medical claims specialist

AFIABLEE Healthcare & IT Solutions LLP

<p><b>Company:</b> Afiablee Healthcare<br/><b>Position:</b> Medical Billing AR Specialist</p><p><b>Dear Candidate,</b><br/>Afiablee Healthcare is hiring an experienced <b>Medical Billing Accounts Receivable (AR) Specialist</b> to join our growing team. The ideal candidate should have strong knowledge of insurance follow-ups, denials, and payment posting, along with excellent communication skills and attention to detail.</p><p><b>Interested candidates can call us at 912-987-2778.</b></p><p><b>Responsibilities:</b></p><ul><li>Follow up on outstanding insurance claims</li><li>Review and resolve denials and rejections</li><li>Submit and resubmit claims as needed</li><li>Maintain accurate billing and payment records</li></ul><p><b>Requirements:</b></p><ul><li>Minimum 1 year of experience in Medical Billing (AR)</li><li>Familiarity with EOBs, claim follow-ups, and payer portals</li><li>Strong communication and analytical skills</li></ul><p><b>Kind Regards,</b></p><p><b>HR Team</b></p><p>Job Type: Full-time</p><p>Pay: &#8377;18,000.00 - &#8377;27,000.00 per month</p><p>Work Location: In person</p>

Medical Billing AR Specialist

AppedologyPK Recruitment

<p>Job Summary:</p><p>We are seeking a detail-oriented and analytical professional to join our team as a Denial Management Specialist within the Medical/Behavioral Health domain. The primary responsibility of this role is to identify, analyze, and resolve claim denials to ensure accurate and timely reimbursement. The ideal candidate will possess a strong understanding of insurance processes, medical billing, and payer guidelines, particularly within behavioral health services. This position requires excellent problem-solving skills, attention to detail, and the ability to multitask effectively while maintaining a high level of accuracy and compliance. The candidate should also demonstrate strong communication abilities to coordinate with payers, clients, and internal teams for swift resolution of denied or underpaid claims.</p><p>Key Responsibilities:</p><ul><li>Review and analyze denied or underpaid medical and behavioral health claims to determine root causes.</li><li>Work with insurance companies to resolve denials and ensure timely and accurate reimbursement.</li><li>Identify recurring denial trends and collaborate with billing and clinical teams to prevent future occurrences.</li><li>Prepare and submit appeals with appropriate supporting documentation in accordance with payer requirements.</li><li>Maintain detailed records of denial activities, appeal statuses, and resolutions in the billing system.</li><li>Communicate effectively with payers, clients, and internal departments to ensure issues are addressed promptly.</li><li>Monitor claim status and follow up proactively to reduce outstanding accounts receivable.</li><li><b>Ensure compliance with all HIPAA, payer, and organizational policies during all denial management processes.</b></li></ul><p>Requirements:</p><ul><li>High school diploma or equivalent; associate&rsquo;s or bachelor&rsquo;s degree in accounting, finance, or a related field is a plus.</li><li>Proven experience in billing, accounting, or administrative roles.</li><li>Strong attention to detail and numerical accuracy.</li><li>Proficiency in Microsoft Excel and billing/accounting software.</li><li>Excellent communication and organizational skills.</li><li>Ability to work independently and meet deadlines.</li></ul><p>Job Type: Full-time</p>

Denial Management Specialist (MEDICAL BILLING US HEALTHCARE)

University of Oklahoma

<div></div><div><div><div><div><div><p>Join the Center for Public Management (OU CPM) at the University of Oklahoma and be part of a team dedicated to making a daily impact in the lives of Oklahomans. Located within the College of Continuing Education, OU CPM specializes in providing training, research, and consulting to enhance the efficiency and effectiveness of public sector agencies, staff, and community partners. Our focus is not only on professional and programmatic development but also on fostering a culture of growth and opportunity since 1994.</p><p>
If making a meaningful difference in public service excites you, OU CPM is where your passion meets purpose.</p><p>
The Developmental Disability Program Specialist duties include but are not limited to:</p><ul><li>
Planning, monitoring, resolving problems and coordinating operations and service delivery for publicly funded clients of CPM research</li><li>
Retrieve and analyze information, adjust service authorizations, research adjudication of medical denied claims</li><li>
Review over payments</li><li>
Complete requests from Providers by using multiple databases</li><li>
Research state and federal policies to develop and implement procedures to ensure compliance with state and federal requirements</li><li>
Prepare, review and maintain detailed records and reports to measure project activities</li><li>
Participate in work teams to develop project goals and support materials, process create medical claims and billing maintain and implement monitoring tools to ensure service provider training is performed.</li><li>
Preforms various duties as needed to successfully fulfill the function of the position.</li></ul><p><b>
This position may be eligible for remote or hybrid work.</b></p><div><br>
</div></div><div><b>
Job Requirements</b><div></div><p><b><br>
Required Education and Experience:</b> High School Diploma or GED, <b>AND:</b></p><ul><li>
18 months experience in data analysis, project coordination, or related experience.</li></ul><p><b>
Skills:</b></p><ul><li>
Ability to communicate verbally and in writing</li><li>
Ability to understand written material and instructions</li><li>
Excellent customer service skills</li><li>
Basic computer skills</li><li>
Detail oriented</li><li>
Ability to research information to obtain an answer or solution to a problem in a timely manner</li></ul><p><b>
Certifications: </b>None</p><p><b>
Advertised Physical Requirements:</b></p><ul><li>
Ability to sit and talk for prolonged periods.</li><li>
Hand and finger dexterity.</li><li>
Engage in repetitive motion of he wrist, hand, and fingers.</li><li>
Standard Office Environment.</li></ul><p><b>
Departmental Preferences:</b></p><ul><li>
18 months in medical claim research, data analysis, and/or program evaluation experience</li><li>
Knowledge of Medicare/Medicaid rules and regulations</li><li>
Knowledge of Oklahoma Waiver program for developmental disability</li>
Knowledge of ICD<li>10 and CPT coding</li><li>
Knowledge of EVV (Electronic Verification Visits)</li><li>
Knowledge of medical claim billing</li></ul><p><b>
Special Instructions:</b> If you are selected as a final candidate for this position, you will be subject to The University of Oklahoma Norman Campus Tuberculosis Testing policy. To view the policy, visit https://hr.ou.edu/PoliciesHandbooks/TBTesting.</p><p><b>
Why You Belong at the University of Oklahoma: </b>The University of Oklahoma values our community's unique talents, perspectives, and experiences. At OU, we aspire to harness our innovation, creativity, and collaboration for the advancement of people everywhere. You Belong Here!</p><div><b>
Equal Employment Opportunity Statement: </b>The University, in compliance with all applicable federal and state laws and regulations, does not discriminate on the basis of race, color, national origin, sex, sexual orientation, marital status, genetic information, gender identity/expression (consistent with applicable law), age (40 or older), religion, disability, political beliefs, or status as a veteran in any of its policies, practices, or procedures. This includes but is not limited to admissions, employment, housing, financial aid, and educational services.</div><div><br>
</div></div><div><b>
Hiring contingent upon a Background Check?</b><b>:</b> Yes</div><div><b>
Special Indications</b><b>:</b> Hiring contingent upon police records check<div>
</div></div><div><b>
Job Posting</b><b>:</b> Oct 24, 2025</div></div><div><div><div><div><p><b>
JOB DESCRIPTION HELP</b></p><div></div><div><br>
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<div><b>Required Attachments</b></div>
<div>
Documents required for this position are listed under the &quot;Required Attachments&quot; section of this job listing. You will be required to upload and attach these documents in the application process.</div><div><br>
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<div><b>Important:</b> ALL required documents must be attached to your job application or your documents will not be visible to the hiring department!</div></div></div></div></div></div></div></div></div></div>

Contact Center Coordinator

MeshSquare

<p><b>Job description:</b></p><p>Responsible for Insurance verifications, Authorizations, collecting, posting, and managing account payments. Responsible for submitting claims and following up with insurance companies.</p><p><b>Essential Functions:</b></p><ul><li>Prepares and submits medical claims daily to various insurance companies either electronically or by paper.</li><li>Promptly processes payments from insurance companies.</li><li>Identifies and resolves Insurance &amp; patient billing complaints.</li><li>Follows up on aging claims or delinquent accounts.</li><li>Participates in educational activities and attends monthly billing meetings.</li><li>Maintains the strictest confidentiality; adheres to all HIPAA - PHI guidelines/regulations</li></ul><p><b>Skills/Experience:</b></p><ul><li>Knowledge of Medical and/or mental health billing/collection practices.</li><li>Sound Knowledge of Medical and/or mental health Payers&rsquo; guidelines and submission process.</li><li>Expertise in Medicare &amp; Medicaid + MCOs&rsquo; Claims processing</li><li>Knowledge of Authorizations &amp; Denial Management</li><li>Knowledge of computer programs.</li><li>Knowledge of business office procedures.</li><li>Ability to operate a computer and basic office equipment.</li><li>Ability to operate a multi-line telephone system.</li><li>Skill in answering a telephone pleasantly and helpfully.</li><li>Ability to read, understand, and follow oral and written instructions.</li><li>Ability to establish and maintain effective working relationships with team members or Supervisors.</li><li>Must be well-organized and detail-oriented.</li><li>This written job description is not intended to be all-inclusive.</li><li>All employees are expected to perform any duties assigned within reason not listed in this job description when management requests.</li></ul><p><b>Experience:</b></p><ul><li>Candidates with at least 1 to 3 years of experience in Medical Billing &amp; A/R Management.</li></ul><p><b>Job Rewards and Benefits:</b></p><ul><li>Paid Leaves</li><li>HR Bonus</li><li>Inflation Bonus</li><li>Promotion</li><li>Increments</li><li>MTD Bonus</li><li>Annual Trip</li><li>Medical Coverage</li><li>Leave Encashment</li><li>Contributory Saving Plan (CSP)</li><li>Saturday and Sunday Off</li><li>Transportation allowances only for female staff</li><li>Complementary Food (Dinner) &amp; Tea/Green Tea (Two times)</li></ul><p><b>Location:</b></p><p>Meds IT Nexus Office No 1, Top Floor, Gold Mark Plaza, Asghar Mall road, Rawalpindi</p><p><b>Job Timing:</b></p><p>05:30 PM To 02:30 AM (night shift)</p><p>Job Type: Full-time</p><p>Work Location: In person</p><p>Job Type: Full-time</p><p>Pay: Rs50,000.00 - Rs70,000.00 per month</p><p>Work Location: In person</p>

A/R Specialist

Allianz

<p><b>Key responsibilities/What you do:</b></p> <ul> <li>Review and assess medical claims for both inpatient and outpatient services to determine coverage eligibility and compliance with policy terms.</li> <li>Validate Diagnosis-Related Group (DRG) coding for inpatient admissions using ICD-10-CM and CPT standards, ensuring alignment with clinical documentation.</li> <li>Apply thorough knowledge of UAE healthcare billing regulations, including DHA, DOH, and MOH guidelines, to ensure claims meet local compliance standards.</li> <li>Identify and rectify incomplete or inaccurate claim submissions.</li> <li>Ensure all required documentation is present and properly coded aligning with policy guidelines.</li> <li>Notify payers regarding claims that exceed predefined financial thresholds, ensuring timely communication and resolution.</li> <li>Track and maintain both quantitative (volume) and qualitative (accuracy) metrics for claims processing.</li> <li>Achieve assigned daily processing targets while maintaining high levels of accuracy and efficiency.</li> <li>Collaborate with internal departments to resolve claim-related queries.</li> <li>Perform other responsibilities as assigned by the department lead, in line with the scope of the role.</li> </ul>

Medical Claims Senior Assessor

Med-Metrix

Job Purpose
<br>The Medical Claims Analyst is responsible for collections, account follow up, billing and allowance posting for the accounts assigned to them.
<br><br>
Duties and Responsibilities
<br><ul>
<li>Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites</li>
<li>Meets and maintains daily productivity/quality standards established in departmental policies</li>
<li>Uses the workflow system, client host system and other tools available to them to collect payments and resolve accounts</li>
<li>Adheres to the policies and procedures established for the client/team</li>
<li>Knowledge of timely filing deadlines for each designated payer</li>
<li>Performs research regarding payer specific billing guidelines as needed</li>
<li>Ability to analyze, identify and resolve issues causing payer payment delays</li>
<li>Ability to analyze, identify and trend claims issues to proactively reduce denials</li>
<li>Communicates to management any issues and/or trends identified</li>
<li>Initiate appeals when necessary</li>
<li>Ability to identify and correct medical billing errors</li>
<li>Send appropriate appeals, accurate requesting information, supporting documentation, and effective communication to complete recovery process</li>
<li>Understanding of under or over payments and credit balance processes</li>
<li>Assist with special A/R projects as needed. Analytical skills and the ability to communicate results are required</li>
<li>Act cooperatively and courteously with patients, visitors, co-workers, management and clients</li>
<li>Work independently from assigned work queues</li>
<li>Maintain confidentiality at all times</li>
<li>Maintain a professional attitude</li>
<li>Other duties as assigned by the management team</li>
<li>Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards</li>
<li>Understand and comply with Information Security and HIPAA policies and procedures at all times</li>
<li>Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties</li>
</ul>
Qualifications
<br><ul>
<li>Completed at least High School education</li>
<li>Minimum 1 year of Healthcare Account Receivable/Collections in a BPO setting or environment (claims payments processing, claims status and tracking, Medical Billing, AR Follow ups, Denials and Appeals-outbound healthcare providers)</li>
<li>Experienced on medical billing/ AR Collections</li>
<li>Background in calling insurance (Payer) to verify claim status and payment dispute</li>
<li>Strong interpersonal skills, ability to communicate well at all levels of the organization</li>
<li>Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses</li>
<li>High level of integrity and dependability with a strong sense of urgency and results oriented</li>
<li>Excellent written and verbal communication skills required</li>
<li>Gracious and welcoming personality for customer service interaction</li>
</ul>
Working Conditions
<br><ul>
<li>Must be amenable to work night shifts</li>
<li>Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.</li>
<li>Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.</li>
<li>Work Environment: The noise level in the work environment is usually minimal.</li>
</ul>
Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.

Medical Claims Analyst

Allianz Partners

Key Responsibilities/What You DoReview and assess medical claims for both inpatient and outpatient services to determine coverage eligibility and compliance with policy terms.Validate Diagnosis-Related Group (DRG) coding for inpatient admissions using ICD-10-CM and CPT standards, ensuring alignment with clinical documentation.Apply thorough knowledge of UAE healthcare billing regulations, including DHA, DOH, and MOH guidelines, to ensure claims meet local compliance standards.Identify and rectify incomplete or inaccurate claim submissions. Ensure all required documentation is present and properly coded aligning with policy guidelines.Notify payers regarding claims that exceed predefined financial thresholds, ensuring timely communication and resolution.Track and maintain both quantitative (volume) and qualitative (accuracy) metrics for claims processing.Achieve assigned daily processing targets while maintaining high levels of accuracy and efficiency.Collaborate with internal departments to resolve claim-related queries.Perform other responsibilities as assigned by the department lead, in line with the scope of the role.Key Benefits/What We OfferOur employees play an integral part in our success as a business. We appreciate that each of our employees are unique and have unique needs, ambitions and we enjoy being a part of their journey.We are there to empower and encourage you with your personal and professional development ensuring that you take control by offering a large variety of courses and targeted development programs. All that in a global environment where international mobility and career progression are encouraged. Caring for your health and wellbeing is key priority for us. This is why we build Work Well programs to providing you with peace of mind and give the flexibility in planning and arranging for a better work-life balance.Allianz Group is one of the most trusted insurance and asset management companies in the world. Caring for our employees, their ambitions, dreams and challenges, is what makes us a unique employer. Together we can build an environment where everyone feels empowered and has the confidence to explore, to grow and to shape a better future for our customers and the world around us.We at Allianz believe in a diverse and inclusive workforce and are proud to be an equal opportunity employer. We encourage you to bring your whole self to work, no matter where you are from, what you look like, who you love or what you believe in.We therefore welcome applications regardless of ethnicity or cultural background, age, gender, nationality, religion, disability or sexual orientation.

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