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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

Medical Records Specialist

FULL_TIME

Were a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

HOUR

About TEKsystems:
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<li>We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.</li>
<li>The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.</li>
</ul>

TEKsystems

Continued Qualifications Specialist

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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

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Claims Knowledge: Strong ability to read and understand EOBs; deep understanding of insurance denials and unresolved claims resolution; knowledge of ICD-10, CPT, HCPCS, and CMS-1500 claim format. Investigate and resolve unresolved claims (denials, underpayments, delayed payments); troubleshoot claim data and submit written appeals with supporting documentation and timely follow-up.

United Wound Healing

Accounts Receivable Specialist

While performing the duties of this position, the employee may occasionally be required to stand, walk, or sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch, or crawl; and talk or hear. Employees in this position may be required to assist directly - or coordinate appropriate assistance - to ensure access to LUX Infusion’s services for individuals with disabilities, including patients, visitors, employees, or others.

LUX Infusion

Reimbursement Specialist

Your sales experience equips you to continually grow your income as you provide the needed security for times of distress and vulnerability. As a customer-oriented expert, you will market the best Life/Health insurance services and products to benefit clients and their families.

Mike Ball - State Farm Agent

Life/Health Insurance Position - State Farm Agent Team Member

The Default Title Curative Specialist is responsible for facilitating the clearance of title defects referred by clients in connection with default, foreclosure, REO, and related mortgage servicing matters. Constantly communicating effectively verbally in English, including accurately exchanging information with others following identification of correct procedures.

NewRez LLC

Default Title Curative Specialist

As the first point of contact for our collision center, you will assist customers who have experienced automobile accidents or need auto body repairs. Customer Assistance : Be knowledgeable and assist customers in person or by phone with their collision insurance claims, estimate/repair procedures, and the steps needed to process their claims.

Bob Weaver Auto

Administrative Assistant - Collision Specialist

CONTRACTOR

Minimum (Required) Qualifications: (must be met in order to perform the job at the required level) Entry level position; 0-2 years of pharmacy billing experience Strong communication, interpersonal, and prioritization skills Must be highly organized and detail-oriented. 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.

Apidel Technologies

Billing Specialist I

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Mental/Physical Requirements: Must possess the physical and mental abilities to perform the tasks normally associated with a Dental Billing Specialist position such as: Frequent and prolonged work at a computer and/or on the phone for extended periods with repetitive typing, arm and hand motion. Ability to critically think which means the ability to think clearly and rationally about what to do or what to believe; understand logical connections between ideas; and identify, construct, and evaluate arguments.

Family First Health

Dental Billing Specialist I

If you are someone who thrives in the field, takes initiative, refuses to wait for opportunities to come to you, is self-confident yet approachable and can earn people's trust quickly in a high-stress situation we would like to meet you. At A GRADE Property Restoration , we help homeowners and businesses within Northern/Central NJ and tri-state areas recover after devastating fire, water, storm, and other property losses.

WEEK

A GRADE Property Restoration

Emergency Restoration Outside Sales 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 providers, 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

Specialist, Accounts Receivable

The Pharmacy Benefit Credit and Refund Specialist Coordinator will ensure timely and accurate credit balance resolution with payers while demonstrating excellent customer service to patients, healthcare professionals, and insurance carriers. Position Summary: CVS Health Specialty Pharmacy, a mail service pharmacy in the Monroeville area has an opportunity for a full-time Pharmacy Benefit Credit and Refund Specialist Coordinator to handle insurance credit balance follow up.

CVS Health offers a world of promising job opportunities across a diverse range of careers in everything from corporate and pharmacy roles to retails positions. No matter where you work at CVS Health, your unique skills, talents and abilities are welcome and valued. We recognize and reward greatness and want our employees to know their work is making a difference in the lives of millions. Join us today. Together we can continue making innovative, high-quality health and pharmacy services safe, affordable and accessible – for all.

CVS Health Corp

Pharmacy Benefit Credit and Refund Specialist Coordinator, Revenue Cycle (Hybrid)

ARCCA, LLC, an ATS Family of Companies, is a growing national forensic, scientific, and engineering firm with six offices nationwide located in Penns Park, PA (suburban Philadelphia); Pittsburgh, PA; Chicago, IL; Hollywood, FL; Oakland, CA; and Seattle, WA. This role plays a critical part in maintaining healthy cash flow, building strong customer and vendor relationships, and ensuring the accurate and timely processing of billing and payment activities.

Applied Technical Services Inc

Accounts Receivable & Accounts Payable Specialist (58110)

Our exceptional and busy, privately owned dental office in beautiful North Huntingdon is looking for a full-time front office specialist. · Coordinate with other team members to ensure an enjoyable and efficient experience for the patient.

Northern Sky Dental

Dental Front Office Specialist

What You’ll Do The Pharmacy Prior Authorization Specialist will ensure patients receive the medication that requires pre-authorizations from insurance carriers by receiving prescriptions, addressing and rectifying rejected claims and conducting necessary third-party authorization requests. Knowledge of pharmacy terminology, pharmacy insurance claims, Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, experience with CoverMyMeds.

Onco360

Pharmacy Prior Authorization Specialist

This position works closely with insurance payors to resolve claim issues, reduce denials, and support overall financial performance. The Medical Reimbursement Specialist plays a key role in the revenue cycle by ensuring accurate and timely reimbursement for services rendered.

Lawall

Medical Reimbursement Specialist

Conduct comprehensive research for assigned appeals and grievances, including review of enrollment and eligibility, provider participation status, benefit plan provisions, authorization records, claim history, clinical or administrative documentation, prior correspondence, and the circumstances surrounding the denial of services or rejection of claims. Assess each submission to confirm that it meets applicable appeal or grievance criteria, identify the appropriate case type, category, subcategory, level of review, and root cause, and document the classification accurately in designated systems.

At the Blue Cross and Blue Shield Association (BCBSA), we provide business strategy, technical support and consulting expertise to 36 Blue Cross and Blue Shield companies across the nation, employing more than 1,000 of the best strategic thinkers in the industry.  We are a Brand manager that sets quality control standards for the 36 independent companies that use the Blue Cross and Blue Shield Brands, and we serve as a trade association that represents these Blue companies. It is through our involvement that the Blues companies share a united vision and strategy while also benefiting from the local strength of all member companies.

Blue Cross and Blue Shield Association

Appeals Specialist

Please selectCold CallingCommunity ReferralConvention/Conference AttendeeCorrectional Facility Employee ReferralDirect MailEmail CorrespondenceI was referred by a current or former employeeInternet Job BoardJob FairNewspaperOrganization/AssociationOtherSchoolSearch EngineSocial MediaWexford Health Hosted EventWHS Employee Referral. The HR Specialist is responsible for providing full human resources generalist support for managers, supervisors, and front-line employees including employee relations counseling; communicating and enforcing HR policies and procedures; compensation and benefit administration; conducting investigations; creating and delivering corrective action; performance management; workers' compensation; and leave administration.

Wexford Health Sources Inc

HR Specialist

Loss Management Specialist - Radnor PA Skip To ContentBrightMove JobsReturn to Essent.usCareersInterested in joining a fast-paced results-focused company that cares about its employees and is helping shape Americas housing finance industry Essent is currently interviewing for the following open positionsToggle navigationPortal HomeCreate Profile Share This Requisition Loss Management Specialist Job Title Loss Management Specialist Requisition ID 27777556 Location Radnor PA 27104 Other Location Description Essent Group Ltd. NYSE ESNT is a Bermuda-based holding company collectively with its subsidiaries Essent which serves the housing finance industry by offering private mortgage insurance reinsurance risk management products and title insurance and settlement services to mortgage lenders borrowers and investors to support homeownership.

Insurance Claims Specialist Jobs in Pennsylvania

Medical Records Specialist MPOWERHealth

Continued Qualifications Specialist TEKsystems

Senior Benefits Specialist Hajoca Corporation

Accounts Receivable Specialist United Wound Healing

Reimbursement Specialist LUX Infusion

Life/Health Insurance Position - State Farm Agent Team Member Mike Ball - State Farm Agent

Default Title Curative Specialist NewRez LLC

Administrative Assistant - Collision Specialist Bob Weaver Auto

Billing Specialist I Apidel Technologies

Dental Billing Specialist I Family First Health

Emergency Restoration Outside Sales Specialist A GRADE Property Restoration

Specialist, Accounts Receivable THE WRIGHT CENTER

Pharmacy Benefit Credit and Refund Specialist Coordinator, Revenue Cycle (Hybrid) CVS Health Corp

Accounts Receivable & Accounts Payable Specialist (58110) Applied Technical Services Inc

Dental Front Office Specialist Northern Sky Dental

Pharmacy Prior Authorization Specialist Onco360

Medical Reimbursement Specialist Lawall

Appeals Specialist Blue Cross and Blue Shield Association

HR Specialist Wexford Health Sources Inc

Loss Management Specialist Essent Guaranty, Inc.

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