, computer, copier, and fax machine
Excellent interpersonal and communication skills and good math knowledge essential
Some College (preferred)
Three or more years of experience in a health care organization
ICD9 and CPT coding (advanced skills) (preferred)
Experience with charge posting or collections (preferred)

Job Responsibility

Maintains flow of patient check-in, verifies demographic and insurance information, and enters into the computer database
Assists with answering phones, taking messages, and assisting with patient and staff inquiries
Responds to CBO requests for patient account corrections and/or maintenance in a timely manner
Schedules appointments for patients in accordance with physician guidelines
Collects time of service payment amounts
collects prior balance amounts, and/or arranges payment plans as requested
Checks in patients, verifies, and updates necessary information in the medical record
Assists patients with completing all necessary forms
Schedules appointments according to the clinician template and follows office scheduling policies
Assists front office lead/supervisor with other administrative duties such as front-end duties, denials, workques and correct any errors to ensure clean claims

Fulltime

Clinic Patient Representative Senior - Specialty Cardiology

Greets, instructs, directs, and schedules patients and visitors. Serves as a lia...

Location

United States , Longview

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

High school diploma or equivalent
Knowledge of managed care preferred
Ability to operate 10 key calculator by touch, telephone, computer, copier, and fax machine
Excellent interpersonal and communication skills and good math knowledge essential
Three or more years of experience in a health care organization

Job Responsibility

Maintains flow of patient check-in, verifies demographic and insurance information, and enters into the computer database
Assures that information in the patient account is accurate
Assists with answering phones, taking messages, and assisting with patient and staff inquiries
Responds to CBO requests for patient account corrections and/or maintenance in a timely manner
Schedules appointments for patients in accordance with physician guidelines
Collects time of service payment amounts
collects prior balance amounts, and/or arranges payment plans as requested
Checks in patients, verifies, and updates necessary information in the medical record
Assists patients with completing all necessary forms
Schedules appointments according to the clinician template and follows office scheduling policies

Fulltime

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Medical Claims Representative

Job Description

Job Responsibility

Requirements

What we offer

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