claims qa specialist

MedStar Health

<div>About this Job:

MedStar Health has an opportunity for a Patient Accounts Specialist to join the Billing team with MedStar's Patient Financial Services. As a Patient Accounts Specialist on the Billing team, you will be responsible for processing daily billing to include review and correction of daily edits to ensure that payments are met in a timely manner and that benchmarks are met. Ensures compliance with Federal regulations. Work must meet QA standards to ensure both departmental and Patient Financial Services benchmarks are met. 
 
We are specifically looking for candidates who have experience with third-party billing and working electronic payer rejections. Strong knowledge of UB04 and/or 1500 forms, the ability to read/interpret an explanation of benefits as well as proficiency in Microsoft Excel. 
Full time, Monday &ndash; Friday, 7am - 3:30pm schedule working on-site at the billing office located in Nottingham, MD. 
Primary Duties:<ul><li>Daily AM Renamer balancing and validation of the 837i and 837p.</li><li>Patient Accounts Specialist productivity</li><li>Electronic claim rejections</li><li>Processing of paper claims with medical records/attachments</li><li>Daily Billing Reconciliation completion</li><li>Monitor and follow up on daily claim holds with weekly reconciliation.</li><li>Processing of daily interrupt processing of Centralize Coding and Revenue Control claim referrals, etc.</li><li>Processing of returned mail</li><li>Processing of assigned billing projects</li></ul> 
Qualifications:<ul><li>High school graduation or equivalent.</li><li>1 year experience in patient accounting, accounts receivable, or related healthcare field, or an equivalent combination of experience and college education in Accounting, Finance or Healthcare Administration.</li><li>Detailed working knowledge and demonstrated proficiency in multiple payers application billing and/or collection processes, including governmental and non-governmental.</li><li>Requires basic working knowledge of UB04 and/or 1500 and Explanation of Benefits (EOB).</li><li>Requires some knowledge of medical terminology and CPT/ICD-10 coding.</li><li>Excellent communication, analytical, interpersonal and organizational skills.</li><li>Proficient uses of hospital registration and/or billing systems and personal computers as well as Microsoft Excel and Word applications. Ability to type 35 WPM</li></ul>
This position has a hiring range of : USD $18.70 - USD $32.72 /Hr.</div>

Patient Accounts Specialist I - Billing

Pigeon Engineering

3. QA/QC Coordinator (for Scaffolding Billings and Documentation)Job Title: QA/QC Coordinator - Billings &amp; DocumentationDepartment: Quality Assurance / CommercialReports To: Scaffolding Project Operations ManagerLocation: Doha, Qatar (office-based with site coordination)Job Summary: The QA/QC Coordinator manages quality assurance processes, documentation control, and billing support for scaffolding projects. This role ensures all works comply with contract specifications, client requirements, and internal standards while facilitating accurate, timely invoicing through proper measurement, records, and handover documentation.Key Responsibilities:<ul><li>Implement and monitor the company&rsquo;s QA/QC plan specific to scaffolding activities.</li><li>Review and maintain all project documentation: method statements, risk assessments, inspection reports, CISRS certificates, material test certificates, and scaffold tags/handover records.</li><li>Conduct internal quality audits and coordinate third-party/client inspections.</li><li>Verify scaffold quantities (erection/dismantling volumes in m&sup3;) for accurate progress measurement and billing.</li><li>Prepare and submit monthly progress claims, variation claims, and supporting documentation to clients/main contractors.</li><li>Track non-conformances, corrective actions, and lessons learned.</li><li>Maintain digital and physical project files for audits and close-out.</li><li>Support commercial team with as-built drawings, daily reports, and quantity take-offs.</li><li>Ensure compliance with ISO 9001 (if certified), QCS, and client quality requirements.</li><li>Assist in pre-qualification and tender documentation.</li></ul>Qualifications &amp; Experience:<ul><li>Bachelor&rsquo;s Degree in Civil Engineering, Quantity Surveying, or related field.</li><li>5+ years of QA/QC and documentation experience in construction/scaffolding in Qatar/GCC.</li><li>Familiarity with scaffolding measurement methods and billing practices.</li><li>Knowledge of contract forms (e.g., FIDIC) and client portals (Ashghal, etc.).</li></ul>Skills &amp; Competencies:<ul><li>Strong organizational and documentation management skills (Excel, SharePoint, or document control software).</li><li>Attention to detail and accuracy in billing/quantity verification.</li><li>Good understanding of scaffolding terminology and inspection processes.</li><li>Excellent written and verbal communication in English.</li><li>Proficiency in MS Office and basic AutoCAD.</li></ul>Pay: QAR6,500.00 - QAR8,500.00 per monthWork Location: In person

QAQC Coordinator (Scaffolding Division)

The Inventor Solutions

At The Inventor Solutions, we are scaling rapidly in the US healthcare outsourcing space, managing multiple dental and medical billing clients across the United States.We are looking for a high-impact Operations Manager who can take ownership of delivery, drive operational excellence, and build a strong, process-driven team.This role is not about supervision it is about ownership, accountability, and scale.Key Responsibilities<ul><li>Lead and manage end-to-end RCM operations (Dental &amp; Medical Billing)</li><li>Oversee teams handling:</li><li>Insurance Verification</li><li>Charge Entry</li><li>Claims Submission</li><li>AR Follow-ups</li><li>Ensure high accuracy and QA standards across all client deliverables</li><li>Build and implement SOPs, KPIs, and performance dashboards</li><li>Identify operational gaps and drive process improvements</li><li>Manage and mentor Team Leads and QA personnel</li><li>Act as the primary escalation point for critical client issues</li><li>Ensure adherence to client SLAs and turnaround times</li><li>Collaborate with Sales &amp; Client Success teams for onboarding new clients</li><li>Drive productivity, efficiency, and team accountability</li></ul>What We&rsquo;re Looking For<ul><li>6-7+ years of experience in Healthcare RCM / Dental Billing Operations</li><li>Proven experience managing teams of 15&ndash;50+ resources</li><li>Strong understanding of:</li><li>US Insurance workflows</li><li>Claims lifecycle</li><li>Denial management</li><li>Experience in building or managing QA frameworks</li><li>Strong leadership and decision-making ability</li><li>Excellent communication skills (written &amp; verbal)</li><li>Ability to work in a fast-paced, night-shift environment</li></ul>Preferred (Bonus)<ul><li>Experience working with US-based clients</li><li>Exposure to process automation or workflow tools</li><li>Prior experience in scaling operations in a startup environment</li></ul>Compensation &amp; Benefits<ul><li>Competitive market salary (based on experience)</li><li>Performance-based growth and incentives</li><li>Fast-track career progression into Senior Operations / Leadership roles</li><li>Opportunity to work directly with US healthcare clients</li></ul>Work Details<ul><li>Location: On-site (Rawalpindi/Islamabad)</li><li>Shift: Night Shift (US Hours)</li><li>Department: Operations/Healthcare RCM</li></ul>Why Join Us<ul><li>Be part of a rapidly growing healthcare outsourcing company</li><li>Work in a high-growth environment with real ownership</li><li>Build and lead teams at scale</li><li>Direct exposure to international clients and processes</li></ul>Work Location: In person

Operations Manager

Physicians Revenue Group

Position: QA Analyst (Medical Billing &ndash; Fresher) Location: Lahore (Township) Shift: Night Shift Experience: Fresh GraduatesJob Summary: We are looking for a detail-oriented QA Analyst (Fresher) to join our medical billing team. The ideal candidate will be responsible for reviewing processes, ensuring accuracy, and maintaining quality standards across billing operations.Key Responsibilities:<ul><li>Review medical billing processes for accuracy and compliance</li><li>Perform quality checks on claims, charges, and documentation</li><li>Identify errors and report discrepancies</li><li>Ensure adherence to billing guidelines and company policies</li><li>Maintain records of QA findings and prepare reports</li><li>Coordinate with billing and operations teams for corrections</li><li>Support continuous improvement in quality standards</li></ul>Requirements:<ul><li>Bachelor&rsquo;s degree (Analytics / Accounting / Healthcare preferred)</li><li>Strong attention to detail and analytical skills</li><li>Good communication skills</li><li>Basic knowledge of medical billing (preferred but not mandatory)</li><li>Willingness to work night shifts</li></ul>What We Offer:<ul><li>Training &amp; learning opportunity for fresh graduates</li><li>Growth in the medical billing domain</li><li>Professional work environment</li></ul>Job Type: Full-timeAbility to commute/relocate:<ul><li>Lahore: Reliably commute or planning to relocate before starting work (Preferred)</li></ul>Application Question(s):<ul><li>Would you be available to work from 6:00 PM to 3:00 AM?</li></ul>Education:<ul><li>Bachelor's (Preferred)</li></ul>Work Location: In person

QA Analyst (Medical Billing – Fresher)

American business solutions inc

<div><h3 class="jobSectionHeader">Job Summary</h3>
We are seeking an experienced Business Analyst with strong Auto Insurance domain expertise and hands-on experience with Guidewire applications. The ideal candidate will work closely with business users, product owners, developers, and QA teams to analyze business requirements, support Guidewire implementations, and drive successful delivery of insurance technology solutions.
<h3 class="jobSectionHeader">Key Responsibilities</h3>
<ul><li>Gather, analyze, and document business and functional requirements for Auto Insurance projects.</li>
<li>Work extensively with Guidewire applications including PolicyCenter, ClaimCenter, and BillingCenter.</li>
<li>Collaborate with underwriting, claims, policy administration, and billing teams to understand business processes and system requirements.</li>
<li>Create BRD, FRD, user stories, use cases, workflow diagrams, and gap analysis documentation.</li>
<li>Conduct stakeholder meetings, requirement workshops, and business process discussions.</li>
<li>Support Guidewire implementation, enhancement, migration, and integration initiatives.</li>
<li>Coordinate with development and QA teams during design, testing, UAT, and deployment phases.</li>
<li>Analyze defects, support issue resolution, and ensure business requirements are properly implemented.</li>
<li>Participate in Agile/Scrum ceremonies including sprint planning, backlog grooming, and daily stand-ups.</li>
<li>Ensure compliance with insurance regulations and organizational standards.</li>
</ul><h3 class="jobSectionHeader">Required Qualifications</h3>
<ul><li>Bachelor&rsquo;s degree in Business Administration, Information Technology, Insurance, or related field.</li>
<li>5+ years of Business Analyst experience within Property &amp; Casualty (P&amp;C) Insurance.</li>
<li>Strong experience in Auto Insurance domain.</li>
<li>Hands-on experience with Guidewire products:
<ul><li>Guidewire PolicyCenter</li>
<li>Guidewire ClaimCenter</li>
<li>Guidewire BillingCenter</li>
</ul></li><li>Strong understanding of insurance lifecycle processes including policy issuance, endorsements, renewals, claims, and billing.</li>
<li>Experience in requirement gathering, process mapping, and business analysis documentation.</li>
<li>Strong communication, analytical, and stakeholder management skills.</li>
<li>Experience working in Agile/Scrum methodology.</li>
</ul><h3 class="jobSectionHeader">Preferred Skills</h3>
<ul><li>Guidewire implementation or upgrade project experience.</li>
<li>Knowledge of Guidewire integrations and APIs.</li>
<li>Experience with JIRA, Confluence, and SQL.</li>
<li>Exposure to testing/UAT coordination.</li>
<li>Guidewire certification is a plus.</li>
</ul><h3 class="jobSectionHeader">Technical Skills</h3>
<ul><li>Guidewire Suite (PolicyCenter, ClaimCenter, BillingCenter)</li>
<li>JIRA / Confluence</li>
<li>SQL</li>
<li>MS Excel, Visio, PowerPoint</li>
<li>Agile / Scrum</li></ul></div>

Business Analyst (Auto Insurance & Guidewire Experience)

Old Republic International

<div>WHO ARE WE? 
Old Republic Surety Company underwrites contract, fidelity, and commercial bonds, serviced through a strong and partnered network of independent insurance agencies. Solutions provided include bid bonds, performance and payment bonds, and maintenance bonds for large, middle market and smaller growing contractors. ORSC consistently offers superior service and creative underwriting options in all 50 states and some of the U.S. territories.
ORSC continues to expand it geographic footprint and product offering while consistently delivering significant, market-leading growth and maintaining a strong underwriting margin.<div>
Are you ready to take your career to the next level as a Claims Specialist with a company known for stability, expertise, and integrity? At Old Republic Surety Company, we&rsquo;re looking for a driven and detail-oriented Claims Specialist who thrives in a fast-paced environment and is passionate about delivering fair, timely, and strategic claim resolutions.</div><div></div><div> 
</div><div>
As a Claims Specialist, you&rsquo;ll play a role in protecting our clients and our business by managing complex commercial surety claims from investigation through resolution.</div><div></div><div> 
</div><div>
We&rsquo;re seeking a Claims Specialist who is analytical, proactive, and confident in decision-making. If you enjoy interpreting complex legal documents, negotiating outcomes, and collaborating with professionals across industries, this role is designed for you.</div><div>
</div><h3 class="jobSectionHeader">
What You&rsquo;ll Do as a Claims Specialist</h3><ul><li>
Ensure equitable claim service is performed in a timely and professional manner involving commercial surety claims</li><li>
Interpret bond language to determine company liability and identify issues requiring escalation</li><li>
Coordinate investigations, working closely with internal teams and external partners</li><li>
Evaluate resolution strategies and recommend effective courses of action</li><li>
Establish and maintain appropriate reserves while proactively mitigating loss</li><li>
Negotiate and settle claims within authority limits, clearly communicating liability decisions</li><li>
Develop surety defenses and manage complex coverage issues</li><li>
Pursue salvage opportunities, including indemnification and subrogation efforts</li><li>
Control Loss Adjustment Expenses through strategic use of attorneys, consultants, and accountants</li></ul><h3 class="jobSectionHeader">
What You Bring</h3><div>
As a successful Claims Specialist, you combine technical expertise with strong communication and organizational skills. You&rsquo;re comfortable working independently while managing multiple priorities with precision.</div><ul><li>
High School Diploma or equivalent required</li><li>
Minimum 2 years of related experience or 3 years in insurance claims</li><li>
Strong ability to interpret complex legal and financial documents</li><li>
Excellent negotiation and communication skills</li><li>
Proficiency with Microsoft Office and computer systems</li><li>
Exceptional attention to detail and organizational abilities</li><li>
Ability to maintain confidentiality and exercise sound judgment</li><li>
Strong proofreading and recordkeeping skills</li></ul>
COMPANY BENEFITS
Financial:<ul><li>
Competitive salary</li><li>
401k Savings &amp; Profit-Sharing Plan, including company match contribution</li><li>
Roth investment options</li><li>
529 Education Savings Plan</li><li>
Employee Referral Bonus Program</li></ul>
Health:<ul><li>
Health Insurance</li><li>
Dental Insurance</li><li>
Flexible Spending &amp; Health Savings Account options</li><li>
Life Insurance</li><li>
Vision Insurance</li><li>
Supplement Life Insurance</li><li>
Long-Term Disability Insurance</li><li>
Paid Leave of Absence Benefits</li><li>
Accident &amp; Critical Illness Insurance</li><li>
Pet Insurance</li></ul>
Work-Life Balance:<ul><li>
37.5 hour standard work week</li><li>
Casual business attire</li><li>
Generous paid time-off (PTO)</li><li>
Paid holidays</li><li>
Volunteer opportunities</li><li>
Company-sponsored events and outings</li></ul><div><div><div><div>
#LI-VG1</div></div></div></div>
Old Republic Surety Company is an Equal Opportunity Employer and is committed to maintaining a diverse workplace.</div>

Claims Specialist, Commercial

First Chicago Insurance Company

<div>Are you unhappy at your present job?
Are you going nowhere in your current position?
Is it time for a change? 
Are you an experienced Auto Bodily Injury Claims Specialist looking to join a growing company where you will be rewarded for your hard work, and have future upward career growth opportunities? 
If you answered YES to the above, it's time to talk to First Chicago Insurance Company!
We offer:
<ul><li>Competitive Salaries</li><li>
Excellent benefits</li><li>
Growth opportunities!</li></ul>
Apply only if you consider yourself a career professional who loves to work, because we work hard here! 
If you are an experienced AUTO CLAIMS PROFESSIONAL (with many years of auto and especially non-standard auto related experience) we'll make sure you are COMPENSATED AS A PROFESSIONAL!! 
We are seeking an experienced Auto Bodily Injury Claims Specialist!
The Auto Bodily Injury Claims Specialist will be responsible for investigating and settlement of automobile bodily injury claims. They will settle complex liability claims which require greater investigation and verification, as well as casualty claims including severe injuries which may result in extended disability or bodily injury as well as coverage related litigation. 
DUTIES &amp; RESPONSIBILITIES:<ul><li>
Review &amp; determine course of action on each file assigned, utilizing technical knowledge &amp; experience for the purpose of supporting final disposition of a loss</li><li>
Conduct thorough investigations and keep accurate and relevant documentation of file activity on each claim assigned including coverage, liability status, and damages that are applicable for each claim</li><li>
Process Bodily Injury, and coverage claims in accordance with established office procedures</li><li>
Work closely with Third Parties, plaintiff counsel, Claim Director and Chief</li><li>
Operating Officer to determine necessary injury and coverage investigation</li><li>
Research case and statutory law in order to conduct proper claim investigation</li><li>
Document policy status, coverage, liability and damages on all claims and notify re-insurer on qualifying claims</li><li>
Prepare and present claim evaluations for the appropriate settlement authority</li><li>
Maintain reasonable expense factors</li><li>
Handle other duties as assigned</li></ul> 
QUALIFICATIONS REQUIRED:<ul><li>
3-5 Years in Auto Casualty claims experience a MUST!</li><li>
Non-Standard Auto Claims experience preferred, not required</li><li>
Minimum 5 years of Auto Bodily Injury Casualty experience to be considered hybrid/remote</li><li>
Knowledge of legal and medical terminology</li><li>
Excellent negotiation, communication, written, organizational and interpersonal skills</li><li>
Ability to pass written examinations where required by state statutes to become a licensed claims adjuster</li><li>
Proficiency in Microsoft Office products</li></ul> 
First Chicago Insurance Company provides a competitive benefits package to all full- time employees. Following are some of the perks First Chicago employees receive:<ul><li>
Competitive Salaries</li><li>
Commitment to your Training &amp; Development</li><li>
Medical and Dental and Vision Reimbursement</li><li>
Short Term Disability/Long Term Disability</li><li>
Life Insurance</li><li>
Flexible Spending Account</li><li>
Telemedicine Benefit</li><li>
401k with a generous company match</li><li>
Paid Time Off and Paid Holidays</li><li>
Tuition Reimbursement
</li><li>Wellness Program</li><li>
Fun company sponsored events</li><li>
And so much more!</li></ul> 
Estimated Compensation Range: $54,750/year-$97,500/year*<ul><li>Published ranges are estimates</li></ul></div>

Auto Casualty Claims Specialist

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