claims coordinator

SNQ Herbal

Are you a healthcare enthusiast with a talent for navigating the world of medical insurance? Med-Right LLC is looking for a proactive Medical Claims Coordinator to join our expanding team in Doha. This is more than just a desk job&mdash;it is an opportunity to be the vital link between patients, providers, and insurance companies. If you thrive on accuracy, enjoy problem-solving, and want to work in an environment that values professional growth, we want to hear from you.About the CompanyMed-Right LLC is a premier Third-Party Administrator (TPA) and healthcare management firm dedicated to making healthcare accessible and transparent. With a network of thousands of providers and a reputation for leveraging high-end technology, we simplify complex medical processes. At Med-Right, we believe that a healthy life is a happy life, and we work tirelessly to ensure our beneficiaries get the right care at the right time.Why Work With Us?<ul><li>Professional Growth: We provide regular training on the latest medical coding (ICD-10, CPT) and AI-driven claims processing tools.</li><li>Supportive Environment: Join a multicultural team that values respect, teamwork, and collaborative success.</li><li>Modern Benefits: Competitive tax-free salary, comprehensive private health insurance, and annual air ticket allowance.</li><li>Stability: Work with an ISO-certified organization that is a leader in the Middle Eastern healthcare sector.</li></ul>Key Responsibilities<ul><li>Review and evaluate medical claims for eligibility, accuracy, and compliance with insurance policies.</li><li>Coordinate with healthcare providers to obtain missing documentation or clarify billing discrepancies.</li><li>Process prior authorization requests and respond to inquiries from insurance companies and clients.</li><li>Monitor claims status and identify trends in denials to suggest process improvements.</li><li>Ensure all data entry is handled with high precision within our Claims Management System.</li><li>Maintain strict confidentiality of patient records in accordance with healthcare regulations.</li></ul>Skills and Requirements<ul><li>Education: Bachelor&rsquo;s degree in Pharmacy, Nursing, Medicine, or a related healthcare field.</li><li>Technical Skills: Proficiency in MS Office (especially Excel) and familiarity with medical coding systems (ICD-10/CPT).</li><li>Communication: Excellent verbal and written communication skills in English; Arabic is a plus.</li><li>Analytical Mindset: Strong attention to detail and the ability to spot errors in complex medical invoices.</li><li>Adaptability: Comfortable working in a fast-paced environment and learning new digital health tools.</li><li>Experience: 1&ndash;2 years in medical claims, insurance coordination, or a TPA setting is preferred, though motivated fresh graduates are welcome to apply.</li></ul>Join Our Team TodayReady to take the next step in your healthcare administration career? We have simplified our application process to respect your time. Click the apply button to submit your CV and join a company that is shaping the future of healthcare management in Qatar.Apply Now and start your journey with Med-Right LLC.Med-Right LLC is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.الراتب المدفوع: QAR٥٬٠٠٠٫٠٠&nbsp;لكل شهرموقع العمل: بشكل شخصي

Herbal Products Coordinator

Curant Health

JOIN A LEADING HEALTHCARE COMPANYAt Curant Health, our vision is personalized healthcare driven by choice and defined by value. As a Curant Health employee, your role is to deliver on that vision every day by delivering excellent Customer Service, Personalized Care, Accountability, Innovation, and Integrity. You take initiative, set goals, and solve problems while collaborating with friends and colleagues. Together, we make a meaningful impact on our patients' lives.In return, Curant Health is committed to providing you competitive pay, excellent benefits, and an opportunity to make a difference each day as we strive to reach our vision to be the preferred health care partner by excelling in quality, service, and affordability.SummaryThe Billing Coordinator is responsible for managing and overseeing the billing and collection process for pharmacy claims, including insurance reimbursements and patient payments. This role also provides clerical support by sorting and filing both paper and electronic reports. The Billing Coordinator works closely with the department manager to identify and implement strategies that ensure data accuracy and integrity. Additionally, this position provides backup support to other team members within the department to ensure continuity of operations.Responsibilities<ul><li>Process Insurance Claims: Submit, monitor, and manage pharmacy claims to third-party payers, including commercial insurance, Medicare, and Medicaid.</li><li>Monitor aging reports and follow up on unpaid or partially paid claims and patient balances.</li><li>Investigate and correct errors in billing submissions and refile or appeal denied claims as needed.</li><li>Generate patient invoices, explain charges, and collect payments while maintaining excellent customer service.</li><li>Accurately post payments received from insurance companies and patients to appropriate accounts.</li><li>Regularly reconcile accounts receivable balances to ensure accuracy and identify discrepancies.</li><li>Communicate with payers to verify coverage, clarify issues, and expedite claim resolutions.</li><li>Maintain accurate and organized records of billing activities in compliance with HIPAA and pharmacy regulatory standards.</li></ul>Qualifications<ul><li>Pharmacy claims adjudication experience preferred.</li><li>Pharmacy technician experience preferred.</li><li>Associate&rsquo;s or Bachelor&rsquo;s degree in Accounting preferred.</li><li>2+ years of Accounts Receivable experience preferred.</li></ul>To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Why Work for Us? We offer competitive pay, paid holidays, benefits, paid time off, and a work/life balance. Not only that, but we also offer paid parental leave, recognition programs, promotion opportunities, a comprehensive training program to enhance your career, and employee prescription discounts.Our Core Values consist of ICARE: Integrity, Communication, Accountability, Relationships, and Excellence, and we take pride in you embodying those traits.Curant Health is an equal opportunity employer.Job Type: Full-timePay: $50,000.00 per yearBenefits:<ul><li>401(k)</li><li>401(k) matching</li><li>Dental insurance</li><li>Health insurance</li><li>Life insurance</li><li>Paid time off</li><li>Vision insurance</li></ul>Application Question(s):<ul><li>How many years of Pharmacy Claims Adjudication do you have?</li><li>How many years of Accounts Receivable experience you have?</li><li>How many years of experience you have susing Pieoneer or Epic?</li></ul>Experience:<ul><li>Pharmacy Technician: 1 year (Preferred)</li></ul>Work Location: In person

Billing Coordinator

DynaFire

<div>Description:

We are seeking a skilled Claims and Risk Coordinator to oversee and manage claims related to workers' compensation, auto, general liability, and property across our Florida and Georgia location and to oversee and manage ongoing litigation and safety documentation, coordinate training, and assist in the implementation of safety programs and initiatives. The ideal candidate will have a broad range of claims experience across these areas, as well as strong organizational and communication skills. The ideal candidate will have a broad range of claims experience across these areas, as well as strong organizational and negotiation skills. This role involves investigating claims, assessing liability, ensuring claims are handled efficiently while adhering to company policies and legal regulations and communicating with all levels of employees from field technicians to upper management<ul><li>
Claims Management:</li><li>
Manage and investigate workers' compensation, auto, general liability, and property claims from initial report to final resolution.</li><li>
Evaluate claims for validity, coverage, and potential risks, and ensure alignment with DynaFire&rsquo;s policies and insurance coverage.</li><li>
Conduct thorough interviews with employees, witnesses, and other involved parties to gather essential facts and evidence.</li><li>
Regular communication with insurance brokers and agents during the claims and investigation process.</li><li>
Investigation &amp; Documentation:</li><li>
Investigate incidents including workplace injuries, automobile accidents, property damage, and third-party liability claims.</li><li>
Collect, review, and analyze evidence such as medical reports, accident reports, photos, and expert evaluations.</li><li>
Ensure all necessary documentation is secured and maintained throughout the claims process.</li><li>
Maintain confidential information and documentation</li><li>
Claims Evaluation:</li><li>
Review insurance policies and coverage to determine the appropriate handling of claims.</li><li>
Work closely with legal, medical, and engineering experts to assess damages, injuries, or liabilities.</li><li>
Identify potential subrogation opportunities and report suspected fraudulent claims.</li><li>
Act as the main point of contact for management, providing clear communication on claims status and resolution outcomes.(move to claims management)</li><li>
Compliance &amp; Reporting:</li><li>
Ensure all claims are managed in compliance with relevant state and federal regulations.</li><li>
Stay updated on regulatory changes and industry best practices.</li><li>
Prepare accurate reports on claims status, trends, and financial impact for internal management.</li><li>
Other responsibilities as the company and position grows.</li></ul>
Requirements:

Training and Certification Requirements:<ul><li>
Education:</li><li>
Bachelor&rsquo;s degree in insurance, risk management, business, or a related field preferred.</li><li>
Certifications such as AIC (Associate in Claims), CPCU (Chartered Property</li><li>
Casualty Underwriter), or WC (Workers' Compensation) certifications are highly desirable.</li><li>
Experience:</li><li>
3+ years of experience in claims adjusting across workers' compensation, auto, general liability, and property claims.</li><li>
Experience in the service industry preferred</li><li>
Experience in private organizations, third-party administrators (TPAs), or self-insured entities is a plus.</li><li>
Skills &amp; Competencies:</li><li>
Strong analytical skills with the ability to evaluate complex claims and legal issues.</li><li>
Proficient in claims management software and Microsoft Office Suite.</li><li>
Excellent verbal and written communication skills, with the ability to clearly explain complex issues.</li><li>
High degree of organization, attention to detail, and the ability to handle multiple claims simultaneously.</li><li>
Fluent in Spanish and English - Written and Verbal</li></ul>
What We Offer:<ul><li>
Paid time off (PTO) and holidays.</li><li>
Comprehensive benefits package including medical, dental, and vision insurance.</li><li>
Short term and long-term disability.</li><li>
401(k) matching.</li><li>
Employer funded life insurance.</li><li>
Opportunities for professional development and growth.</li><li>
Employee Referral Program.</li></ul>
About Us:
At DynaFire, we are your comprehensive partner for all fire and life safety needs. From expert support and installation to state-of-the-art sprinkler and fire alarm systems, we deliver tailored solutions to protect your business and assets. Whether you're looking to enhance security or ensure regulatory compliance, reach out to DynaFire today for industry-leading solutions and exceptional service.
DynaFire is an equal employment opportunity employer dedicated?to promoting an inclusive, diverse, and innovative environment for our employees. We provide all qualified applicants with employment consideration without regard to race, color, religion, sex, pregnancy, childbirth, ancestry, national origin, age, protected veteran status, marital status, genetic information, gender identity or expression, sexual orientation, disability, or any other protected status in accordance with applicable federal, state, or local laws.</div>

Claims and Risk Coordinator

Provox Global Solutions

We are hiring an experienced Dental Billing Coordinator to support a multi-location dental group based in Texas. Our client operates approximately 20 offices on Dentrix Enterprise transitioning to Curve. The successful candidates will be embedded with the client&rsquo;s billing function and will report directly to the client&rsquo;s Billing Manager.This is not a back-office data entry role. The Billing Coordinator is accountable for the full revenue cycle &mdash; from claim creation through submission, posting, denials, appeals, and AR follow-up. The work is methodical, detail-driven, and measured against clear performance KPIs. Candidates who have been held to numerical targets in past roles and can speak fluently to those numbers will stand out.What You Will Do<ul><li>Own end-to-end billing for assigned offices and providers, from claim creation through final adjudication and payment posting.</li><li>Bill out all claims within 48 hours of date of service</li><li>Submit clean claims through the clearinghouse, including correct CDT coding, appropriate narratives, and required attachments (x-rays, perio charts, intraoral images).</li><li>Post insurance payments accurately, including ERA reconciliation, contractual write-offs, adjustments, and triggering of secondary claims.</li><li>Work the AR aging report on a strict cadence &mdash; no claim over 30 days untouched, with priority focus on the 60+ and 90+ day buckets.</li><li>Manage denials and rejections methodically: investigate the root cause, correct the underlying issue, and submit timely appeals with supporting documentation.</li><li>Communicate professionally and promptly with office staff and providers when missing information, coding clarifications, or clinical narratives are needed.</li><li>Track and report individual performance against committed KPIs (clean claim rate, days in AR, percentage of AR over 90 days, net collection ratio, write-off accuracy).</li><li>Identify recurring issues &mdash; payer-specific quirks, coding errors, documentation gaps &mdash; and escalate them with proposed solutions.</li><li>Maintain compliance with HIPAA and all relevant patient data handling protocols.</li></ul>Required Qualifications<ul><li>Minimum 3 years of hands-on US dental billing experience, including end-to-end ownership of the revenue cycle (not just one slice such as posting or verification).</li><li>Strong working knowledge of dental Medicaid billing &mdash; eligibility rules, prior authorization requirements, fee schedules, and common denial patterns.</li><li>Working knowledge of Medicare Advantage dental benefits and the differences between Advantage plans and traditional commercial PPOs.</li><li>Demonstrated ability to talk specifically about past performance through KPIs &mdash; collection percentage, write-off percentage, days in AR, clean claim rate, denial rate. Candidates who cannot speak to numbers from prior roles will not be considered.</li><li>Proficiency with at least one major dental practice management system (Dentrix, Dentrix Enterprise, Eaglesoft, Open Dental, or Denticon).</li><li>Comfortable working within a major dental clearinghouse (Claim.MD, DentalXChange, Vyne Trellis, or equivalent).</li><li>Strong written and verbal English communication skills &mdash; this role interacts directly with US-based providers, office managers, and the client's billing manager on a daily basis.</li><li>Ability and willingness to work the 6:00 PM to 3:00 AM PKT shift to align with US Central Time business hours.</li><li>High attention to detail, methodical work habits, and disciplined follow-up &mdash; these are the three qualities that separate strong billers from average ones.</li></ul>Job Type: Full-timeApplication Question(s):<ul><li>This is an onsite-based position, and the shift timings are from 6:00 PM to 3:00 AM PKT to align with US Central Time business hours. Are you comfortable with this?</li></ul>Experience:<ul><li>Dentrix : 1 year (Required)</li><li>Dental Billing : 1 year (Required)</li><li>AR: 1 year (Required)</li></ul>Work Location: In person

Dental Billing Specialist

NJM Insurance Group

<div>General Summary: A brief description of the main purpose for this position.
The Appraisal Vendor Coordinator oversees and works with NJM shops to ensure processes are followed and customer issues are resolved.
Hours:<ul><li>
Monday to Friday- 8AM - 4:15PM</li><li>
Hybrid opportunity once training is complete</li><li>
Position can be filled within the West Trenton, Parsippany, or Hammonton NJM office.</li></ul>
Essential Duties and Responsibilities: Essential functions of this job are listed below in order of priority. Reasonable accommodations may be made to enable individuals to perform the essential duties. Regular and predictable onsite attendance is an essential function of the job.<ul><li>
Serve as a liaison between various General Claims departments on repair processes</li><li>
Ensure NJM shops complete required processes to keep customers and NJM informed of repair status</li><li>
Provide updates to customers and Claims staff of status of repair escalations</li><li>
Document all issues into NJM&rsquo;s Vendor Tracker</li><li>
Serve as a point of contact for Enterprise Rent-a-Car to monitor rental average for NJM shops</li><li>
Recover reimbursements from NJM shops due to excess rental or corrective repairs needed</li><li>
Address all Customer Surveys needing attention involving negative shop performance and/or customer dissatisfaction</li><li>
Review estimates from NJM Staff and Independent Companies as part of a bi-monthly Audit</li><li>
Perform Paint &amp; Material calculations to resolve cost issues with shops</li><li>
Provide monthly report on shops not following required update process</li><li>
Complete arbitration responses on a monthly basis</li></ul>
Required Qualifications: Knowledge, skills &amp; abilities, experience, minimum &amp; desired education, certification and/or license requirements.<ul><li>
Familiar with CCC One Estimating platform</li><li>
Minimum 3 years repair shop or Auto Appraiser experience</li><li>
Strong communication skills</li><li>
Ability to prioritize workload</li><li>
High School Diploma or GED</li></ul>
Preferred Qualifications:<ul><li>
Experience with NJM&rsquo;s Vendor Portal</li></ul>
Compensation: Salary is commensurate with experience and credentials.
Pay Range: $77,698-$90,252<div><div><div><div><div><div><div>
Eligible full-time employees receive a competitive Total Rewards package, including but not limited to a 401(k) with employer match up to 8% and additional service-based contributions, Health, Dental, and Vision insurance, Life and Disability coverage, generous PTO, Paid Sick Leave, and paid parental leave in addition to state-mandated leave. Employees may also be eligible for discretionary bonuses.</div></div></div></div></div></div></div><div><div><div><div><div><div><div>
Legal Disclaimer: NJM is proud to be an equal opportunity employer. We are committed to attracting, retaining and promoting a diverse and inclusive workforce that is fully representative of the diversity that exists in the communities in which we do business.</div></div></div></div></div></div></div></div>

Appraisal Vendor Coordinator

Accuracy Plus Medical Laboratory

Accuracy Plus Medical Laboratory (APML) is seeking a detail-oriented and experienced Insurance &amp; Coding Coordinator to join our team in Abu Dhabi. This role is critical in ensuring the accuracy of medical coding, facilitating smooth insurance claim processing, and maintaining compliance with UAE healthcare regulations.The ideal candidate will possess a deep understanding of the Abu Dhabi healthcare landscape and hold professional certifications in medical coding.Key Responsibilities<ul><li>Medical Coding: Review medical records and translate laboratory services, diagnoses, and procedures into appropriate ICD-10, CPT, and DRG codes.</li><li>Claims Management: Prepare, submit, and track insurance claims to ensure timely reimbursement and minimize rejections/denials.</li><li>Regulatory Compliance: Ensure all coding and billing practices adhere to DOH (Department of Health &ndash; Abu Dhabi) regulations and international standards.</li><li>Liaison: Act as the primary point of contact between the laboratory, insurance providers, and healthcare practitioners to resolve queries or claim discrepancies.</li><li>Documentation: Maintain precise records and provide reports on claim status, denial patterns, and revenue cycles.</li></ul>Required Qualifications &amp; Skills<ul><li>Education: Bachelor&rsquo;s degree in Healthcare Administration, Life Sciences, or a related field.</li><li>Certification: Must be a Certified Coder from AAPC (CPC) or AHIMA (CCS).</li><li>Experience: * Minimum of 2 years of medical coding experience within the UAE.</li><li>Prior experience working in a hospital or healthcare facility within Abu Dhabi is highly preferred.</li><li>Technical Proficiency: Advanced knowledge of ICD-10, CPT, and DRG coding systems.</li><li>Communication: Strong written and verbal communication skills in English; ability to communicate complex insurance data clearly.</li><li>Attributes: High attention to detail, strong analytical skills, and the ability to work effectively in a fast-paced environment.</li></ul>Job Type: Full-timePay: AED4,000.00 - AED5,000.00 per monthAbility to commute/relocate:<ul><li>Abu Dhabi: Reliably commute or planning to relocate before starting work (Required)</li></ul>Application Question(s):<ul><li>What is your notice period?</li><li>What is your visa status?</li></ul>Experience:<ul><li>Medical Coding: 1 year (Required)</li></ul>Work Location: In person

Insurance & Coding Coordinator

Colorado Access

The vision of Colorado Access is to have healthy communities transformed by the care that people want at a cost we can all afford. Our mission is to partner with communities and empower people through access to quality, affordable care.
 
Why should you consider a career with Colorado Access?
 We are a Colorado-based company, working to improve the health of our state. We care for individuals, families, and children who receive health care under Child Health Plan Plus (CHP+) and Health First Colorado (Colorado's Medicaid Program). Our focus is driving improvements in quality, member experience, outcomes, and cost. We are a mission-driven organization whose foundation is built by our vision, supported by our values and pillared by diversity, equity and inclusion.
 1. Find work/life balance: We offer PTO, floating holidays, nine company paid holidays, a hybrid work environment, an Employee Assistance Program and a 401K.
 2. Be a part of something bigger and make an impact: We serve the underserved and most vulnerable populations in our community through access to quality and affordable health care. No matter what you do for Colorado Access, you are impacting our community and making a difference.
 3. Sharpen your skills, learn, and grow: We support your continued development through tuition reimbursement, leadership training, promotion opportunities, performance evaluations, employee recognition, and a language pay stipend.
 
What you will do: 
We are looking for a CLAIMS & ADJUSTMENT SPECIALIST who can help shape our vision and support our mission. Here is what the position will look like.
 <ul>
<li>Researches, analyzes, and determines appropriate outcome for provider carrier disputes based on company policies and procedures and regulations, while meeting quality and production standards as established by department director.</li>
<li>Documents and maintains claim appeal status in the claim appeal tracking tool. Sends out applicable provider carrier dispute outcome letters, and other correspondence.</li>
<li>Performs research and analysis on a variety of claim adjustments. Applies claims knowledge, company policies and procedures, and regulations to appropriately adjust claims.</li>
<li>Manages and works daily claim pend reports. Finalizes claims as needed and communicates with Cognizant on the status of daily pend reports.</li>
<li>Submits, manages and follows up on Snow tickets associated with claims and appeals to Cognizant.</li>
<li>Assists with auditing of special projects, as needed.</li>
<li>Assists with department training of new employees.</li>
<li>Serves as a back up to the Claims Coordinator and will log in claim appeals into the claim appeals tracking tool, when needed.</li>
</ul>
What you will bring: 
Education: High School Diploma or equivalent required. Associates degree in health, social services or additional college courses preferred. Equivalent combination of experience and/or education may substitute with a preference for four years progressive relevant work experience.
 
Experience: Minimum of four years’ healthcare experience. Three years of claims or appeals processing experience preferred.
 
Knowledge, Skills, and Abilities: Solid knowledge of claims payment and record keeping required. Must possess basic understanding of health care, medical terminology, medical procedures and managed care principles. Requires familiarity with all claim forms and coding types including CPT/HCPCS, ICD-10, HCFA 1500 and UB-92. Demonstrates support for the company’s mission, vision and values. Excellent organization skills and decision-making skills required. Excellent written and verbal communications skills required. Must be able to interpret data and effectively summarize information. Knowledge of Microsoft Excel, Access & Word strongly preferred. May be required to manage multiple priorities and projects with tight deadlines.
 
Licenses/Certifications: A valid driver's license and proof of current auto insurance will be required for any position requiring driving.
 
Together we will be: an innovative and collaborative team who supports each other, the employees and vision of the company to reach our goals individually, together and as an organization.
 
Pay, Perks and Benefits at Colorado Access: 
The compensation for this position is $65,900.00 - $77,700.00 annually and is a non-exempt (hourly) position. . Colorado Access has provided a compensation range that represents its good faith estimate of what Colorado Access may pay for the position at the time of posting. Colorado Access may ultimately pay more or less than the posted compensation range. The salary offered to the selected candidate will be determined based on factors such as the qualifications of the selected candidate, departmental budget availability, internal salary equity considerations, and available market information, but not based on a candidate’s sex or any other protected status.
 
In addition to being part of a mission driven organization serving our community, as an eligible Colorado Access employee, you’ll receive a generous benefits package, that includes:
 <ul>
<li>Medical, dental, vision insurance that starts the first day of the month following start date.</li>
<li>Supplemental insurance such as critical illness and accidental injury.</li>
<li>Health care and dependent care flexible spending account options.</li>
<li>Employer-paid basic life insurance and AD&D (employee, spouse and dependent).</li>
<li>Short-term and long-term disability coverage.</li>
<li>Voluntary life insurance (employee, spouse, dependent).</li>
<li>Paid time off</li>
<li>Retirement plan</li>
<li>Tuition reimbursement (based on eligibility).</li>
<li>Annual bonus program (based on eligibility, requirements and performance).</li>
</ul>
Where you will work: 
This position will be a hybrid model work environment, a blend of ‘In-Office’ and ‘Remote.’
 
We are not able to support out of state employees at this time as we continue to serve our members and community in the metro Denver area and across the beautiful state of Colorado.
 
Colorado Access is committed to providing equal opportunities to all people regardless of race, color, national origin, age, sex, genetic information, religion, pregnancy, disability, sexual orientation, veteran status or any other status protected by applicable law. We strive to maintain a work environment that is free from unlawful harassment and discrimination.

Claims & Adjustment Specialist

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