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Summary: AS A BILLING SPECIALIST I, you'll be responsible for billing and collecting patient accounts receivable balances from the insurance companies in a prompt and efficient manner. This position interprets all contracts and determines the correct and timely payment and ensures the work-flow of the billing department runs smoothly.

Penn Highlands Healthcare

Billing Specialist Physician Billing

The Patient Estimate Specialist works closely with scheduling, Patient Access, Financial Counseling, clinical departments, coding, billing, and other Revenue Cycle teams to ensure patients receive clear and accurate information regarding their anticipated financial responsibility prior to receiving services. This position serves as a subject matter resource for the Good Faith Estimate (GFE) process for uninsured and self-pay patients, as well as estimates for insured patients based on available insurance benefits, contracted rates, patient responsibility, and University Health pricing.

Truman Medical Centers

Patient Estimate Specialist

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We envision vibrant and healthy communities supported by inclusive healthcare that embraces each member's unique culture, needs, and values, and emboldens them to make healthful choices that fuel their well-being and the well-being of others. Communicating with payers, providers, and other entities to quickly and accurately obtain or provide information beneficial to the credentialing or enrollment needs of the organization.

Union Community Care

Billing/Payer Enrollment Specialist (63202)

We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE). Responsibilities: · Verifies or obtains patient eligibility and/or authorization for healthcare services performed by searching payer web sites or client eligibility systems, or by conducting phone conversations with the insurance carrier or healthcare providers.

Savista

AR Specialist 2

This position is responsible for handling day-to-day technical billing questions from team, training/re-training staff and/or new hires, reviewing demographics, running eligibilities, preparing and submitting claims to appropriate insurances, corresponding with patients, reviewing and analyzing accounts receivable balances, and other duties as assigned to support the Billing Department. Field patient phone calls, take patient payments, set up payment plans, review and research patient accounts for purposes of identifying billing trends and maintaining a clean AR aging.

HOUR

The Primary Health Network

Lead Billing Specialist

irecruit

Submit clean, accurate ambulance claims in a timely manner Ensure compliance with CMS ambulance billing guidelines Review documentation for medical necessity, PCS forms, narratives, and mileage Manage accounts receivable and aggressively follow up on unpaid claims Resolve denials, underpayments, and rejections Prepare and submit appeals as needed Post and reconcile payments accurately Identify trends in denials and underpayments and recommend corrective actions Communicate with operations regarding documentation deficiencies Track and report billing KPIs, including clean claim rate and A/R aging Assist with audits, payer requests, and compliance reviews Required Qualifications (Non-Negotiable) Minimum 1 year of ambulance/medical billing experience OR NAAC Certified Ambulance Coder Strong knowledge of: o Medicare and MA ambulance billing guidelines o Managed care plans o Levels of Service Billing requirements o PCS forms and medical necessity documentation o Modifiers, base rates, and mileage billing o Strong Working knowledge of ICD-10 diagnosis codes Proven experience with denial management and appeals Ability to independently manage A/R and follow-ups High attention to detail and strong organizational skills Knowledge of HIPAA and Patient Privacy and Compliance Laws. The Ambulance Billing Specialist is responsible for managing the complete billing lifecycle, including charge entry, claim submission, denial management, appeals, payment posting, and accounts receivable follow-up.

Billing Specialist Clearfield EMS

Skills/Knowledge: Required: Pharmacy insurance and benefit verification, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills. Pharmacy Benefit Verification Summary The Benefit Verification Specialist will investigate, review, and load accurate patient insurances, including medical and pharmacy coverage, assign coordination of benefits, run test claims to obtain a valid insurance response on patient medications, investigate/identify authorization requirements needed to obtain medication coverage, and enroll eligible patients in copay card assistance programs.

Onco360

Pharmacy Benefit Verification Specialist

This position involves verifying insurance coverage for proposed dental treatments, preparing, and submitting predetermination requests, and communicating with patients to provide estimates of insurance benefits. Accurately create, batch, and send dental claims to insurance companies within 72 hours of the patient's date of service.

Smilebuilderz LLC

Dental Billing Specialist

The Billing Operations Specialist works closely with Pharmacy Benefit Manager (PBM) and payers to determine billing guidelines for PANTHERx Rare Pharmacy as well as makes collection calls daily on assigned accounts that are past due. If you are looking for a career in the healthcare field that embraces authentic dedication to patient care, you don’t need to look beyond PANTHERx.

Pantherx Specialty LLC

Pharmacy Billing Operations Specialist

clearcompany

Alabama - Home Teleworkers, Alabama - Home Teleworkers, Arizona - Home Teleworkers, Arkansas - Home Teleworkers, California - Home Teleworkers, Colorado - Home Teleworkers, Connecticut - Home Teleworkers, Delaware - Home Teleworker, District of Columbia - Home Teleworkers, Florida - Home Teleworkers, Georgia - Home Teleworkers, Idaho - Home Teleworkers, Illinois - Home Teleworkers, Indiana - Home Teleworkers, Iowa - Home Teleworkers, Kansas - Home Teleworker, Kentucky - Home Teleworkers, Louisiana - Home Teleworkers, Maine Home Teleworkers, Maryland - Home Teleworkers, Massachusetts - Home Teleworkers, Michigan - Home Teleworkers, Minnesota - Home Teleworkers, Mississippi - Home Teleworker, Missouri - Home Teleworker {+ 20 more}. Actively shapes our company culture through words and actions (e.g., supporting employee resource groups, mentoring employees, volunteering, joining cross-functional projects, encouraging team member involvement in these activities).

YEAR

CSAA Insurance Group is an insurance company that offers automobile and other personal lines of insurance to AAA members.

CSAA Insurance Group

Sr. Litigation Specialist (Remote)

Role Summary: Responds to medical record requests from insurance carriers at varying stages of claim processing as an integral part of recognizing the maximum reimbursement from each claim. Intermediate level of expertise using Microsoft Office Suite (Outlook, Excel, Word, Teams) and PDF software (NitroPro).

MPOWERHealth

Mailroom Specialist

Betterteam

The successful candidate will bring strong attention to detail, excellent communication skills, and relevant healthcare billing experience, along with the ability to collaborate effectively with Finance, Health Services, residents, and external partners. Adjacent to famous Longwood Gardens, residents and staff enjoy the local cultural opportunities, vibrant towns, and working in an oasis in the heart of the Brandywine valley.

Kendal-Crosslands Communities Careers

Billing and Reimbursement Specialist

Parties which may be contacted to resolve an outstanding balance include but are not limited to patients, responsible parties, insurance carriers, case managers, employers, referring physician, attorneys and facility personnel. As part of our commitment in creating a fair, efficient, and consistent hiring process we may use artificial intelligence (AI) to help our recruiting teams organize, summarize, and analyze information provided by candidates, including resumes, application responses, and other materials submitted during the application process.

THE WRIGHT CENTER

Supervisor, AR Medical Payment Specialist

Additional Data: Select Medical strives to provide our employees with a solid work-life balance, as we understand that happy employees have both fulfilling careers and fulfilling lives beyond our doors. Performs all necessary collection efforts with Medicare and the Commercial/Medicaid payers to obtain correct payment for services rendered in a timely manner.

Superior quality and care. Compassion and Respect. Results oriented. Teamwork. Resourcefulness. These are the core values upon which Select Medical was built. Since its founding in 1996, Select Medical has passionately focused on providing superior, patient-centered care that improves quality of life.Co-founded by Rocco Ortenzio and Robert Ortenzio, Select Medical began as a regional provider of outpatient physical rehabilitation. Contract therapy was added to the company's specialized health care offerings in 1997, and was quickly followed by the introduction of long-term acute care in 1998. In 1999, Select Medical made one of its largest acquisitions by purchasing NovaCare Physical Rehabilitation and Occupational Health. In three years, Select Medical had grown from a small start-up into a diversified health care company with a national presence. This progressive yet responsible growth was one attribute that led to the company's recognition as one of the Best Managed Companies in America by Forbes magazine.

Select Medical

Medicare Exhaust Specialist

[AW]-iCims

Savista partners with healthcare providers to improve their financial strength by implementing integrated spend management and revenue cycle solutions that help control cost, improve margins and cash flow, increase regulatory compliance, and optimize operational efficiency. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE).

AR Specialist 2- Complex Clinical Denials

Job Summary: The Pharmacy Billing Representative will ensure timely and accurate billing for unbilled claims and ensure account payment for outstanding balances while demonstrating excellent customer service to patients, healthcare professionals and insurance carriers. This position requires work within several different operating systems and web based programs to retrieve document images, collect supporting or additional information on fills and work claims through to resolution to ensure compliant, timely and accurate billing practices.

Amicis Global

Pharmacy Billing Specialist I - PA

Ceipal

FULL_TIME

Responsibilities: Role Summary: Responds to medical record requests from insurance carriers at varying stages of claim processing as an integral part of recognizing the maximum reimbursement from each claim. Intermediate level of expertise using Microsoft Office Suite (Outlook, Excel, Word, Teams) and PDF software (NitroPro).

Medical Records Specialist

This job will deliver value to the Health Plan, and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA), using skills including but not limited to Hierarchical Condition Category (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment Data Validation (RADV) Audits. Flexes between coding projects, including Retro and Prospective, with different MA, ESRD, and ACA HCC Models; works independently in various coding applications and electronic medical record systems to support departmental goals.

Highmark provides millions of people with the security of quality health insurance
Our history of helping families and companies with their health insurance needs dates to the 1930s, when our predecessor companies were established to help Pennsylvania's residents pay for health care.
Highmark was created in 1996 by the consolidation of two Pennsylvania licensees of the Blue Cross and Blue Shield Association — Pennsylvania Blue Shield (now Highmark Blue Shield) and Blue Cross of Western Pennsylvania (now Highmark Blue Cross Blue Shield). We are now one of the largest health insurers in the United States.
Highmark's officers and board of directors set the company's strategic direction and corporate policies. They are guided by our mission, vision and values.

Highmark Inc

Hierarchical Condition Category (HCC) Coding Specialist

Assist in administering the company's Retirement and Pension plans, working directly with retirement plan trustees in setting up benefits for retirees, checking accuracy of payments, and tracking transactions in the retirement software database. Professionally and accurately respond to written and oral inquiries from teammates, retirees, and family members regarding the areas of employee benefits, enrollment, benefit programs, COBRA, and retirement plans.

In 1858, one enterprising individual invested his life savings of $200 to start a business grinding key stops for plumbers in Philadelphia. More than 150 continuous years of service later, that business is known as Hajoca Corporation. Hajoca has a robust history of helping to shape advances in plumbing. But we attribute our success to two simple truths - a unique business philosophy and talented people.
<h3>If we seem big, please take a closer look. Our roots run very deep.</h3>
Hajoca blends the clout of a large company with the opportunity of a small one. We understand that tastes and styles are different from place to place, so a "one size fits all" approach does not work. Our businesses have the freedom to operate like any local company and our managers conduct themselves with the focus and passion of business owners, right down to the products they carry and the people they hire.
Entrepreneurs welcome...and sought.
Good customer service means quality of work; exceptional customer service means quality of people. Members of our team are enthusiastic, driven to excel and singly steadfast in their commitment to service, integrity and reliability. They're also your neighbors and friends. They understand your unique needs because they've lived in your community for years.
Our locations are called Profit Centers and not branches, reflecting this independence. Our teammates have the opportunity to take home a share of the profits made in their Profit Center. Our decentralized culture gives each Profit Center Manager the same high degree of responsibility, autonomy, and accountability as an owner. The National Support Centers in Lafayette Hill, PA, and Baton Rouge, LA, are dedicated to enabling the success of our Profit Centers. Teammates at these locations and throughout the US provide services that are essential for our Profit Center Managers to have a playing field on which they can succeed through their own efforts and ideas. The company will continue to grow and prosper because our fundamental business philosophy works: emphasis on entrepreneurial spirit, expert knowledge, strong incentives for our teammates, and devotion to Hajoca’s proven business principles.

Hajoca Corporation

Senior Benefits Specialist

Work schedule Full-time Travel Required Not required Appointment type Permanent Occupations and job series 0501 Financial Administration And Program Supervisory status Yes Federal service type This job is in the Competitive Service Represented by a union No Drug test No Security clearance Not Required Position sensitivity and risk Non-sensitive NS Low Risk. Implements and manages all aspects of insurance verification activities for CPAC clients including the E-IV program contractor sourced new insurance uploads routine verification and re-verification of patient specific insurance coverage pre-registration of patients with scheduled admissions and ambulatory procedures prior to appointment processing data entry and verification of newly identified insurance card data.

Insurance Claims Specialist Jobs in Pennsylvania

Billing Specialist Physician Billing Penn Highlands Healthcare

Patient Estimate Specialist Truman Medical Centers

Billing/Payer Enrollment Specialist (63202) Union Community Care

AR Specialist 2 Savista

Lead Billing Specialist The Primary Health Network

Billing Specialist Clearfield EMS Penn Highlands Healthcare

Pharmacy Benefit Verification Specialist Onco360

Dental Billing Specialist Smilebuilderz LLC

Pharmacy Billing Operations Specialist Pantherx Specialty LLC

Sr. Litigation Specialist (Remote) CSAA Insurance Group

Mailroom Specialist MPOWERHealth

Billing and Reimbursement Specialist Kendal-Crosslands Communities Careers

Supervisor, AR Medical Payment Specialist THE WRIGHT CENTER

Medicare Exhaust Specialist Select Medical

AR Specialist 2- Complex Clinical Denials Savista

Pharmacy Billing Specialist I - PA Amicis Global

Medical Records Specialist MPOWERHealth

Hierarchical Condition Category (HCC) Coding Specialist Highmark Inc

Senior Benefits Specialist Hajoca Corporation

Supervisory Financial Administration Specialist - IV Manager U.S. Department of Veterans Affairs

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