claims resolution specialist

Westchester Medical Center Health Network

<div><div><div><div><div><div>Job Title: Payment Resolution Analyst
Company: NorthEast Provider Solutions Inc.
<div>City/State: Valhalla, NY
</div>Category: Finance/Info Systems
Department: Patient Accounts-WMC Health
Union: No
</div><div>Position: Full Time
Hours: 7:30am-4pm
Shift: AM
Req #: 45219
Posted Date: Oct 24, 2025
Hiring Range: $28.16 - $35.40</div><div><div> 
<div>
</div></div></div></div></div></div></div><div><h3 class="jobSectionHeader">Job Details:</h3>
Job Summary:
The Payment Resolution Analyst processes all out of network insurance claims to ensure appropriate payments are received, negotiates payments with payers, provides good faith estimates to potential patients and processes and follows up on independent dispute resolution appeals.
Responsibilities:
<ul>
<li>Reconciles billing and payment data on an automated system to maintain and update receivable status on out of network payments posted on the patients' account.</li>
<li>Communicates with third party payers by means of correspondence or by telephone to start payment negotiation on accounts that are deemed &ldquo;underpaid&rdquo; per set guidelines.</li>
<li>Reviews payments to assess if account will be sent for independent dispute resolution.</li>
<li>Prepares and submits appeals for independent dispute resolution.
</li><li>Negotiates with third party payors on underpayments.</li>
<li>Tracks outcomes.</li>
<li>Works collaboratively with other departments to ensure accuracy of patient billing.</li>
<li>Responsible for maintaining and implementing new process/procedures based on regulatory updates.</li>
<li>Any other responsibility as directed.</li>
</ul>Qualifications/Requirements:

Experience:
1 year billing and follow up experience in a hospital environment preferred
Education:
High school or equivalency diploma and combination of years of experience, college education or healthcare certification equivalent.
Licenses / Certifications:
Other:
Must possess strong organizational and communication skills, and Microsoft office aptitude (Word/Excel/Outlook. Must be comfortable with data entry utilizing multiple patient access programs and software. Work effectively in a multi task fast paced environment prioritizing and completing tasks in a timely manner. Problem solving skills and attention to detail to assess and resolve conflict in a timely manner. Proficient in oral and written communications.
About Us:
NorthEast Provider Solutions Inc.
Benefits:
We offer a comprehensive compensation and benefits package that includes:
<ul>
<li>Health Insurance</li>
<li>Dental</li>
<li>Vision</li>
<li>Retirement Savings Plan</li>
<li>Flexible Savings Account</li>
<li>Paid Time Off</li>
<li>Holidays</li>
<li>Tuition Reimbursement</li></ul></div></div>

Payment Resolution Analyst

sync bpo

Key Responsibilities:<ul><li>Follow up on unpaid or denied medical claims with insurance companies and patients.</li><li>Review aging reports and maintain proper AR follow-up strategies.</li><li>Handle claim re-submissions, appeals, and corrections.</li><li>Identify and resolve payment discrepancies and billing issues.</li><li>Maintain accurate documentation of all activities and correspondence.</li><li>Collaborate with team members to meet monthly collection targets.</li></ul>Requirements:<ul><li>Experience: Minimum 1&ndash;2 years of experience in AR follow-up / Medical Billing (US Healthcare).</li><li>Education: Bachelor&rsquo;s degree (preferred in Business, Finance, or related field).</li><li>Skills:</li><li>Strong knowledge of EOBs, denials, and claim resolution.</li><li>Excellent communication (spoken and written English).</li><li>Proficient in MS Office and medical billing software (e.g., ModMed, Kareo, Athena, eClinicalWorks, etc.).</li><li>Ability to work independently and in a team environment.</li></ul>Location SabzazarTimings: 0500PM to 02:00AMJob Type: Full-timePay: Rs50,000.00 - Rs100,000.00 per monthEducation:<ul><li>Bachelor's (Required)</li></ul>Experience:<ul><li>1-2: 1 year (Preferred)</li></ul>Location:<ul><li>Lahore (Required)</li></ul>Work Location: In person

Medical Billing AR Recovery

TED Recruitment

Location: London or South EastRegion: UK-London Salary / Rate: £120000 per annum, bonus etc. THE ROLE An exciting requirement for an experienced CLAIMS CONSULTANT with a Quantity Surveying background at Partner Designate level to join my client as soon as possible either in London / South East or based from the East of England or East Midlands although candidates from other locations may also be considered.Some trips to head office in Suffolk will be required.My client is heavily involved with claims and delay on a range of project types in the construction industry. They also provide commercial support to a wide range of clients which include major developers, end users, main contractors and subcontractors. THE CLIENT My client is a specialist firm with their head office in Suffolk working on claims, delay, expert work and commercial support for projects for buildings, infrastructure and more.They provide technical support to lawyers and have acted as Party Representative for construction clients on adjudications.They also provide specialist construction arbitration and construction adjudication services. THE CANDIDATE They now have an opening for an ambitious Partner Designate Claims Consultant to join them ASAP based either from London / South East covering work across the UK and some further afield or from the East Midlands or East of England, although candidates from other UK locations will be considered.You must have excellent experience in dispute resolution and it is likely that you are a Quantity Surveyor by training with excellent experience of construction claims, adjudication, dispute resolution etc.You may have worked on claims across a variety of sectors including buildings, infrastructure, civils, MEP, power, utilities etc.You are likely to have a BSc in Quantity Surveying, be MRICS qualified and you may also have done an MSc in Construction Law or LLB.You must have sound knowledge of standard construction forms of contract, in particular JCT and NEC and ideally you may have used FIDIC too.You will have an excellent financial understanding of all stages of projects.You will have knowledge of Part II of the Construction Act particularly with respect to adjudication and payment.Dispute experience would be advantageous.The ideal candidate will not mind occasionally working on the odd live project too and be able to identify project difficulties and pinch points.You may have worked on projects for building, civils, MEP, utilities and similar sectors.Ideally you will have an outgoing personality and be able to either bring clients or get involved in business networking, business development etc.You will ideally also have potential clients that can be brought to my client.My client would like someone to join them for a few months as an Associate or Partner Designate before becoming a full Partner.Initial salary in the region of £120,000 per annum plus bonus etc. once a Partner.How to Apply: Please email your c.v. quoting the job reference number to Contact:Denise NevilleReference: DNP9570<ul><li></li><li> (0), or </li></ul><img src="https://www.jobg8.com/Tracking.aspx?ORllwQ7xBmgLMysi8bbZ6YPtfu34mvOGu" width="0" height="0" />

Partner Designate Claims Consultant

MaxRemind

Job Title: Medical Billing Specialist &amp; Reporting AnalystJob Summary:We are seeking a Medical Billing Specialist &amp; Reporting Analyst to manage end-to-end billing operations and ensure accuracy in claims submission, payment posting, and reporting. The ideal candidate will have strong analytical skills, proficiency in Excel, and a deep understanding of the US healthcare billing process.Key Responsibilities:<ul><li>Prepare, review, and submit medical claims to insurance companies accurately and timely.</li><li>Monitor claim rejections and denials; identify root causes and ensure prompt resolution.</li><li>Post payments and reconcile accounts to ensure proper posting in the system.</li><li>Generate and maintain daily, weekly, and monthly performance reports related to billing and collections.</li><li>Track KPIs such as claim submission accuracy, denial rates, and payment turnaround times.</li><li>Perform data analysis to identify trends and provide insights for process improvement.</li><li>Maintain confidentiality and compliance with HIPAA and company policies.</li></ul>Requirements:<ul><li>Familiarity with EHR/PM systems and payer portals.</li><li>Strong analytical and communication skills.</li><li>Detail-oriented, organized, and able to meet deadlines.</li><li>Bachelor&rsquo;s degree (preferably in Business, Finance, Healthcare, or related field).</li><li>6 months to 1.5 years of experience in US medical billing and reporting.</li></ul>Job Type: Full-TimeTimings: 8:00 PM &ndash; 5:00 AMLocation: Old Airport Road, Fazal Town phase 2, RawalpindiJob Type: Full-timePay: Rs40,000.00 - Rs50,000.00 per monthWork Location: In person

Medical Billing Specialist and Analyst

Vida Health

<div><div>We are seeking a detail-oriented Claims Operations Specialist to own the end-to-end billing process for both medical and pharmacy claims. This role oversees claim submission, tracking, reconciliation and serves as a key point of contact for internal teams and clients. The ideal candidate is a quick learner with strong analytical skills and a desire to grow in a fast-paced, non-traditional healthcare environment. Experience with digital health, S-codes or pharmacy claims is a plus.</div>
<h3 class="jobSectionHeader">Responsibilities:
</h3><ul><li>Oversee the full revenue cycle process for both medical and pharmacy claims, including submission, QA, payment posting and AR follow-up.</li><li>
Review, investigate and resolve claim denials and rejections to ensure timely and accurate reimbursement.</li><li>
Assist with client onboarding, including claims setup, payer integration, Candid configuration and rules engine alignment.</li><li>
Perform monthly billing operations such as claims reconciliation, bank reconciliation and revenue validation.</li><li>
Serve as a point of contact for clients, participating in onboarding calls, monthly check-ins and responding to billing questions.</li><li>
Collaborate with Sales, Product, Data and Client Success teams on RFPs, internal process updates and issue resolution.</li></ul><h3 class="jobSectionHeader">
Qualifications:</h3><ul><li>
Bachelor&rsquo;s degree in Healthcare Administration, Business or a related field, or equivalent practical experience.</li><li>
CPB, CRCS or CMRS strongly preferred.</li><li>
4+ years of experience in revenue cycle management, medical billing or claims operations.</li><li>
Experience in the digital health space is a plus.</li><li>
Prior experience using Candid or similar RCM platforms is preferred.</li><li>
Advanced Excel skills (e.g., pivot tables,VLOOKUP, formulas).</li><li>
Familiarity with BigQuery, Looker, NetSuite and Candid.</li><li>
Understanding of general healthcare reimbursement principles.</li><li>
Familiarity with pharmacy claims and/or alternative coding (eg., S-codes) preferred.</li></ul><ul><li>
Self-starter with a proactive approach to problem-solving.</li><li>
Strong analytical mindset with the ability to work through ambiguity.</li><li>
Comfortable working independently with minimal direction.</li><li>
Strong attention to detail and accountability for high-quality work.</li><li>
Effective communicator with experience engaging clients directly.</li></ul></div>

Claims Operations Specialist

Euro Systems

Job Title: Legal Contracts Specialist Location: United Arab Emirates Industry: Contracting / Construction Employment Type: Full-TimePosition OverviewWe are looking for a highly skilled Legal Contracts Specialist to oversee and manage all legal and contractual matters related to our construction and contracting projects in the UAE. The ideal candidate will have a strong background in UAE laws, FIDIC contracts, and construction law, with hands-on experience drafting, negotiating, and reviewing a variety of commercial and subcontracting agreements. This role ensures full legal compliance and mitigates risk across all business operations.Key Responsibilities<ul><li>Draft, review, and negotiate contracts, subcontracts, NDAs, MOUs, and other legal agreements in line with UAE laws and company standards.</li><li>Provide legal and contractual guidance to management and project teams on contract interpretation, obligations, and risk exposure.</li><li>Ensure compliance with UAE Civil Code, FIDIC standards, and relevant legal frameworks.</li><li>Identify potential legal risks and advise management on mitigation strategies and corrective actions.</li><li>Support claims preparation, variation orders, and dispute resolution with proper documentation and legal reasoning.</li><li>Liaise with external legal counsel for arbitration, litigation, and complex legal matters.</li><li>Review tender documents and bid conditions, identifying contractual risks and recommending amendments.</li><li>Maintain an organized repository of contracts, legal correspondence, and compliance records.</li><li>Monitor and manage contract renewals, terminations, and performance guarantees.</li><li>Stay updated on changes in UAE legislation and construction regulations that impact company operations.</li></ul>Qualifications &amp; Experience<ul><li>Bachelor&rsquo;s degree in Law, Legal Studies, or a related discipline (LLB or higher preferred).</li><li>5&ndash;8 years of experience as a Legal or Contracts Specialist in the UAE construction or contracting industry.</li><li>Deep understanding of UAE Civil Law, FIDIC Contracts, and construction dispute resolution procedures.</li><li>Proven ability to draft and negotiate complex contractual documents.</li><li>Strong analytical, problem-solving, and decision-making skills.</li><li>Excellent communication and negotiation skills with attention to detail.</li><li>Proficient in MS Office and legal/contract management tools.</li><li>Fluent in English; knowledge of Arabic is an advantage.</li></ul>Preferred Skills<ul><li>Experience in arbitration, mediation, or dispute resolution.</li><li>Sound understanding of commercial and corporate legal frameworks.</li><li>Ability to work under pressure and manage multiple projects simultaneously.</li><li>High level of professional integrity, confidentiality, and business ethics.</li></ul>Job Type: Full-timePay: AED12,000.00 - AED15,000.00 per month

Legal Contracts Specialist

Prima Systems

Digital Prima Systems is a reputable healthcare technology company specializing in providing innovative solutions for medical billing and revenue cycle management. We are committed to assisting healthcare providers in optimizing their financial operations and ensuring timely reimbursement for services rendered.Responsibilities:<ul><li>Insurance Claims Processing:</li><li>Review and prepare accurate insurance claims for submission to various payers.</li><li>Verify patient insurance coverage, benefits, and eligibility.</li><li>Ensure proper coding (CPT, ICD-10, HCPCS) and documentation for claims accuracy.</li><li>Submit claims electronically or by paper according to payer requirements.</li><li>Payment Posting and Reconciliation:</li><li>Post payments received from insurance companies and patients into the billing system.</li><li>Reconcile payments against billed amounts to identify discrepancies.</li><li>Investigate and resolve any discrepancies in payments, adjustments, or denials.</li><li>Accounts Receivable Management:</li><li>Monitor and follow up on unpaid or denied claims to ensure timely resolution.</li><li>Contact insurance companies to inquire about claim status and facilitate payment.</li><li>Review aging reports regularly to prioritize and address delinquent accounts.</li><li>Initiate appeals for denied or underpaid claims and track the appeal process.</li><li>Patient Billing and Communication:</li><li>Generate patient statements and invoices for outstanding balances.</li><li>Work with patients to establish payment plans or arrangements.</li><li>Provide clear and compassionate communication regarding billing inquiries or issues.</li><li>Documentation and Reporting:</li><li>Maintain accurate and organized records of all billing and collection activities.</li><li>Generate reports on accounts receivable status, aging trends, and collection efforts.</li><li>Prepare regular updates and summaries for management review.</li><li>Compliance and Regulations:</li><li>Ensure compliance with HIPAA regulations and other billing guidelines.</li><li>Stay informed about changes in billing regulations and payer policies.</li><li>Implement best practices to maximize reimbursement and minimize compliance risks.</li></ul>Requirements:<ul><li>Proven experience as an Accounts Receivable Specialist in medical billing or a related field.</li><li>In-depth knowledge of medical terminology, billing codes (CPT, ICD-10, HCPCS), and insurance claims processes.</li><li>Proficiency in using medical billing software and electronic health record (EHR) systems.</li><li>Strong understanding of insurance policies, reimbursement methodologies, and billing guidelines.</li><li>Excellent analytical skills to identify and resolve billing discrepancies efficiently.</li><li>Effective communication skills to interact professionally with insurance companies, patients, and internal teams.</li><li>Detail-oriented with a high level of accuracy in data entry and financial calculations.</li></ul>Job Type: Full-timePay: Rs80,000.00 - Rs95,000.00 per monthExperience:<ul><li>Account Receivable: 1 year (Preferred)</li></ul>Language:<ul><li>English (Preferred)</li></ul>Work Location: In person

Medical Billing - AR Executive

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