NewClinical Quality Improvement Specialist- Fairfax, VA Vitas HealthcareClinical Quality Improvement Specialist- Fairfax, VAFairfax, VAp>Performs quality monitoring activities (tracking, trending, and analysis) including, but not limited to: Hospice Quality Reporting Program (HQRP): data collection and analysis of data associated with HQRP components, including but not limited to: Consumer Assessment of Healthcare Providers and Systems survey (CAHPS), claims-based measures, Hospice Item Set and any future measures. Root Cause Analysis (RCA): co-facilitate RCA meeting with program management, ensure required documents are completed, document meeting on appropriate templates, submission of documents to required email distribution group, monitor effectiveness of corrective action plan and report outcomes to program leadership.
Senior Liability Claims Specialist CorVel Enterprise Claims, Inc.Senior Liability Claims SpecialistRockville, MD$61,053–$98,334 / yearPart timePay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).
Associate Claims Specialist - Workers Compensation - Central Region Liberty Mutual Holding Company IncAssociate Claims Specialist - Workers Compensation - Central RegionAlexandria, VARemotep>As a Workers Compensation Associate Claims Specialist, you will develops the knowledge and skills needed to conduct thorough investigations, make decisions about liability / compensability, evaluate losses, negotiate settlements and manage an inventory of commercial property/casualty and disability claims by participating in a comprehensive training program, one-on-one mentoring, and on-the-job training. Investigates new claims by reviewing first reports of loss and supporting materials, determines the best first point of contact (claimants, customers, witnesses, etc.) to gather information regarding injuries or loss refers tasks to auxiliary units as necessary and posts file accordingly.
Senior Claims Specialist I - Workers Compensation - Central Region Liberty Mutual Holding Company IncSenior Claims Specialist I - Workers Compensation - Central RegionAlexandria, VARemotep>Responsibilities: Plans and conducts investigations of claims (including such activities as interviewing insureds, witnesses and claimants, collecting and evaluating appropriate documentation and securing evidence and protecting the chain-of-custody) to analyze and confirm coverage and to determine liability, compensability and damages; determines need for, and engages independent adjusters, cause and origin experts and independent medical examiners. Demonstrates an advanced knowledge of claims case handling practices, legal liability, general insurance policy coverage, and the states tort laws as normally acquired through a bachelors degree (or equivalent training) plus 3 to 5 years directly related work experience.
Senior Liability Claims Specialist CorVel CorpSenior Liability Claims SpecialistRockville, MD$61,053–$98,334 / yearPay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. ABOUT CORVEL: CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries.
Liability Claims Specialist CorVel CorpLiability Claims SpecialistRockville, MD$52,999–$85,473 / yearPay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. ABOUT CORVEL: CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries.
Social Insurance Specialist (Claims Specialist) (ICTAP) (Temporary) Social Security AdministrationSocial Insurance Specialist (Claims Specialist) (ICTAP) (Temporary)DC$74,678–$121,371 / yearAdditional Telecommunications Relay Services options are available in each state: https://www.fcc.gov/general/trs-state-and-territories. In addition, they resolve discrepancies, clarify issues and make final decisions for initial and post-entitlement for benefits and payments; adjudicate and authorize entitlement or disallowance actions at all levels of difficulty and complexity under programs administered by SSA.
Field Office - Claims Specialist (Bilingual) (Spanish) Social Security AdministrationField Office - Claims Specialist (Bilingual) (Spanish)Camp Springs, MD$46,610–$91,815 / yearGS-7: One (1) year of specialized experience at the GS-5 level (or equivalent) that demonstrates the ability to (1) assist individuals in establishing their entitlement to receive benefits (e.g., retirement, disability, public aid, insurance, taxes, etc.); (2) adjudicate, authorize or reconsider claims; (3) explain benefit (e.g., retirement, disability, public aid, insurance, taxes, etc.) entitlements or requirements to the general public; (4) evaluate benefit (e.g., retirement, disability, public aid, insurance, taxes, etc.) program operations to assess the integrity and quality; or (5) interpret benefit (e.g., retirement, disability, public aid, insurance, taxes, etc.) program requirements to formulate policies, procedures or guidelines. If you are using experience to qualify, you must have: GS-5: Three years of general experience equivalent to the next lower grade level in the federal service that demonstrates the ability to 1) review problems to identify significant factors, gather pertinent data, and recognize solutions; 2) plan and organize work; and 3) communicate effectively orally and in writing.
Claims Specialist Sr - Professional Liability Sedgwick Claims Management Services, Inc.Claims Specialist Sr - Professional LiabilityVA$76,085–$125,000 / yearul>In-depth knowledge of appropriate medical malpractice insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security application procedures as applicable to line-of-business. Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines.
Senior Environmental Technical Claims Specialist Argo Group International Holdings IncSenior Environmental Technical Claims SpecialistMD$99,200–$118,100 / yearAlternatively, we are also open to consider candidates working from home anywhere in the continental United States This individual will report to a manager who works in New York City and is focused on adjudicating first and third party commercial environmental claims (mostly complex storage tank claims) and contributing to providing superb results for our clients. Boston metro area, California outside of Los Angeles & San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, New Jersey (outside of New York City metro area), New York State (outside of New York City metro area), Washington, D. C.
Senior Construction Defect Technical Claims Specialist Team Lead Argo Group International Holdings IncSenior Construction Defect Technical Claims Specialist Team LeadMDRemote$156,000–$187,500 / yearBoston metro area, California outside of Los Angeles & San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, New Jersey (outside of New York City metro area), New York State (outside of New York City metro area, including but limited to Albany county), Washington, D. C. Qualifications / Experience Required: A deep knowledge of construction defect claims adjudication, along with an exceptional focus on customer service, typically achieved through: A minimum of seven years' experience adjudicating construction defect claims with exposure of $100,000 or more.
Senior Construction Defect Technical Claims Specialist Argo Group International Holdings IncSenior Construction Defect Technical Claims SpecialistMDRemote$137,496–$164,934 / yearBoston metro area, California outside of Los Angeles & San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, New Jersey (outside of New York City metro area), New York State (outside of New York City metro area, including but limited to Albany county), Washington, D. C. Essential Responsibilities: Working under limited oversight under broad management direction, adjudicate construction defect claims at the highest authority limits on assignments reflecting the highest degree of technical complexity, potentially with major impact on departmental results.
Global Casualty Claims Specialist Under Armour IncGlobal Casualty Claims SpecialistBaltimore, MD$60,000–$80,000 / yearp>At Under Armour, we are committed to empowering those who strive for more, and the companys values - Act Sustainably, Celebrate the Wins, Fight on Together, Love Athletes and Stand for Equality - serve as both a roadmap for our teams and the qualities expected of every teammate. Handles a multitude of tasks simultaneously while maintaining focus and effectiveness, maintaining a high productivity level to maximize the productivity of the department leadership.
Sr. Claims Specialist BerkleySr. Claims SpecialistManassas, Virginia$110,000–$160,000 / yearWe provide a comprehensive portfolio of commercial property casualty insurance, automobile liability and workers’ compensation, along with claim services, providing expertise to meet the unique business needs of our customers. The company offers a competitive compensation plan and robust benefits package for full time regular employees which for this role include: • Base Salary Range: $110,000-$160,000 • Eligible to participate in annual discretionary bonus.
Associate Claims Specialist Liberty Mutual Holding Company IncAssociate Claims SpecialistAlexandria, VARemoteUnder direct supervision, develops the knowledge and skills needed to conduct thorough investigations, make decisions about liability / compensability, evaluate losses, negotiate settlements and manage an inventory of commercial property/casualty and disability claims by participating in a comprehensive training program, one-on-one mentoring, and on-the-job training. Investigates new claims by reviewing first reports of loss and supporting materials, determines the best first point of contact (claimants, customers, witnesses, etc.) to gather information regarding injuries or loss refers tasks to auxiliary units as necessary and posts file accordingly.
Stop Loss Claims Specialist Marsh McLennanStop Loss Claims SpecialistWashingtonp>The primary role of the Stop Loss Claims Analyst role is to manage the stop loss claims process for the MMA Stop Loss Center of Excellence including establishing the claims submission process in accordance with vendor processes, overall tracking and auditing to assure timely payment of eligible stop loss claims managed by the Center of Excellence. REQUIRED EDUCATION AND EXPERIENCE: Minimal of High School Graduate with Associate’s Degree in Risk Management & Insurance, Actuarial Science, Mathematics and/or other related field is preferred or equivalent experience preferred; Minimum of two years prior work experience the Benefits Brokerage, Consulting, or Insurance industry; Strong background in self-funding, stop loss or claims administration required.
Claims Recovery Specialist II (Remote) Blue Cross and Blue Shield AssociationClaims Recovery Specialist II (Remote)DCRemote$42,624–$78,144 / yearSpecialist will assist to maximize recovery amounts due to refund of payments made in error to members and/or providers, retro terms and/or focused provider audits. ESSENTIAL FUNCTIONS: Under supervision, reviews, audits, and/or initiates recovery efforts for medical, and/or dental claims to recover overpayments, ensuring all parts of the process are documented properly.
NewSenior Claims Benefit Specialist CVS Health CorpSenior Claims Benefit SpecialistMD$18.50–$42.35 / hourp>In this role, you will: Perform adjustments across all dollar amount levels on customer service platforms, specifically by using technical and claims processing expertise. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Social Insurance Specialist (Claims Technical Expert) (ICTAP) (Temp) Social Security AdministrationSocial Insurance Specialist (Claims Technical Expert) (ICTAP) (Temp)DC$89,508–$137,128 / yearExamples of specialized experience include functioning as a lead worker or performing quality control functions in reviewing caseloads (e.g., income maintenance, benefits, pension plans, health insurance, etc.); adjudicating, authorizing, investigating or reconsidering claims; and evaluating benefit programs to assess the integrity and quality of operations. Additional Telecommunications Relay Services options are available in each state: https://www.fcc.gov/general/trs-state-and-territories.
Senior Claims & Insurance Operations Specialist - US Free2moveSenior Claims & Insurance Operations Specialist - USWashington, District of ColumbiaYou will evolve in an ultra-dynamic, innovative, agile, internationally-focused structure and integrate our talented teams, full of ideas and motivation and with multidisciplinary skills, at the crossroads of the digital eco-system and the fast-changing automotive sector. Born from the merger of the Stellantis Group and the start-up TravelCar, Free2move, thanks to its agility and its spirit of conquest has managed to establish itself in just few years as a reference player to revolutionize the mobility of all travellers.
Claims Loss Specialist Restoration Estimator & Project Manager PuroClean Metropolitan WashingtonClaims Loss Specialist Restoration Estimator & Project ManagerRockville, Marylanddiv>Please submit your resume and a brief summary of your relevant experience in estimating, project management, restoration, reconstruction, construction, commercial work, multifamily work, or property claims.Flexible work from home options available. The Claims Loss Specialist is expected to take ownership of assigned jobs, prepare accurate estimates, communicate with all parties involved, sell the job and help manage the project through production and closeout.
Veterans Claims Examiner (Training/Quality Specialist) U.S. Department of Veterans AffairsVeterans Claims Examiner (Training/Quality Specialist)DC$93,598–$121,680 / yearInformation about CTAP eligibility is on OPMs Career Transition Resources website at http://www.opm.gov/policy-data-oversight/workforce-restructuring/employee-guide-to-career-transition/. Please visit the Human Resources and Administration/Operations, Security, and Preparedness (HRA/OSP), https://www.va.gov/EMPLOYEE/docs/The-Fair-Chance-to-Compete-Act.pdf.
NewAssociate Claims Clinical Specialist Genworth Financial IncAssociate Claims Clinical SpecialistVA$55,800–$81,000 / yearYou will be part of a remote team of clinicians that spend their days reviewing clinical assessments completed by field assessors and writing Plans of Care for Long Term Care Insurance and other government sponsored insurance plans. CareScout is a wholly owned subsidiary of Genworth Financial, Inc, a Fortune 500 provider of products, services and solutions that help families address the financial challenges of aging.
Claims Loss Specialist Restoration Estimator & Project Manager PuroSystems LLCClaims Loss Specialist Restoration Estimator & Project ManagerRockville, MD$60,000–$80,000 / yearThe Claims Loss Specialist is expected to take ownership of assigned jobs, prepare accurate estimates, communicate with all parties involved, sell the job and help manage the project through production and closeout. Please submit your resume and a brief summary of your relevant experience in estimating, project management, restoration, reconstruction, construction, commercial work, multifamily work, or property claims.
Claim Specialist - Property Field Inspection State FarmClaim Specialist - Property Field InspectionSilver Spring, Maryland$64,965.62–$99,000 / yearp style="margin:0px">Visit our State Farm Careers page for more information on our benefits, locations, and the hiring process of joining the State Farm team!. Competitive candidates should reside within one of the listed zip codes and will service this same territory: 20812 20814 20815 20816 20817 20818 20832 20833 20850 20851 20852 20853 20854 20855 20860 20889 20895 20896 20899 20901 20902 20903 20904 20906 20910 20912.
Field Claims Adjuster III, PL Property (Flex Team) Nationwide Mutual Insurance CoField Claims Adjuster III, PL Property (Flex Team)Baltimore, MD$79,500–$148,500 / yearNationwide pays on a geographic-specific salary structure and placement within the actual starting salary range for this position will be determined by a number of factors including the skills, education, training, credentials and experience of the candidate; the scope, complexity and location of the role as well as the cost of labor in the market; and other conditions of employment. Qualifications: · 5 years of insurance field/property claims handling or adjusting experience · Solid experience/proficiency with Xactimate · Solid experience writing own estimates and handling claims start to finish · Strong customer service competency · Strong written & verbal communication skills.
Claims Adjuster II, Field Property - National Catastrophe Nationwide Mutual Insurance CoClaims Adjuster II, Field Property - National CatastropheWashington$62,500–$115,500 / yearNationwide pays on a geographic-specific salary structure and placement within the actual starting salary range for this position will be determined by a number of factors including the skills, education, training, credentials and experience of the candidate; the scope, complexity and location of the role as well as the cost of labor in the market; and other conditions of employment. In this role, you'll conduct on-site inspections, evaluate property damages, determine policy coverage, and make timely, accurate decisions using a variety of tools and resources, including vendor estimates, independent adjusters, and self-written assessments.
Claims Representative I Elevance HealthClaims Representative IMarylandApplicants who require accommodation to participate in the job application process should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact. Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.
Claims and Finance Lead - Washington, DC - Onsite Gainwell Technologies LLCClaims and Finance Lead - Washington, DC - OnsiteDCRemote$35,900–$51,300 / yearGainwell Technologies defines "wages" and "wage rates" to include "all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits. Education & Experience: Bachelor's degree (or equivalent experience) in Business, Finance, Accounting, Healthcare Administration, or a related field; 5-7+ years in claims resolution, financial operations, or related roles, including 2-3+ years of leadership experience.
Senior Claim Benefit Specialist - Remote CVS Health CorpSenior Claim Benefit Specialist - RemoteDCRemote$18.50–$42.35 / hourOur teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Applies medical necessity guidelines, determines coverage, verifies eligibility, identifies discrepancies, and implements cost‑containment measures to support accurate claim adjudication.
Medical Claims Processor II- Baltimore City Fire & Police Employees Retirement System City of BaltimoreMedical Claims Processor II- Baltimore City Fire & Police Employees Retirement SystemBaltimore, MD$57,978–$94,498 / yearExperience: Have three years of experience in medical claims or ambulance services billing and collection work in a workers' compensation unit, ambulance services billing unit, hospital, health maintenance organization or insurance firm. Eligible candidates under final consideration for appointments to positions identified as positions of trust will be required to complete authorization for a Criminal Background Check and/or Fingerprint must be successfully completed.
Claims Investigator - Part Time Allied UniversalClaims Investigator - Part TimeCollege Park, MD$24–$28 / hourClaim Investigators validate the facts of loss for Insurance claims through scene Investigations, claimant and witness Interviews, document retrieval and data Interpretation. Associate's degree in Criminal Justice with a minimum of four (4) years of demonstrated experience conducting complex insurance investigations or adjusting complex claims.
Claim Benefit Specialist CVS Health CorpClaim Benefit SpecialistWork At Home, DC$17–$28.46 / hourAnalyzes claims data and generate reports to identify trends, patterns, or areas for improvement to help inform process enhancements, policy changes, or training needs within the claims processing department. Performs claim documentation review, verifies policy coverage, assesses claim validity, communicates with healthcare providers and policyholders, and ensures accurate and timely claims processing.
Senior Consultant- Epic Resolute Hospital Billing Claims and Remittance Deloitte Touche Tohmatsu LtdSenior Consultant- Epic Resolute Hospital Billing Claims and RemittanceVA$91,000–$143,000 / yearBuilds rapport and always promotes teamwork by maintaining a professional and positive attitude, working to maintain open and professional lines of communication with all end users and colleagues, and utilizing key change management principles. Our Industry Solutions team brings clients the knowledge of industry leaders who understand the relevant processes and technologies for their industry-and apply them with a process and mindset that tailors transformational change to their specific organization.
Technical Specialist, Construction Claim The Travelers Companies IncTechnical Specialist, Construction ClaimChantilly, VA$85,600–$141,200 / yearDirectly investigate each claim through prompt and strategically-appropriate contact with appropriate parties such as policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent of liability, damages, and contribution potential. Actively engages in the identification, selection and direction of appropriate internal and/or external resources for specific activities required to effectively evaluate claims, such as Subrogation, Risk Control, nurse consultants, and fire or fraud investigators, and other experts.
Senior Property Adjuster (Commercial Property Claims) - Washington, DC Engle Martin & Associates, Inc.Senior Property Adjuster (Commercial Property Claims) - Washington, DCDCPHYSICAL ACTIVITIES AND REQUIREMENTS: In addition to the working conditions and associated physical activities and requirements above, the incumbent may be required to climb, balance, stoop, kneel, crouch, crawl, reach, stand, walk, push, pull, lift, finger, grasp, or feel, especially in the course of investigating and assessing property damage; these requirements may include the need to lift weights of up to 50 pounds, including a ladder. The work requires close visual acuity, with or without correction, to prepare reports containing words, symbols, and numerical figures; the incumbent is required to view a computer terminal, use a keyboard, read printed documents, make detailed visual inspections, perceive color, perceive depth, and have a sufficient field of vision to carry out all inspection and related duties.
Sr Claims Reviewer TriWest Healthcare AllianceSr Claims ReviewerBaltimore, MDRemoteFull timeProficient with claim and coding tools such as Supercoder, Clinical Decision Support Tool, Current Procedural Terminology, Health Care Financing Administration Common Procedure Coding System, and American Dental coding. This role will serve as a SME and will collaborate with Claims leadership, Training, the Claims Content Specialist, and internal business partners to ensure procedures and training materials are accurate and complete.
NewMedical Biller/Collections Specialist Independent Dialysis Foundation, Inc.Medical Biller/Collections SpecialistBaltimore, Maryland$25–$35 / hourThe ideal candidate possesses strong knowledge of insurance billing, excellent organizational skills, and the ability to independently manage multiple priorities while working collaboratively with our accounting and clinical teams. If you are an experienced medical billing professional who enjoys solving complex reimbursement issues and making a meaningful impact within a mission-driven healthcare organization, we encourage you to apply.
Medical Billing Specialist AudigyMedical Billing SpecialistWashingtonLeveraging your strong attention to detail and at least three years of experience in billing for primary care or specialty medicine, you will be responsible for managing accounts receivable, investigating and resolving insurance claims, and supporting our commitment to outstanding customer service. Participates in educational activities and enhances knowledge and skills to keep up to date of current coding changes, fee schedules, and applicable state and federal programs as they relate to claim submission.
Certified Medical Billing & Coding Specialist CLINICA FAMILIAR DE ARLINGTONCertified Medical Billing & Coding SpecialistFalls Church, VAThe ideal candidate is detail-oriented, organized, and experienced with insurance claims, coding accuracy, and revenue cycle workflows. We are seeking a Certified Medical Billing & Coding Specialist to join our busy healthcare practice.
Revenue Recovery Specialist, MVA RSource LLCRevenue Recovery Specialist, MVAMDRemoteThe Opportunity: Manage an inventory of accounts in a team-based environment for medical payments, third-party liability, and health benefits coverage to include: • New and priority accounts to be worked within client specified protocols, including coverage investigation. A specialist must be able to multi-task, prioritize as necessary to timely resolve account for payment, and maintain a high level of professionalism during all correspondence with auto payers, health payers and attorneys daily.
Temporary Billing Specialist My PsychiatristTemporary Billing SpecialistFalls Church, VirginiaContact insurance companies by phone, email, fax, and written correspondence to resolve issues preventing claims from being processed correctly, including verifying benefits and eligibility dates. Working various denials from insurances including coverage in question, medical necessity, bundling, non-covered procedures, incorrect coding, credentialing, etc.
Senior Medical Coding Specialist (Remote) Blue Cross and Blue Shield AssociationSenior Medical Coding Specialist (Remote)DCRemote$67,464–$133,991 / yearThis role utilizes coding expertise, combined with medical policy, credentialing, and contracting rules knowledge, to build effective guidelines and resources for providers on the expected methodologies for billing and code submissions to maximize quality and STARs outcomes while not compromising payment integrity. Consults with various teams, including the Practice Transformation Consultants, Medical Policy Analysts and Provider Networks colleagues to interpret coding and documentation language and respond to inquiries from providers.
Junior Revenue Cycle Management (RCM) Specialist - Hybrid Bethesda, MD CareTalk HealthJunior Revenue Cycle Management (RCM) Specialist - Hybrid Bethesda, MDNorth Bethesda, MDThe notice explains the categories of personal information we collect, how we use and retain it, whether we sell or share it, and your privacy rights under California law: https://caretalkhealth.com/california-privacy-notice. • 1–2 years of experience in revenue cycle management, medical billing, claims follow-up, accounts receivable, or a related healthcare administrative role (preferred).
NewLegal Administrative Specialist U.S. Department of Veterans AffairsLegal Administrative SpecialistWashington, DC$50,460–$80,243 / yearCUSTOMER SERVICE: Works with clients and customers (that is, any individuals who use or receive the services or products that your work unit produces, including the general public, individuals who work in the agency, other agencies, or organizations outside the Government) to assess their needs, provide information or assistance, resolve their problems, or satisfy their expectations; knows about available products and services; is committed to providing quality products and services. Please use this checklist to make sure you have included other documents required for your application, such as a copy of your transcript (if using education to qualify), SF-50s (current/former Federal employees), documentation to support Veterans Preference claims, or ICTAP/CTAP documentation (for displaced Federal employees).
Patient Accounts Specialist II - Physicians Billing MedStar Health Research InstitutePatient Accounts Specialist II - Physicians BillingMDRemote$20.57–$36.27 / hourp>Under general supervision, performs accounts receivable follow-up/collection procedures to obtain timely reimbursement from third party carriers and other payment sources on moderately complicated invoices in a Direct Contract assignment and/or with an invoice balance. Knowledge, Skills, and Abilities: Effective negotiating skills to include ability to resolve complex billing and collection situations with individual patients or third-party payers.
Patient Access Specialist - UVA Health Haymarket Emergency Department University of VirginiaPatient Access Specialist - UVA Health Haymarket Emergency DepartmentVA2023-2024 U.S. News & World Report "Best Hospitals" guide rates UVA Health University Medical Center as "High Performing" in 5 adult specialties and 14 conditions/procedures. These jobs focus on managing the financial aspects of patient care, including billing, insurance claims, payment processing, financial counseling, utilization and revenue cycle analysis.
Billing & Reconciliation Specialist Release RecoveryBilling & Reconciliation SpecialistWashington, DC$65,000–$75,000This individual will work closely with the Director of Business Operations and Director of Revenue Operations to ensure that cash pay invoicing, contracting, and insurance claims are accurate, timely, and reimbursed in full. Manage extension requests and contracts, including communication with clients and guarantors regarding billing questions and account needs.
Medical Collections Specialist HCA Healthcare IncMedical Collections SpecialistReston, VAWhat you will do in this role:You will perform follow up activities on accounts to ensure prompt paymentYou will identify coding or billing errors from EOBs and work to correct themYou will monitor insurance claims and contact insurance companies to resolve claims You will update the patient account record to identify actions takenYou will assign bad debt accounts to the collection agency You will act as a liaison and administer contracts in collection of third party accounts (Medicare and Medicaid)You will complete account reconciliation of accounts turned over to outside agenciesYou will negotiate payment plans on self-pay accounts You are responsible for maintaining accounts receivable and creating a reduction in bad debt Qualifications you will need:Minimum (1) year of experience in a medical office setting highly preferred. Referral services for child, elder and pet care, home and auto repair, event planning and more Consumer discounts through Abenity and Consumer Discounts Retirement readiness, rollover assistance services and preferred banking partnerships Education assistance (tuition, student loan, certification support, dependent scholarships) Colleague recognition program Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence) Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.
Coding Specialist III - Plastics/Podiatric Surgery MedStar Health Research InstituteCoding Specialist III - Plastics/Podiatric SurgeryMD$28.76–$48.96 / hourli>Handles complex coding case review including but not limited to surgical coding (Orthopaedics Cardiac Neurosurgery Otolaryngology etc.) extraction, co-surgery scenarios, multi-visceral transplant cases, comorbidity evaluation. In addition to interacting with physicians on coding issues, ensures that physician encounter forms, the GE IDX billing system and processes are up to date and compliant regarding coding issues.