Payments Claim Specialist Job at Robert Half (Los Angeles)

Retail Payments Specialist

This hybrid position will be located at our Corporate Office in Camp Hill, PA. E...

Location

United States , Camp Hill

Salary:

21.00 - 24.00 USD / Hour

Foot Locker

Expiration Date

Until further notice

Requirements

Minimum education requirement: High School Diploma or equivalent
Prior experience in an operations role helpful
Proficient in Microsoft Office Suite products (i.e. Word, PowerPoint, and especially Excel)
Excellent verbal and written communication and organizational skills
Proficient computer use experience and ability to learn new software and systems
Detail-oriented and organized
Ability to work both independently and collaboratively
Proactive, adaptable, and committed to delivering results

Job Responsibility

Monitor, track, and address day-to-day armored car operations such as missed pickups and change order discrepancies
Create and manage cases in external vendor platforms for cash-in-transit concerns and follow up as necessary
Address ServiceNow tickets submitted by the store teams relating to safe issues and missed pickups
Work with the banking team to track outstanding claims
Export reporting from external vendor platforms
Participate in weekly/monthly meetings with our armored car vendors
discuss concerns as necessary
Assist the department on other operational tasks

What we offer

Employee Discount
Paid Time Off
Medical | Dental | Vision Coverage
401(k) | Roth 401(k)
Life Insurance
Flexible Spending Account
Paid Parental Leave
Opportunities for Advancement
Tuition Reimbursement for Qualified Courses
Strong Company Culture

Fulltime

Senior Claim Benefit Specialist

We’re building a world of health around every individual — shaping a more connec...

Location

United States , Work at Home

Salary:

18.50 - 42.35 USD / Hour

CVS Health

Expiration Date

Until further notice

Requirements

Minimum of 18 months of medical claim processing experience with a health insurance payor or third‑party administrator
Proven success working in a high‑volume, production‑driven environment
Demonstrated ability to manage multiple assignments with accuracy, efficiency, and attention to detail
High School Diploma required

Job Responsibility

Reviews and adjudicates complex, sensitive, and specialized medical claims in accordance with established plan processing guidelines
Functions as a subject matter expert by providing coaching, and offering guidance on escalated or technically challenging issues
Supports customer service operations by addressing inquiries and resolving issues to ensure a positive member experience
Reviews pre‑specified claims and those that exceed specialist adjudication authority or processing expertise
Applies medical necessity guidelines, determines coverage, verifies eligibility, identifies discrepancies, and implements cost‑containment measures to support accurate claim adjudication
Ensures compliance with all regulatory requirements and confirms that payments align with company policies and procedures
Identifies and reports potential overpayments, underpayments, and other claim irregularities
Performs claim rework calculations as needed
Trains and mentors as needed to enhance team performance and technical proficiency
Conducts outbound calls to obtain required information for claims or reconsideration requests

What we offer

Medical, dental, and vision coverage
Paid time off
Retirement savings options
Wellness programs

Fulltime

Senior Claim Benefit Specialist

We’re building a world of health around every individual — shaping a more connec...

Location

United States

Salary:

18.50 - 42.35 USD / Hour

CVS Health

Expiration Date

Until further notice

Requirements

Minimum of 18 months of medical claim processing experience with a health insurance payor or third‑party administrator
Proven success working in a high‑volume, production‑driven environment
Demonstrated ability to manage multiple assignments with accuracy, efficiency, and attention to detail
High School Diploma required

Job Responsibility

Reviews and adjudicates complex, sensitive, and specialized medical claims in accordance with established plan processing guidelines
Functions as a subject matter expert by providing coaching, and offering guidance on escalated or technically challenging issues
Supports customer service operations by addressing inquiries and resolving issues to ensure a positive member experience
Reviews pre‑specified claims and those that exceed specialist adjudication authority or processing expertise
Applies medical necessity guidelines, determines coverage, verifies eligibility, identifies discrepancies, and implements cost‑containment measures to support accurate claim adjudication
Ensures compliance with all regulatory requirements and confirms that payments align with company policies and procedures
Identifies and reports potential overpayments, underpayments, and other claim irregularities
Performs claim rework calculations as needed
Trains and mentors as needed to enhance team performance and technical proficiency
Conducts outbound calls to obtain required information for claims or reconsideration requests

What we offer

Affordable medical plan options
401(k) plan (including matching company contributions)
Employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance

Fulltime

New

Billing Specialist

This is a full-time position with full benefits (health, dental, vision, 403B, p...

Location

United States , Shrewsbury

Salary:

26.44 - 31.25 USD / Hour

Veterans Inc.

Expiration Date

Until further notice

Requirements

Associate degree in Healthcare Administration, Business Administration, Accounting, Finance, or related field preferred
Equivalent work experience may be substituted for formal education
Minimum of five (5) years of healthcare billing experience
Minimum of three (3) years of experience in insurance verification, authorizations, billing support, claims preparation, or payer relations
Experience in Behavioral Health and/or Substance Use Disorder services strongly preferred
Experience working with MassHealth, Medicare, Medicaid Managed Care Organizations, and commercial insurance plans
Must be able to successfully pass a CORI/Background records check
Compliance with Veterans Inc. COVID-19 Vaccination Policy

Job Responsibility

Verify coverage: Confirm insurance eligibility, benefits, and payer-specific requirements for all new admissions and existing clients
Update systems: Maintain precise insurance records within the EHR and communicate coverage limitations or authorization needs to staff
Secure approvals: Obtain, track, and maintain authorizations for behavioral health and substance use disorder (SUD) services
Coordinate tracking: Manage expiration dates, submit Notices of Admission (NOAs), and collaborate with utilization review to prevent gaps in coverage
Audit accounts: Review documentation and authorizations prior to claim submission to prevent payment delays
Partner with contractors: Coordinate directly with the agency's external billing contractor to resolve edits, corrections, and claim issues
Stay compliant: Ensure all billing aligns with MassHealth, Medicare, Medicaid MCOs, commercial guidelines, BSAS, and HIPAA regulations
Act as an expert: Research payer updates and serve as the internal resource for evolving billing policies
Analyze trends: Identify systemic billing errors or authorization issues contributing to claim denials
Improve processes: Partner across admissions, clinical, and finance teams to implement process improvements that protect revenue

What we offer

BCBS Medical, Dental, and Vision Insurance
Employer Paid Short and Long-Term Disability and Life Insurance
$2500 Medical Opt-Out program if you have medical coverage through another source
Retirement Plan (403B) with a $2000 Match
Flexible Spending Accounts
Tuition Reimbursement Program
Paid Parental Leave

Fulltime

New

Medical Billing Specialist

We are looking for a detail-oriented Medical Billing Specialist to support reven...

Location

United States , Charlotte

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Experience in medical billing, including claim submission, denial review, and payment follow-up
Working knowledge of medical coding principles and the ability to recognize and correct claim-related errors
Background in medical collections and account resolution within a healthcare billing environment
Familiarity with medical claims processing and payer reimbursement procedures
Experience using EPACES or similar eligibility and claims support systems
Strong customer service skills with the ability to handle billing inquiries clearly and professionally
High attention to detail, solid organizational skills, and the ability to manage deadlines effectively

Job Responsibility

Review denied and rejected medical claims, identify the source of billing or coding discrepancies, make necessary corrections, and submit claims again within required timeframes
Confirm patient insurance eligibility and benefit details before services are provided to help prevent avoidable claim issues and support accurate cost estimates
Apply medical billing and coding knowledge to ensure claim information is complete, compliant, and aligned with payer requirements
Monitor claim status and pursue outstanding balances through consistent follow-up with insurance carriers and other payers
Support collection efforts by investigating unpaid accounts and coordinating appropriate next steps for resolution
Use billing platforms and tools such as EPACES to access coverage information, review claim activity, and maintain accurate account updates
Communicate clearly with patients, payers, and internal teams to address billing questions and resolve account concerns professionally

What we offer

Medical, vision, dental, and life and disability insurance
Company 401(k) plan

Parttime

Insurance Follow-Up Specialist

We are looking for an Insurance Follow-Up Specialist to join a healthcare revenu...

Location

United States , Danville

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Experience handling insurance follow-up within a medical billing, revenue cycle, or healthcare accounts receivable environment
Working knowledge of accounts receivable processes, claim status review, denial resolution, and payer reimbursement workflows
Ability to interpret payer requirements and apply billing corrections with a high degree of accuracy
Comfortable navigating payer websites, clearinghouse tools, and other online resources used for eligibility and claim research
Strong attention to detail with the ability to identify registration, charge, or billing discrepancies before they affect payment
Effective time management skills and the ability to maintain productivity while working a high-volume follow-up queue
Clear written and verbal communication skills for coordinating claim issues and payment resolution
Familiarity with healthcare billing standards, remittance review, and insurance payment adjustment practices

Job Responsibility

Prepare and submit initial insurance claims through both electronic platforms and paper processes, ensuring bills are sent out accurately and on schedule
Examine claim details before submission to confirm charges, coding-related edits, and billing data align with payer expectations
Apply current knowledge of payer-specific billing rules to identify issues, make needed corrections, and reduce avoidable denials or delays
Use payer portals and online resources to verify coverage, monitor claim progress, and stay informed on updates that may affect reimbursement
Manage daily accounts receivable work queues to pursue unpaid insurance balances and support prompt collection of outstanding amounts
Investigate payer denials, rejections, and clearinghouse responses, coordinate corrections, and resubmit claims or route balances appropriately when needed
Review patient registration and account information for completeness and accuracy to help prevent downstream billing errors
Process insurance credit balances correctly and support departmental expectations for quality, productivity, and follow-up performance

What we offer

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

Medical Billing Specialist

We are seeking a detail-oriented Medical Biller with strong customer service ski...

Location

United States , Charlotte

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

1+ years of experience in medical billing, medical collections, or healthcare revenue cycle
Strong customer service skills with experience communicating sensitive financial information
Ability to explain billing concepts clearly to patients and non-technical audiences
High attention to detail and accuracy in data entry and claim processing
Strong problem-solving skills and ability to handle difficult conversations professionally
Working knowledge of medical billing codes (ICD-10, CPT, HCPCS preferred)
Experience with medical billing systems and electronic health records (EHR)
Reliable, organized, and able to manage multiple priorities in a fast-paced environment

Job Responsibility

Process and submit medical claims accurately and timely to insurance carriers
Review patient accounts and insurance payments to ensure correct posting and follow-up
Respond to patient billing inquiries with professionalism, empathy, and clear explanations
Resolve billing issues, payment discrepancies, and rejected or denied claims
Coordinate with insurance companies, providers, and internal teams to resolve account issues
Maintain accurate documentation and notes within billing systems
Follow HIPAA guidelines and maintain confidentiality of patient information

What we offer

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

Parttime

Reimbursement Specialist

In this role you will perform Reimbursement Specialist duties for assigned terri...

Location

United States , Saint Paul

Salary:

49600.00 - 68200.00 USD / Year

Baxter

Expiration Date

Until further notice

Requirements

3+ years of industry experience, preferably in health insurance and/or durable medical equipment
Third party payer experience strongly preferred
Exceptional written, verbal, and interpersonal communications
Strong critical thinking and problem-solving skills
Detail orientated and ability to multi-task
Ability to work independently as well as in a team environment
Possess the ability to manage time and prioritize critical priorities
Proficiency in Microsoft Office Software
Experience with Total Information Management System (TIMS) a benefit

Job Responsibility

Perform verification of eligibility and benefits to determine coverage and payer requirements
Ensure all benefit information is loaded correctly to reduce rework and allow for clean claims
Gather clinical documentation to support medical necessity for Cardiology products and assess clinical documentation to ensure all applicable prescription, face to face, and coverage criteria requirements are met
Prepare and submit prior authorization requests to insurance companies including commercial payers as well as government payers including Medicare and Medicaid
Process authorization decisions from payers timely to streamline and drive revenue
Negotiate payment rates for letter of agreement to ensure maximum collection potential
Provide a superior customer experience by leveraging ability to discuss payer policies, coverage criteria, benefit limitations, potential cost, or any pertinent product information with patients and healthcare teams
Understand and adhere to all policies for Baxter and 3rd party payers to ensure the highest standards of quality and compliance

What we offer

Medical and dental coverage that start on day one
Insurance coverage for basic life, accident, short-term and long-term disability, and business travel accident insurance
Employee Stock Purchase Plan (ESPP), with the ability to purchase company stock at a discount
401(k) Retirement Savings Plan (RSP), with options for employee contributions and company matching
Flexible Spending Accounts
Educational assistance programs
Time-off benefits such as paid holidays, paid time off ranging from 20 to 35 days based on length of service
Family and medical leaves of absence
Paid parental leave
Commuting benefits

Fulltime

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Payments Claim Specialist

Job Description

Job Responsibility

Requirements

What we offer

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