claims advocate

Keating Auto Group

Seeking individual to work with insurance companies being the advocate for the policy holder.

Claims Adjuster

Oral Surgery Partners

<div><div>Title: Billing Specialist</div>
<div>Practice: Mid Kansas Oral &amp; Maxillofacial Surgery<br>
Location: Wichita, KS</div>
<div>Hours: Monday - Friday 8:00am - 5:00pm</div>
<p><b>
Position Purpose:</b></p>
<p>
The Oral Surgery Billing Specialist is responsible for managing the billing and reimbursement process for oral surgery procedures. This may include verifying insurance coverage, coding claims accurately, submitting claims, following up on unpaid claims, and ensuring timely payments. The ideal candidate will have a strong understanding of oral surgery billing practices, dental and medical insurance processes, and exceptional attention to detail.</p>
<p><b>
Respo</b><b>nsibilities:
</b></p><ul><li>Insurance Verification and Coordination:
<ul><li>Verify patient insurance eligibility and benefits before procedures.</li>
<li>Obtain prior authorizations for oral surgery procedures when needed.</li>
<li>Coordinate benefits between medical and dental insurance plans.</li>
</ul></li><li>Claims Submission and Management:
<ul><li>Accurately verify codes and submit claims using ICD-10, CPT, and CDT codes.</li>
<li>Ensure compliance with payer guidelines and regulatory requirements.</li>
<li>Resolve discrepancies or denials in a timely manner.</li>
</ul></li><li>Accounts Receivable Management:
<ul><li>Monitor aging reports and follow up on outstanding claims.</li>
<li>Communicate with insurance companies to resolve claim issues or delays.</li>
<li>Post insurance payments and adjustments accurately.</li>
</ul></li><li>Patient Billing and Communication:
<ul><li>Prepare and send patient statements for balances owed.</li>
<li>Help to handle patient billing inquiries and explain charges or insurance denials.</li>
</ul></li><li>Documentation and Reporting:
<ul><li>Maintain accurate records of billing activities and insurance correspondence.</li>
<li>Generate regular reports on accounts receivable, claims status, and payment trends and report those to practice leader and RCM advisor.</li>
</ul>
</li> </ul><p><b>Qualifications:
</b></p><p><b>Education/Certification:</b></p>
<ul>
<li>High School Diploma or equivalency, required.</li>
<li>Associate's degree or certification in medical/billing or coding, preferred.</li>
</ul>
<p><b>Experience:</b></p>
<ul>
<li>Minimum of 1 year of experience in dental or medical billing (Dental or oral surgery experience preferred).</li>
<li>Knowledge of ICD-10, CPT, and CDT coding.</li>
<li>Familiarity with dental/medical billing software (e.g., WinOMS, DSN, Sensei, etc).</li>
<li>Knowledge of medical and dental insurance processes, including coordination of benefits.</li>
</ul>
<p><b>Performance Requirements:</b></p>
<ul>
<li>Strong organizational skills</li>
<li>Excellent communication and customer/patient-service capabilities.</li>
<li>Ability to handle multiple tasks</li>
<li>Ability to work in fast-paced environment</li>
<li>Analytical and detail-oriented</li>
<li>Able to work independently with exceptional initiative and sound judgment</li>
<li>Ability to handle sensitive information confidentially.</li>
<li>Positive attitude, change advocate, able to lead by example</li></ul><br>
<p></p>
<p><b>
DISCLAIMER</b></p>
<p><i>
The above statements are intended to describe the general nature and level of the work being performed by people assigned to this work. This is not an exhaustive list of all duties and responsibilities. OPS's management reserves the right to amend and change responsibilities to meet business and organizational needs as necessary.</i></p></div>

Billing Specialist

Gallagher

<div><b>Introduction</b><br>
<div>
At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it&rsquo;s our purpose. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people&rsquo;s lives. It takes empathy, precision, and a strong sense of partnership&mdash;and that&rsquo;s exactly what you&rsquo;ll find here. We&rsquo;re a team of fast-paced fixers, empathetic experts, and outcomes drivers &mdash; people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes, you&rsquo;ll play a vital role in helping businesses and individuals move forward with confidence. Here, you&rsquo;ll be supported by a culture that values teamwork, encourages curiosity, and celebrates the impact of your work. Because when you&rsquo;re here, you&rsquo;re part of something bigger. You&rsquo;re part of a team that shows up, stands together, and leads with purpose.
</div><br>
<b>Overview</b><br>
<div><b>
Salary:</b> Salary can be up to $120,000 per year, dependent upon experience</div><div><b>
Claims Background:</b> Professional Liability Claims, Paralegal experience, or related insurance support role<br>
<b>Jurisdictional Experience:</b> Open to any<br>
<b>Active Adjuster Licenses:</b> Must be willing to obtain all licenses as required by the manager within a specified timeframe</div><div>
</div><div>
The Claims Specialist within GB Specialty is responsible for managing moderately complex <b>Healthcare Professional Liability</b> claims. This role manages the full claim life cycle, including coverage analysis, investigation, evaluation, and resolution, while ensuring claims are handled in accordance with client expectations, policy obligations, and regulatory requirements.</div>
<br>
<b>How you'll make an impact</b><br>
<ul><li>
Analyzes coverage and settles moderately complex claims in Healthcare Professional Liability.</li><li>
Generally, incumbent does not work on workers&rsquo; compensation claims.</li><li>
Able to manage the full-life cycle of all assigned claims files.</li><li>
Analyzes coverage and determines defense obligations.</li><li>
Under minimal supervision, conducts thorough analysis and investigations necessary to determine claims exposure and recommend appropriate settlement strategies and action plans.</li><li>
Creates reservation of rights and coverage denial letters.</li><li>
Negotiates settlements with clients, client attorneys, and Public Adjusters.</li><li>
Interacts extensively with various parties involved in the claims process, and may recommend retaining the advice of outside experts as necessary.</li><li>
Prepares reserve and settlement authority requests for client and carrier approval.</li><li>
May act as a client advocate with carriers to ensure proper claims handling, including any necessary scoping, estimating, and addressing of coverage.</li><li>
Has a solid understanding of claims processing and the insurance brokerage business.</li><li>
Has a basic understanding of the terminology and case law associated with correctional medicine professional liability claims.</li><li>
Handles claims consistent with clients&rsquo; and corporate policies, procedures and best practices and in accordance with statutory, regulatory, and ethical requirements.</li><li>
Incumbents at this level should be able to work at full caseload capacity.</li></ul>
<br>
<b>About You</b><br>
<div><b>
Claims Background:</b> Paralegal experience, junior professional liability claims experience, or insurance claims support background, preferably within healthcare or medical professional liability</div><div><b>
Jurisdictional Experience:</b> Open to any<br>
<b>Active Adjusters&rsquo; Licenses:</b> Not required initially; must be willing to obtain licenses as directed</div><div></div><div><b><br>
Required:</b></div><br>
<div></div><ul><li>
Bachelor's Degree Required</li><li>
Minimum 2 years of experience in claims, insurance, paralegal, legal support, or a related environment.</li><li>
Strong insurance fundamentals and understanding of claims processes.</li><li>
Ability to analyze documentation, summarize facts, and support coverage and liability determinations.</li><li>
Computer proficiency with claims systems and standard business software.</li><li>
Must be able to obtain required adjuster licenses within designated timeframes.</li></ul><div><b><br>
Preferred:</b></div><ul><li>
Prior experience within healthcare (medical malpractice) claims is a plus</li></ul><div><b>
Behaviors:</b><ul><li>
Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, and communicate effectively in writing and verbally.</li><li>
Strong analytical skills to support claims decisions and issue resolution.</li><li>
Ability to interpret policies, records, and related documentation.</li></ul><div>
#LI-TJ1</div><div>
#GBSpecialtyCareers</div></div></div><div></div>

Claim Specialist - Healthcare Professional Liability

<div><b>Introduction</b><br>
<div>
At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it&rsquo;s our purpose. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people&rsquo;s lives. It takes empathy, precision, and a strong sense of partnership&mdash;and that&rsquo;s exactly what you&rsquo;ll find here. We&rsquo;re a team of fast-paced fixers, empathetic experts, and outcomes drivers &mdash; people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes, you&rsquo;ll play a vital role in helping businesses and individuals move forward with confidence. Here, you&rsquo;ll be supported by a culture that values teamwork, encourages curiosity, and celebrates the impact of your work. Because when you&rsquo;re here, you&rsquo;re part of something bigger. You&rsquo;re part of a team that shows up, stands together, and leads with purpose.
</div><br>
<b>Overview</b><div><b><br>
Salary: </b>Salary for this position could go up to $119,000 per year, dependent upon experience.</div><div><div><b>
Jurisdictions:</b> Open to any</div><div><b>
Licenses:</b> Must be willing to obtain all licenses as required by the manager within a specified timeframe</div><div><b>
Location:</b> This role is eligible for fully remote work</div><div></div><div><br>
The Claims Specialist within GB Specialty is responsible for managing moderately complex <b>Healthcare Professional Liability</b> claims, with a primary focus on <b>Correctional Medicine</b>. This role manages the full claim life cycle, including coverage analysis, investigation, evaluation, and resolution, while ensuring claims are handled in accordance with client expectations, policy obligations, and regulatory requirements.</div></div>
<br>
<b>How you'll make an impact</b><br>
<ul><li>
Analyzes coverage and settles moderately complex claims in Correctional Medicine Professional Liability.</li><li>
Generally, incumbent does not work on workers&rsquo; compensation claims.</li><li>
Able to manage the full-life cycle of all assigned claims files.</li><li>
Analyzes coverage and determines defense obligations.</li><li>
Under minimal supervision, conducts thorough analysis and investigations necessary to determine claims exposure and recommend appropriate settlement strategies and action plans.</li><li>
Creates reservation of rights and coverage denial letters.</li><li>
Negotiates settlements with clients, client attorneys, and Public Adjusters.</li><li>
Interacts extensively with various parties involved in the claims process, and may recommend retaining the advice of outside experts as necessary.</li><li>
Prepares reserve and settlement authority requests for client and carrier approval.</li><li>
May act as a client advocate with carriers to ensure proper claims handling, including any necessary scoping, estimating, and addressing of coverage.</li><li>
Has a solid understanding of claims processing and the insurance brokerage business.</li><li>
Has a basic understanding of the terminology and case law associated with correctional medicine professional liability claims.</li><li>
Handles claims consistent with clients&rsquo; and corporate policies, procedures and best practices and in accordance with statutory, regulatory, and ethical requirements.</li><li>
Incumbents at this level should be able to work at full caseload capacity.</li></ul>
<br>
<b>About You</b><div><b><br>
Required:</b></div><ul><li><div>
Bachelor&rsquo;s degree required</div></li><li><div>
Minimum 2+ years of experience in handling professional liability claims</div></li><li><div>
Strong insurance fundamentals and understanding of claims processes.</div></li><li><div>
Ability to analyze documentation, summarize facts, and support coverage and liability determinations.</div></li><li><div>
Computer proficiency with claims systems and standard business software.</div></li><li><div>
Must be able to obtain required adjuster licenses within designated timeframes.</div></li></ul><div><b>
Preferred:
</b></div><ul><li>Prior experience within healthcare, medical malpractice, or correctional medicine claims a plus.</li><li>
Strong insurance background (carrier, TPA, brokerage, or claims support experience).</li><li>
JD preferred but not required</li></ul><div><b>
Behaviors:</b></div><div><ul><li>
Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, and communicate effectively in writing and verbally.</li><li>
Strong analytical skills to support claims decisions and issue resolution.</li><li>
Ability to interpret policies, records, and related documentation.</li></ul><div>
#LI-TJ1</div><div>
#GBSpecialtyCareers</div></div></div>

Claim Specialist - Correctional Medicine

Advocate Aurora Health

<div><div><p><b>MAJOR RESPONSIBILITIES</b></p></div><div><ul><li>
Independently review accounts and apply billing follow up knowledge required for all insurance payors to insure proper and maximum reimbursement. Uses multiple systems to resolve outstanding claims according to compliance guidelines.</li><li>
Prebilling/billing and follow up activity on open insurance claims exercising revenue cycle knowledge (ie;CPT,ICD-10 and HCPCS, NDC, revenue codes and medical terminology).Will obtain necessary documentation from various resources.</li><li>
Ability to timely and accurately communicate with internal teams and external customers (ie; third party payors, auditors, other entity) and acts as a liaison with external third party representatives to validate and correct information.</li><li>
Comprehends incoming insurance correspondence and responds appropriately. Identifies and brings patterns/trends to leaderships attention re:coding and compliance, contracting, claim form edits/errors and credentialing for any potential in delay/denial of reimbursement. Obtains and keeps abreast with insurance payer updates/changes, single case agreements and assists management with recommendations for implementation of any edits/alerts.</li><li>
Accurately enters and/or updates patient/insurance information into patient accounting system. Appeals claims to assure contracted amount is received from third party payors.</li><li>
Complies and maintains KPI (Key Performance Indicators) for assigned payers within standards established by department and insurance guidelines.</li><li>
Compile information for referral of accounts to internal/external partners as needed. Compile and maintain clear, accurate, on-line documentation of all activity relating to billing and follow up efforts for each account, utilizing established guidelines.</li><li>
Responsible to read and understand all Advocate Aurora Health policies and departmental collections policies and procedures. Demonstrate proficiency in proper use of the software systems employed by AAH.</li><li>
This position refers to the supervisor for approval or final disposition such as: recommendations regarding handling of observed unusual/unreasonable/inaccurate account information. Approval needed to write off balance&rsquo;s according to corporate policy. Issues outside normal scope of activity and responsibility.</li></ul><p></p><div><p><b>
MINIMUM EDUCATION AND EXPERIENCE REQUIRED</b></p></div><ul><li>
Level of Education: High School Diploma or General Education Degree (GED)</li><li>
Years of Experience: Typically requires 1 year of related experience in medical/billing reimbursement environment, or equivalent combination of education and experience.</li></ul><p></p><div><p><b>
MINIMUM KNOWLEDGE, SKILLS AND ABILITIES (KSA</b><b>)</b></p></div><ul><li>
Must perform within the scope of departmental guidelines for productivity and quality standards.</li><li>
Works independently with limited supervision.</li><li>
Accountable and evaluated to organization behaviors of excellence</li><li>
Basic keyboarding proficiency.</li><li>
Must be able to operate computer and software systems in use at Advocate Aurora Health.</li><li>
Able to operate a copy machine, facsimile machine, telephone/voicemail.</li><li>
Ability to read, write, speak and understand English proficiently.</li><li>
Ability to read and interpret documents such as explanation of benefits (EOB), operating instructions and procedure manuals.</li><li>
Preferred but not required knowledge of medical terminology, coding, terminology (CPT, ICD-10, HCPC) and insurance/reimbursement practices.</li><li>
Ability to communicate well with people to obtain basic information (via telephone or in person).</li></ul><p></p><p><i>
 This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.</i></p></div></div>

Billing Follow Up Representative I

Advocate Construction

<div>
 <strong>
  Are you a highly organized professional who loves solving problems, finalizing property claims, and working from home?
  <br/>
  <br/>
 </strong>
 Advocate Construction, a Top 100 Roofing Contractor spanning 6 states, is looking for an Insurance Processing Specialist to join our team! You will act as the vital bridge between our customers, our internal teams, and homeowner insurance providers. Your daily focus will be facilitating the release of funds for roofing and exterior property claims, securing final customer payments, and ensuring all documentation is flawlessly submitted. Bring your detail-oriented mindset to a growing company that values exceptional service and team collaboration!
 <br/>
 <br/>
 <strong>
  Schedule &amp; Location:
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Location: 100% Remote / Work from Home
  </li>
  <li>
   Hours: Monday &ndash; Friday, 8:00 AM to 5:00 PM CST (Includes a required 1-hour unpaid lunch break)
   <br/>
   <br/>
  </li>
 </ul>
 Visit our career page at https://advocateconstruction.com/careers/ to learn more about who we are and what we do!
 <br/>
 <br/>
 <strong>
  Key Responsibilities
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Fund Recovery: Proactively contact homeowner insurance companies to secure and facilitate the release of approved job funds for property claims.
  </li>
  <li>
   Claim Resolution: Act as a liaison between customers and their property insurance providers to resolve outstanding issues and successfully finalize property claims.
  </li>
  <li>
   Payment Processing: Securely collect and process final payments directly from customers.
  </li>
  <li>
   Cross-Functional Collaboration: Maintain clear and consistent interdepartmental communication to ensure smooth project workflows across the company.
  </li>
  <li>
   Compliance: Ensure all documentation and daily actions strictly adhere to internal company policies and procedures.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Requirements
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Detail-Oriented: Strong attention to detail and a commitment to accuracy in all documentation and data entry.
  </li>
  <li>
   Time Management: Excellent organizational skills with the ability to manage priorities and work effectively in a fast-paced environment.
  </li>
  <li>
   Technical Proficiency: Basic computer skills with a strong comfort level using data entry software and internal tracking systems.
  </li>
  <li>
   Communication Skills: A customer service-oriented mindset backed by clear, professional communication skills (both written and verbal).
  </li>
  <li>
   Discretion &amp; Confidentiality: Proven ability to handle sensitive personal, financial, and insurance information with the utmost confidentiality. (Previous experience with homeowner/property claims is a plus!)
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Benefits
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   100% Remote Work Environment (Save on time and gas!)
  </li>
  <li>
   10 days Paid Time Off annually
  </li>
  <li>
   9 paid holidays per year
  </li>
  <li>
   Comprehensive health benefits program including medical, dental, vision, short and long-term disability.
  </li>
  <li>
   401(k) retirement plan with generous company match
  </li>
  <li>
   Monthly communication stipend
  </li>
  <li>
   Robust technology and tools to help you thrive in your role
  </li>
  <li>
   Career path growth/leadership opportunities
  </li>
 </ul>
</div>


Insurance Processing Specialist - Homeowner Property Claims (Remote) $18 - $20/hr

Crane Agency

<div><div><b>Are you a Workers&rsquo; Compensation/Property Claims Consultant passionate about providing extraordinary service to your clients? Do you want to work for a family-friendly organization that cares about and invests in YOU, promotes a culture of flexibility, provides a life/work balance, and offers a competitive salary and benefits package? If you answered yes to any of these questions, then Crane is an excellent fit for you.
</b></div>
<div></div><div>Here&rsquo;s an overview of what you&rsquo;ll be doing in your exciting, new career as a Claims Consultant:</div>
<ul><li>Conduct client presentations on risk management and claims topics in conjunction with Crane producer units.</li>
<li>Work directly with clients to help educate and assist them with establishing claims reporting procedures, drug testing, background checks, medical cost control, employee handbooks, and the preparation of proper job descriptions.</li>
<li>Inquire on individual claims identified by the broker or the account. Evaluate for appropriate handling and reserving value.</li>
<li>Act as the insured's advocate in coverage disputes with the insurance company.</li>
<li>Analyze trends after obtaining and monitoring loss information from insurance carriers.</li>
<li>Conduct phone inquiries regarding open claims with insurance adjusters.</li>
<li>Prepare claim status reports with visual documentation including Excel graphs and provide the information to clients.</li>
<li>Assist insureds with return-to-work programs for injured workers including light duty, modified duty, and charity placement by coordinating with occupational medicine providers.</li>
<li>Maintain relationships with carrier partners and occupational medicine providers.</li>
<li>Prepare cost benefit analysis for agency management personnel.</li>
<li>Schedule work activities and monitor necessary target completion dates and required deadlines.</li>
<li>Organize and assist in facilitating client seminars.</li>
<li>Work in numerous online carrier claim systems.</li>
<li>Input all required documentation into agency management system.</li>
</ul>
<div></div><div><b>Qualified candidates must have complete knowledge of Property, Liability, and Work Comp claims. Comprehensive expertise of insurance practices and procedures in the industry is a must. Intermediate to Advanced knowledge of Microsoft Office is a must. Knowledge of the EPIC agency management system and an Associate in Claims (AIC) professional designation is a plus!</b></div>
<div>Candidates must be customer focused and possess a friendly, positive attitude with a willingness to help others. Excellent prioritization, verbal and written communication, professional telephone manner, attention to detail, and follow up is required. Candidates must contain effective problem-solving techniques with the ability to multi-task in a fast-paced environment.</div>
<div></div><div><b>About us:</b> At Crane, we understand the needs of our clients because our organization was built by business owners and families just like you. We help our clients prepare for uncertainty by providing the types of insurance products needed to meet your business and personal needs. We also offer a wealth of value-added resources including Risk Management, Claims Consulting, Bonds, and Employee Benefits Consulting. Crane has over 265 employees who are driven to be the best in our industry. Through innovation and technology, we strive daily to exceed customer expectations with service that is responsive and reliable. We value long term relationships with our clients, our employees, and the communities we serve. Founded in 1885, Crane has witnessed the turning of two centuries and continues to thrive today by helping protect what matters most. To find out more about Crane Agency, please visit our website at www.craneagency.com.</div></div>

Commercial Lines Claims Consultant

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