CrawlJobs Logo

Medical Insurance Claims Specialist

https://www.roberthalf.com Logo

Robert Half

Location Icon

Location:
United States, Easthampton

Category Icon
Category:
Insurance

Job Type Icon

Contract Type:
Not provided

Salary Icon

Salary:

Not provided
Save Job
Save Icon
Job offer has expired

Job Description:

Short-term contract opportunity for managing medical insurance claims, ensuring billing functions are precise and efficient, and maintaining meticulous records within a team-oriented workplace focused on customer service.

Job Responsibility:

  • Oversee billing functions and financial verification processes
  • Deliver detail-oriented and timely customer service
  • Uphold organizational and program policies and procedures
  • Administer administrative paperwork as part of the Client Intake Packet via EMR system
  • Ensure intake paperwork adheres to quality assurance standards
  • Respond promptly to intake communications
  • Inform the client about service availabilities, rights, and responsibilities
  • Manage assignment, documentation, and entry of client ID into relevant systems
  • Collaborate with the Clinic Administrator for additional support
  • Perform insurance eligibility checks and input clinical authorizations
  • Schedule clients on clinicians' calendars
  • Participate in staff meetings and utilization reviews
  • Retrieve previous medical/psychiatric records prior to client's initial visit
  • Liaise with clinical staff as needed.

Requirements:

  • Familiarity with EMR (we use Credible) and insurance companies to verify eligibility
  • Proficiency in Billing Functions, including the ability to handle invoices, payments, and financial records
  • Experience in Claim Administration, particularly efficient and accurate processing and tracking
  • Knowledge of Insurance Claims, particularly understanding, processing, and managing various types of claims
  • Familiarity with Insurance Eligibility, to verify client coverage
  • Ability to perform Insurance Follow-up duties, ensuring timely resolution of claims.
What we offer:
  • Medical, vision, dental, and life and disability insurance
  • Eligibility to company 401(k) plan
  • Access to competitive compensation
  • Free online training.

Additional Information:

Job Posted:
March 21, 2025

Employment Type:
Fulltime
Work Type:
On-site work
Job Link Share:

Looking for more opportunities? Search for other job offers that match your skills and interests.

Briefcase Icon

Similar Jobs for Medical Insurance Claims Specialist

New

Medical Billing Specialist

Location
Location
United States , Dothan
Salary
Salary:
Not provided
realtime-it.com Logo
RealTime (AL)
Expiration Date
Until further notice
Flip Icon
Requirements
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
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
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
Read More
Arrow Right

Medical Billing Specialist

We are looking for a detail-oriented Medical Billing Specialist to join a team i...
Location
Location
United States , King of Prussia
Salary
Salary:
Not provided
https://www.roberthalf.com Logo
Robert Half
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • At least 1 year of experience in medical billing, claims, or collections
  • Proficiency in accounting software systems and electronic health record (EHR) systems
  • Familiarity with Medicaid processes and commercial insurance claims
  • Strong understanding of accounts receivable, denial management, and appeals
  • Experience working with billing and authorization functions
  • Ability to accurately input and manage billing data
  • Excellent communication skills to collaborate with team members and external payors
  • Knowledge of compliance policies related to medical billing and collections
Job Responsibility
Job Responsibility
  • Process and submit primary and secondary claims for both commercial insurance and Medicaid
  • Investigate and resolve claim denials, performing appeals as necessary to ensure proper reimbursement
  • Manage accounts receivable by following up on claims through resolution, including correcting billing errors and addressing rejections
  • Input and review billing data for accuracy, ensuring compliance with company policies and procedures
  • Collaborate with the Billing Manager and clinic teams to ensure accurate and timely billing
  • Track and verify Medicaid status for clients while maintaining relationships with payors to facilitate successful claims processing
  • Assist intake teams with Medicaid documentation for new clients and those requiring reassessment
  • Utilize various insurance portals and systems, including Waystar, to handle denial responses and claims follow-ups
  • Ensure adherence to compliance standards in all billing and collections activities
  • Perform other tasks as assigned by the Billing Manager or Director
What we offer
What we offer
  • Medical insurance
  • Vision insurance
  • Dental insurance
  • Life insurance
  • Disability insurance
  • 401(k) plan
  • Fulltime
Read More
Arrow Right

Medical Billing Specialist

We are seeking a dedicated and detail-oriented Medical Billing Specialist to joi...
Location
Location
United States , Hagerstown
Salary
Salary:
Not provided
https://www.roberthalf.com Logo
Robert Half
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • High school diploma or equivalent
  • Associate’s degree in Health Information Technology, Business Administration, or a related field is preferred
  • 1+ years of experience in medical billing and accounts receivable, preferably within a healthcare setting
  • Strong knowledge of medical terminology, coding systems (CPT, ICD-10, HCPCS), and insurance regulations
  • Experience with medical billing software and electronic health records (EHR) systems
  • Excellent communication skills, both verbal and written
  • Detail-oriented with strong organizational and analytical skills
  • Ability to manage multiple priorities and meet deadlines in a fast-paced environment
  • Knowledge of HIPAA regulations and confidentiality requirements
Job Responsibility
Job Responsibility
  • Billing & Coding: Accurately review and submit medical claims to insurance companies, government programs (e.g., Medicare, Medicaid), and patients based on services provided
  • Accounts Receivable Management: Monitor and follow up on unpaid claims and accounts, ensuring timely resolution and payment collection
  • Claim Denial Management: Investigate and resolve denied or rejected claims, working with insurance providers to rectify issues and ensure proper reimbursement
  • Payment Posting: Post payments, adjustments, and denials to patient accounts accurately
  • Patient Communication: Communicate with patients and insurance companies to resolve billing inquiries, provide payment information, and answer any questions related to their accounts
  • Account Reconciliation: Ensure all accounts are reconciled and balanced, identifying discrepancies and making necessary adjustments
  • Compliance: Maintain up-to-date knowledge of relevant billing codes, insurance policies, and regulations to ensure compliance with industry standards and government regulations
  • Reporting: Generate and review accounts receivable reports, aging reports, and other billing data to ensure financial goals are met and identify areas for improvement
  • Collaboration: Work closely with the clinical and administrative teams to resolve any billing issues, discrepancies, or concerns
What we offer
What we offer
  • Medical, vision, dental, and life and disability insurance
  • Company 401(k) plan
  • Access to top jobs
  • Competitive compensation
  • Fulltime
Read More
Arrow Right

Medical Reimbursement Specialist

We are in search of a Medical Reimbursement Specialist to join our team. Station...
Location
Location
United States , Princeton
Salary
Salary:
Not provided
https://www.roberthalf.com Logo
Robert Half
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Minimum of 3 years of experience in a similar role
  • Proficient in benefit functions
  • Demonstrated expertise in billing functions
  • Experience in claim administration
  • Familiarity with collection processes
  • Ability to handle and resolve medical denials
  • Comprehensive knowledge of Medicare
Job Responsibility
Job Responsibility
  • Analyze and categorize outstanding claims based on payer, denial reason, and claim value
  • Investigate and take corrective action on unpaid, denied, or underpaid claims
  • Collaborate with internal teams to obtain missing documentation and expedite claim resubmission
  • Evaluate common denial reasons and address them accordingly, such as coding errors, medical necessity, and prior authorization
  • Submit corrected claims and formal appeals as required
  • Communicate with insurance payers to resolve aged claims and escalate unresolved claims as necessary
  • Maintain comprehensive records of all payer interactions
  • Identify the root causes of denials and implement best practices to prevent future issues
  • Suggest changes to workflow to enhance claim submission accuracy and speed
  • Conduct training for in-house billing teams on claim recovery strategies
What we offer
What we offer
  • medical, vision, dental, and life and disability insurance
  • eligibility to enroll in company 401(k) plan
  • Fulltime
Read More
Arrow Right
New

Entry-Level Medical Coding & Billing Specialist

A respected healthcare organization is seeking an Entry-Level Medical Coding & B...
Location
Location
United States , Baltimore
Salary
Salary:
20.00 - 28.00 USD / Hour
revelstaffing.com Logo
Revel Staffing
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • High School Diploma or GED (Associate’s degree or medical billing coursework a plus)
  • Strong attention to detail, numerical accuracy, and organizational skills
  • Basic computer proficiency, including Microsoft Office and medical billing software
  • Excellent written and verbal communication skills with a professional, customer-service mindset
  • MediClear Certification (or equivalent healthcare compliance credential) required
  • Ability to manage multiple tasks and meet deadlines in a fast-paced healthcare environment
Job Responsibility
Job Responsibility
  • Claims Processing: Organize patient medical costs, review encounter documentation, and accurately code services for billing and insurance claims
  • Billing & Collections: Generate and submit invoices to patients and insurance carriers, monitor outstanding claims, and ensure timely reimbursements
  • Patient Communication: Contact patients to discuss balances, explain insurance coverage, and establish reasonable payment plans with professionalism and empathy
  • Data Entry & Recordkeeping: Enter patient and billing information into administrative systems
  • maintain precise and secure electronic records
  • Collaboration: Work closely with clinical staff, insurance representatives, and the finance department to resolve discrepancies and improve workflow
What we offer
What we offer
  • Competitive starting hourly wage with opportunities for advancement
  • Full medical, dental, and vision insurance
  • Paid time off, holidays, and 401(k) retirement plan with company match
  • Ongoing training in CPT, ICD-10, and insurance billing procedures with career growth into senior coding or revenue cycle roles
  • Fulltime
Read More
Arrow Right

Senior Quality Specialist

Acts as an advocate and subject matter expert guiding the business by serving as...
Location
Location
United States
Salary
Salary:
18.50 - 42.35 USD / Hour
https://www.cvshealth.com/ Logo
CVS Health
Expiration Date
December 23, 2025
Flip Icon
Requirements
Requirements
  • 2+ years of health insurance work experience and/or Healthcare Insurance Quality Review
  • 2+ years of experience working with diagnosis codes and medical terminology
  • Moderate to advanced knowledge of Excel (V-lookups, pivot tables, and/or formulas)
  • High School Diploma or equivalent GED
Job Responsibility
Job Responsibility
  • Acts as an advocate and subject matter expert guiding the business by serving as a quality champion through measuring and monitoring the quality and effectiveness of work processes in claim processing and customer service
  • Consults cross-functionally with other departments to influence and promote change, to continually deliver quality service to both internal and external customers
  • Performs regular quality audits for service operations for multiple products and platforms to drive full and consistent compliance to all required standards
  • Executes both routine and non-routine business support tasks for the Sr Quality Specialist area under limited supervision
  • Acts as a subject matter expert on Quality Specialist workflows, policies, systems requirements, and enhancements
  • Conducts standard quality reviews and audits to proactively measure and monitor team compliance with published policies, and procedures
  • Owns responsibility for supporting targeted quality audit projects, reporting overall results, and making recommendations regarding training needs, quality controls, and procedures to senior management
What we offer
What we offer
  • Affordable medical plan options
  • 401(k) plan with matching company contributions
  • Employee stock purchase plan
  • Wellness screenings
  • Tobacco cessation and weight management programs
  • Confidential counseling
  • Financial coaching
  • Paid time off
  • Flexible work schedules
  • Family leave
  • Fulltime
Read More
Arrow Right

Medical Accounts Receivable Specialist

This role is within the healthcare industry, where you will be crucial in assist...
Location
Location
United States , Jeffersontown, Kentucky
Salary
Salary:
Not provided
https://www.roberthalf.com Logo
Robert Half
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Proficient in Accounting Software Systems
  • Experience with ADP - Financial Services
  • Familiarity with CRM
  • Proficiency in Epic Software
  • Knowledge of ERP - Enterprise Resource Planning
  • Ability to handle Accounting Functions
  • Experience with Accounts Receivable (AR)
  • Proficient in Billing Functions
  • Capable of managing Cash Activity
  • Experience in Cash Handling
Job Responsibility
Job Responsibility
  • Oversee the processing of appeals by collecting necessary information and resubmitting claims
  • Manage the initiation of collection follow-ups for unpaid or rejected claims with the relevant Payer
  • Maintain a robust and positive relationship with team members and Payer representatives
  • Handle communication of payment or denial trending issues that impact revenue, to leadership
  • Take responsibility for reviewing unpaid claims and investigating reasons for payment delays
  • Handle the resolution of claim partial payments and denials with Payers
  • Engage insurance companies and attorneys to resolve any discrepancies and ascertain the status of bills to secure proper reimbursement
  • Review outstanding accounts receivables for assigned Payers and maintain the aging report
  • Ensure any necessary adjustments in accounts are processed accurately and promptly
  • Keep accurate customer credit records and process customer credit applications efficiently
What we offer
What we offer
  • medical, vision, dental, and life and disability insurance
  • eligible to enroll in our company 401(k) plan
  • Fulltime
Read More
Arrow Right
New

Billing Specialist

Location
Location
United States
Salary
Salary:
Not provided
paffordems.com Logo
Pafford EMS
Expiration Date
Until further notice
Flip Icon
Requirements
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
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
Read More
Arrow Right
Welcome to CrawlJobs.com
Your Global Job Discovery Platform
At CrawlJobs.com, we simplify finding your next career opportunity by bringing job listings directly to you from all corners of the web. Using cutting-edge AI and web-crawling technologies, we gather and curate job offers from various sources across the globe, ensuring you have access to the most up-to-date job listings in one place.