insurance plan specialist

AR Insurance Specialist - Mountain Standard Time

GrowthRatio Solutions

Healthcare Service Plan Specialist Location: Bahria Town Phase 7 RawalpindiWorking Hours: 1:30 PM &ndash; 10:30 PM (PKT) | Monday &ndash; FridayStart Date: ASAPAbout the RoleWe&rsquo;re looking for a detail-oriented and highly analytical professional to join our growing healthcare operations team. In this role, you&rsquo;ll be responsible for crafting accurate, compliant, and personalized service plans for seniors seeking home care support.If you have a strong background in medical billing, healthcare documentation, and compliance (HIPAA) and you thrive in structured, process-driven environments this role is designed for you.Key Responsibilities<ul><li>Develop and update individualized service plans based on patient needs and medical data</li><li>Ensure all documentation is accurate, complete, and audit-ready</li><li>Review service plans to ensure full compliance with regulatory and program guidelines</li><li>Collaborate closely with Service Coordinators to maintain efficient workflow and timely delivery</li><li>Manage multiple active cases while maintaining high-quality standards</li><li>Handle sensitive healthcare data with strict adherence to HIPAA compliance protocols</li></ul>What We&rsquo;re Looking For<ul><li>Strong writing and analytical skills (critical for documentation accuracy)</li><li>Exceptional attention to detail and organizational ability</li><li>Ability to manage multiple deadlines and case workflows simultaneously</li><li>Proficiency in digital tools, documentation systems, and spreadsheets</li><li>Clear and professional communication skills</li></ul>Required Experience<ul><li>Experience in medical billing (mandatory)</li><li>Familiarity with HIPAA compliance and handling sensitive medical data (mandatory)</li><li>Background in healthcare, case management, or service plan writing (preferred)</li></ul>Why Join Us?<ul><li>Work with an international healthcare team</li><li>Gain exposure to structured U.S. healthcare systems and compliance standards</li><li>Stable, long-term opportunity with clear workflows and defined processes</li></ul>How to Apply Send your resume at 03078908971Job Type: Full-timePay: From Rs70,000.00 per monthWork Location: In person

Healthcare Service Plan Specialist

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> 
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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> 
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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

Community Health Choice

Job Overview Under the direction of the Manager, Managed Care Pharmacy Operation, the Pharmacy Program Specialist II supports the operational needs of the pharmacy team by managing prior authorization processes, coordinating communication between members and providers, and addressing issues with the Pharmacy Benefit Manager (PBM). The role requires a strong understanding of medical benefit drug coverage and adherence to regulatory timelines. The specialist also contributes to reporting, monitoring delegated PBM functions, and promoting member adherence, while delivering a high level of customer service.QUALIFICATIONS:Required Preferred Education/Specialized Training/Licensure: Bachelor&rsquo;s degree in healthcare field, or in business administration Actively registered with the Texas State Board of Pharmacy as a certified pharmacy technicianWork Experience (Years and Area): Minimum Three (3) years&rsquo; experience with a Health Plan or PBM in related functions Strong experience with prior drug authorization process in a Health Plan or PBMPay: $23.46 - $29.32 per hourBenefits:<ul><li>401(k)</li><li>Dental insurance</li><li>Health insurance</li><li>Paid time off</li><li>Vision insurance</li></ul>Work Location: Hybrid remote in Houston, TX 77081

Pharmacy Program Specialist II

Nulton Diagnostic

<div>BILLING SPECIALIST
Position Description:
We are looking for a Billing Specialist to join our Team!
The Billing Specialist is responsible for all aspects of medical billing within our Agency. Duties include, but are not limited to: speaking with insurance companies, obtaining prior authorizations, daily entry of data, and determining insurance eligibilities. The Billing Specialist will also check eligibilities on patients, communicate directly with patients regarding billing, obtain authorizations and update and maintain patient insurance in the current software. Additional responsibilities will include:
a. Post payments from insurance and clients 
b. Management of the denials/rejections 
c. Reading and understanding 835 files 
d. Generate 1500 form claims via paper or electronically 
e. Navigate insurance websites/maintain user status 
f. General billing duties related to the scope of the position, but not mentioned specifically above.
Education, Experience, Skills, Training:
High School Diploma or equivalent.
The successful applicant must have excellent communication skills, computer skills, and knowledge of Medicare, Medicaid, Commercial and Third-Party Insurers. Applicant must have efficient knowledge of eligibility verification and claims processing. At least one year of billing experience preferred. Must be able to obtain Act 33, Act 34 and FBI clearances.
This is a full-time position with medical, dental and vision benefits, as well as, 401(k) Retirement Plan with matching company contributions, paid vacation and paid holidays.
Nulton Diagnostic and Treatment Center is an equal opportunity employer. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disability status.</div>

Billing Specialist

Catholic High School

Catholic High School, a college preparatory school in Virginia Beach, Virginia has an immediate opening for a full-time Athletic Facilities and Field Maintenance Specialist. Under the direction of the CHS Athletic Directors, the Athletic Facilities and Field Maintenance Specialist is responsible for performing a variety of skilled tasks to maintain and develop the school&rsquo;s athletic fields, stadium grounds and athletic buildings. Experience in landscaping, basic maintenance, and operating lawn machinery is preferred. Interested candidates should email a resume and Diocesan application to Catholic High School Athletic Director of Administration, Kelly Wright, at athletics@chsvb.org.Job Type: Full-timeBenefits:<ul><li>Dental insurance</li><li>Employee assistance program</li><li>Health insurance</li><li>Life insurance</li><li>Paid time off</li><li>Retirement plan</li><li>Vision insurance</li></ul>Experience:<ul><li>Landscaping: 2 years (Preferred)</li></ul>Ability to Commute:<ul><li>Virginia Beach, VA 23462 (Required)</li></ul>Work Location: In person

Athletic Facilities and Field Maintenance Specialist

Simpson General Hospital

<div>Join Our Team at Simpson General Hospital!
Position: Medical Billing Specialist 
Location: Business Office Financial Services 
Schedule: MondayFriday | 8:00 AM 4:30 PM | Full-Time 
Reports to: Business Office Director
At Simpson General Hospital (SGH), we pride ourselves on delivering high-quality healthcare in a warm, hometown environment. We're currently seeking a Medical Billing Specialist to join our Financial Services team. If you're detail-oriented, experienced in healthcare billing, and passionate about supporting patient care behind the scenes, we'd love to hear from you!<h3 class="jobSectionHeader">
Position Summary:</h3>
The Medical Billing Specialist is responsible for preparing insurance claims, following up on denials, and ensuring accurate billing through patient demographic and insurance updates. This role involves regular communication with patients, families, insurance companies, and internal departments.<h3 class="jobSectionHeader">
Essential DutiesResponsibilities:</h3><ul><li>
Edit and submit UB and 1500 claim forms</li><li>
File insurance claims and follow up on billing work queues</li><li>
Correct and rebill claims as needed</li><li>
Assist with claims data for audits</li><li>
Provide excellent customer service</li><li>
Demonstrate professionalism aligned with SGH's mission and values</li><li>
Comply with HIPAA, infection control, and safety guidelines</li><li>
Perform other duties as assigned</li></ul><h3 class="jobSectionHeader">
Qualifications:</h3><ul><li>
Education: High School Diploma or GED (Required); Associate degree (Preferred)</li><li>
Experience: 
<ul><li>
35 years in a healthcare billing/business office setting (Preferred)</li><li>
Proficiency in Microsoft Word, Excel, and customer service</li></ul></li><li>
Strong communication and interpersonal skills</li><li>
Knowledge of claims submission for Medicare, Medicaid, and major insurers</li><li>
Efficient data entry and reconciliation skills</li><li>
Ability to work independently and meet deadlines under pressure</li><li>
Familiarity with healthcare laws and regulations</li></ul><h3 class="jobSectionHeader">
Physical Requirements:</h3><ul><li>
Clear speech and hearing for effective communication</li><li>
Visual acuity for close and distant tasks</li><li>
Occasionally lift up to 25 lbs.</li></ul><h3 class="jobSectionHeader">
Benefits Include:</h3><ul><li>
Health Insurance</li><li>
Dental Insurance</li><li>
Vision Insurance</li><li>
Company-paid Life and AD&amp;D Insurance</li><li>
Supplemental Insurance Options</li><li>
403(b) Retirement Plan</li><li>
Paid Time Off (PTO)</li><li>
Sick Time Off (STO)</li><li>
Discounted In-House Services at SGH ClinicsHospital</li></ul><h3 class="jobSectionHeader">
Ready to Apply?</h3>
Be part of a team that values accuracy, compassion, and community care. Apply today and help us continue providing exceptional service to our patients and families!</div>

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10000 insurance plan specialist jobs Near Me

AR Insurance Specialist - Mountain Standard Time

Healthcare Service Plan Specialist

Claims Specialist, Commercial

Pharmacy Program Specialist II

Billing Specialist

Athletic Facilities and Field Maintenance Specialist

Billing Specialist