medical insurance claims specialist

eVolve Health

<p><b>Evolve Health Medical Claims Specialist</b></p><p>Join the Evolve Health team as a Medical Claims Specialist at our Portland, Oregon administrative offices. Evolve Health provides medication management, interventional psychiatric treatments such as intranasal Spravato&trade; for treatment-resistant depression, transcranial magnetic stimulation (TMS), as well as ketamine infusions for depression, anxiety, and PTSD.</p><p>We are looking for a positive, motivated individual to support our patients and our team. This position requires strong communication skills, critical thinking, attention to detail and compassion for people with mental health struggles.</p><p>To ensure success, you should be professional with good interpersonal skills. The ability to complete duties in an environment that requires multi-tasking is essential.</p><p>We are looking for an individual with well-rounded medical billing experience in some of the following areas:</p><ul><li>Monitoring A/R aging reports.</li><li>Monitoring insurance company policy updates.</li><li>Addressing denied or underpaid claims.</li><li>Preparing/submitting insurance appeals.</li><li>Posting patient and insurance payments.</li><li>Charge entry and submission of clean claims.</li><li>Using insurance portals.</li><li>Benefits and Eligibility verification.</li><li>Prior Authorizations.</li><li>Reviewing patient accounts for accuracy and completeness.</li><li>Answering patient and insurance telephone inquiries.</li><li>In addition to these general duties, we may request that you perform other duties that fit with your training and background experience or provide further training for new duties.</li></ul><p><b>SKILLS AND APTITUDES</b></p><ul><li>Must work well in a team environment</li><li>Positive attitude</li><li>Customer-service minded</li><li>Detail oriented and willing to learn</li><li>Good follow-through and perseverance</li><li>Self-motivated with the ability to work independently</li><li>Able to work in environment with direct communication</li><li>Understanding of HIPAA regulations</li><li>Proficient with Microsoft Word, Excel and Teams</li><li>Previous experience with Advanced MD preferred</li></ul><p><i><b>Please note this is not a remote position.</b></i></p><p>Job Type: Full-time</p><p>Pay: $25.00 - $29.00 per hour</p><p>Expected hours: No more than 40 per week</p><p>Benefits:</p><ul><li>401(k)</li><li>401(k) matching</li><li>Dental insurance</li><li>Flexible schedule</li><li>Health insurance</li><li>Life insurance</li><li>Paid time off</li><li>Vision insurance</li></ul><p>Experience:</p><ul><li>Medical/Psych Billing: 2 years (Preferred)</li></ul><p>Ability to Commute:</p><ul><li>Portland, OR 97222 (Required)</li></ul><p>Work Location: In person</p>

Medical Claims Specialist

Ortiz Insurance Services

<p><b>Job Summary</b>  <br/>We are seeking a proactive and detail-oriented Claims Intake Specialist to join our dynamic team. In this vital role, you will be responsible for efficiently managing the initial intake of insurance claims, verifying coverage, and ensuring accurate documentation. Your energetic approach will help streamline the claims process, support compliance with workers' compensation law, and facilitate timely resolution of claims. This position offers an exciting opportunity to contribute to a fast-paced environment where organization and communication are key to success.</p><p><b>Duties</b></p><ul><li>Receive and review incoming insurance claims, ensuring all necessary medical documentation and records are complete and accurate  </li><li>Verify insurance coverage, including Medicare, Medicaid, and other health plans, using financial software systems  </li><li>Organize and file medical records, claim forms, and supporting documents systematically for easy retrieval  </li><li>Conduct initial assessments of claims using ICD-9, ICD-10, CPT coding, HCPCS codes, DRG classifications, and ICD coding standards  </li><li>Collaborate with medical providers and adjusters to clarify claim details and resolve discrepancies promptly  </li><li>Maintain detailed logs of all claim activities, including filing dates, status updates, and correspondence  </li><li>Ensure compliance with workers' compensation law and medical billing regulations throughout the intake process</li></ul><p><b>Skills</b></p><ul><li>Proven clerical experience with strong organizational skills to manage multiple claims efficiently  </li><li>Expertise in filing systems, medical documentation management, and insurance verification procedures  </li><li>Knowledge of medical terminology, ICD-9/ICD-10 coding standards, CPT coding, HCPCS codes, DRG classifications, and ICD coding practices  </li><li>Familiarity with workers' compensation law and medical billing processes  </li><li>Ability to interpret medical records accurately and utilize financial software effectively  </li><li>Strong attention to detail in handling sensitive information such as medical records and legal documents  </li><li>Excellent communication skills for coordinating with healthcare providers, insurance companies, and internal teams</li></ul><p>Join us in delivering exceptional service by ensuring claims are processed accurately and efficiently! Your dedication will help us maintain high standards of compliance while supporting our mission to provide outstanding care coordination.</p><p>Job Types: Full-time, Part-time, Contract, Temporary</p><p>Pay: $23.64 - $28.47 per hour</p><p>Benefits:</p><ul><li>401(k)</li><li>Flexible schedule</li><li>Health insurance</li><li>Paid time off</li><li>Professional development assistance</li><li>Retirement plan</li><li>Work from home</li></ul><p>Work Location: Remote</p>

Claims Intake Specialist

Certus Healthcare Management

<div><p><b>Company Overview:</b></p>
<p>
Certus Healthcare Management proudly owns and operates a network of 17 communities across Ohio and Michigan, serving both rural and urban populations. Our mission is to deliver personalized, family-focused care that enhances the quality of life for our residents and their families, fostering an environment where everyone&rsquo;s voice is heard and valued.</p>
<p><b>
Overview:</b></p>
<p>
 We are seeking an energetic and detail-oriented Insurance Claims Specialist to lead our claims processing team. In this pivotal role, you will oversee the entire claims lifecycle, ensuring accurate, efficient handling of insurance claims related to health, auto, workers' compensation, and property damage. Your expertise will drive fraud prevention, risk analysis, and effective negotiation strategies to optimize claim outcomes while maintaining exceptional service standards.</p>
<p>
This position will work out of our corporate office located in Mayfield Heights, Ohio. Typical schedule for this position is 9am to 5pm.</p>
<p><b>
Duties</b>:</p>
<ul><li>
Manage and coordinate all aspects of insurance claims processing, including auto estimating, medical documentation review, and construction inspection reports.</li><li>
Lead investigations into potential fraud cases by utilizing fraud detection tools and analysis skills to identify suspicious claims.</li><li>
Oversee risk management procedures by analyzing claim data to identify trends and implement preventative measures.</li><li>
Collaborate with underwriters, medical professionals, auto repair shops, and legal teams to facilitate accurate claim assessments.</li><li>
Ensure compliance with industry standards such as ICD-9/10 coding, CPT coding, HCPCS codes, and Medicare/Medicaid regulations.</li><li>
Develop and implement service writing strategies that enhance customer satisfaction while safeguarding company interests.</li><li>
Provide training and mentorship to claims staff on best practices in negotiation, auto service management, water damage restoration procedures, and clerical processes.</li></ul><p></p><p><b><br>
Qualifications:</b></p>
<ul><li>
Proven experience in insurance claims management with a strong understanding of workers' compensation, auto insurance, medical billing, and construction inspection processes.</li><li>
Demonstrated expertise in negotiation skills and risk analysis techniques.</li><li>
Knowledge of medical terminology, ICD coding (ICD-9/10), CPT coding, HCPCS codes, and medical documentation standards.</li><li>
Familiarity with auto estimating software, auto body repair procedures, automotive repair processes, and auto restoration practices.</li><li>
Strong organizational skills with the ability to manage multiple claims efficiently under tight deadlines.</li><li>
Analytical mindset with proficiency in financial software and insurance verification systems.</li><li>
Mechanical knowledge related to automotive service management or water damage restoration is a plus.</li><li>
Excellent communication skills to liaise effectively with internal teams and external partners.</li></ul><p>
Join us as an Insurance Claims Manager where your expertise will shape a seamless claims experience for our residents while advancing your career in a dynamic environment committed to excellence!</p></div>

Insurance Claims Specialist

AAA The Auto Club Group

<div><p>It&rsquo;s a great time to join AAA The Auto Club Group!
</p><p></p><p><b>JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD
</b></p><p></p><p><b>Job Type:
</b></p><p></p>Full time<br>
<p></p><div><div><p><b>Exempt/Non Exempt:<br>
</b></p></div></div><p></p>Salary
<p></p><p><b>Job Description:<br>
</b></p><p></p><br>
<br>
<p><b>Sr. Claim Specialist - MI PIP &amp; Litigation &ndash; Meemic
</b></p><p><b>Reports to: Claim Manager as appropriate
</b></p><p></p><p><b>****$5,000 Sign-On Bonus for qualified candidates.
</b></p><p></p><p><b><i>This Michigan-based position requires residency within the State of Michigan due to in-person court appearances.
</i></b></p><p></p><p><b>What you will do </b><b>:
</b></p><p>The Auto Club Group is seeking prospective <b>Senior </b><b>Claim Specialist </b>who can work under less supervision with a high-level of authority to handle highly complex technical issues and the most complex claims.
 </p><p></p><p>In this position, you will have the opportunity to:
</p><ul><li><p>Review assigned claims, contact the insured and other affected parties, set expectations for the remainder of the claim process, and initiate documentation in the claim handling system.
</p></li><li><p>Complete coverage analysis on the most complex claims.
</p></li><li><p>Ensure all possible policyholder benefits are identified.
</p></li><li><p>Create additional sub-claims if needed.
</p></li><li><p>Complete an investigation of the facts regarding the claim to further and in more detail determine if the claim should be paid, the applicable limits or exclusions and possible recovery potential.
</p></li><li><p>Conduct thorough reviews of damages and determine the applicability of state law and other factors related to the claim.
</p></li><li><p>Evaluate the financial value of the loss.
</p></li><li><p>Approve payments for the appropriate parties accordingly.
</p></li><li><p>Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit).
</p></li><li><p>Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system.
</p></li><li><p>Utilize strong negotiating skills.
</p></li></ul><p></p><p><b>Senior Claim Specialist </b>assigned to the PIP unit are responsible for claims involving the MCCA or quadriplegic, traumatic brain, amputations, and other catastrophic injuries. The role will require proficiency in dealing with the MCCA and attorney represented claims. Work with insureds, physicians&rsquo; offices, and medical insurance carriers to obtain necessary information to complete the claims review process and make the appropriate determinations.
</p><p></p><p>With our powerful brand and the mentoring, we offer, you will find your position as a <b>Senior </b><b>Claim Specialist </b>can lead to a rewarding career at our growing organization.
</p><p></p><p><b>Work Environment
</b></p><p>This position is currently able to work remotely from a home office location for day-to-day operations unless occasional travel for meetings, collaborative activities, or team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy.
</p><p></p><p><b>How you will benefit </b><b>:
</b></p><ul><li><p>A competitive annual salary between <b>$76,700 to $102,000
</b></p></li><li><p>ACG offers excellent and comprehensive benefits packages, including:
</p></li><li><p>Medical, dental and vision benefits
</p></li><li><p>401k Match
</p></li><li><p>Paid parental leave and adoption assistance
</p></li><li><p>Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays
</p></li><li><p>Paid volunteer day annually
</p></li><li><p>Tuition assistance program, professional certification reimbursement program and other professional development opportunities
</p></li><li><p>AAA Membership
</p></li><li><p>Discounts, perks, rewards, and much more
</p></li></ul><p></p><p><b>We&rsquo;re looking for candidates who </b><b>:
</b></p><p><b>Required Qualifications (these are the minimum requirements to qualify):
</b></p><p></p><p>Education (include minimum education and any licensing/certifications):
</p><ul><li><p>Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience
</p></li><li><p>In states where an Adjuster&rsquo;s license is required, the candidate must be eligible to acquire a State Adjuster&rsquo;s license within 90 days of hire and maintain as specified for appropriate states.
</p></li><li><p>A valid driver's license is required if the primary responsibilities of the role involve conducting in-person inspections or frequent in-person meetings with members.
</p></li></ul><p></p><p>Experience :
</p><p>Five years of experience in the following:
</p><ul><li><p>Negotiation of complex claim settlements
</p></li><li><p>Securing and evaluating evidence
</p></li><li><p>Preparing manual and electronic estimates
</p></li><li><p>Subrogation claims
</p></li><li><p>Resolving complex coverage questions
</p></li><li><p>Taking statements
</p></li><li><p>Establishing clear evaluation and resolution plans for claims
</p></li></ul><p></p><p>Knowledge and Skills :
</p><ul><li><p>Advanced technical knowledge of
</p></li><li><p>Essential Insurance Act (Michigan)
</p></li><li><p>Fair Trade Practices Act as it relates to claims
</p></li><li><p>Subrogation procedures and processes
</p></li><li><p>Intercompany arbitration
</p></li><li><p>Litigation
</p></li></ul><p></p><p>Advanced technical knowledge of :
</p><ul><li><p>Negligence Law
</p></li><li><p>No-Fault Law
</p></li><li><p>Medical terminology and human anatomy
</p></li><li><p>MCCA and attorney represented claims
</p></li></ul><p></p><p>Ability to :
</p><ul><li><p>Handle claims to the line Claim Handling Standards
</p></li><li><p>Follow and apply ACG Claim policies, procedures and guidelines
</p></li><li><p>Work within assigned ACG Claim systems including basic PC software
</p></li><li><p>Perform claim file review and investigations
</p></li><li><p>Demonstrate effective communication skills (verbal and written)
</p></li><li><p>Demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns
</p></li><li><p>Analyze and solve problems while demonstrating sound decision-making skills
</p></li><li><p>Prioritize claim related functions
</p></li><li><p>Process time sensitive data and information from multiple sources
</p></li><li><p>Manage time, organize and plan workload and responsibilities
</p></li><li><p>Attend virtual meetings and corporate/court onsite meetings
</p></li></ul><p></p><p><b>Preferred Qualifications:
</b></p><p>Education
</p><ul><li><p>Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience
</p></li><li><p>Completion of the Insurance Institute of America's: General Insurance Program, Associate in Claims, Associate in Management or equivalent
</p></li><li><p>CPCU coursework or designation
</p></li></ul><p></p><p>#LI-LC1
</p><p></p><p>Who We Are
</p><p>Become a part of something bigger.
</p><p></p><p>The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and customers across 14 states and 2 U.S. territories through AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America.
</p><p></p><p>By continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life&rsquo;s journey through insurance, travel, financial services, and roadside assistance.
</p><p></p><p>And when you join our team, one of the first things you&rsquo;ll notice is that same, whole-hearted, enthusiastic advocacy for each other.
</p><p></p><p>We have positions available for every walk of life! AAA prides itself on creating an inclusive and welcoming environment of diverse backgrounds, experiences, and viewpoints, realizing our differences make us stronger.
</p><p></p><p>To learn more about AAA The Auto Club Group visit www.aaa.com
</p><p></p><p>Important Note:
</p><p></p><p>ACG&rsquo;s Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals. ACG utilizes a geographic pay differential as part of the base salary compensation program. Pay ranges outlined in this posting are based on the various ranges within the geographic areas which ACG operates. Salary at time of offer is determined based on these and other factors as associated with the job and job level.
</p><p></p><p>The above statements describe the principal and essential functions, but not all functions that may be inherent in the job. This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements. Reasonable accommodations will be made for otherwise qualified applicants, as needed, to enable them to fulfill these requirements.
</p><p></p><p>The Auto Club Group, and all its affiliated companies, is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status.
</p><p></p><p>Regular and reliable attendance is essential for the function of this job.
</p><p></p><p>AAA The Auto Club Group is committed to providing a safe workplace. Every applicant offered employment within The Auto Club Group will be required to consent to a background and drug screen based on the requirements of the position.</p></div>

Sr. Claim Specialist - MI PIP & Litigation - Meemic

Renown Health

<div><div><div><div><div><div><div><div><div><p><b>Position Purpose</b></p><br>
</div></div><br>
<div><div><div><div><div><div><div><div><div><div><p>The Insurance and Claims Specialist will review and correct claim errors ensuring accurate, timely claim submission and account follow-up to assigned payors and reimbursement on first claim submitted. The Specialist will appeal healthcare claims denied by third-party payors to obtain reimbursement and handle difficult, hard to collect accounts that have been deemed by the insurance company as unpayable. The Specialist will conduct analysis and resolve incorrect reimbursement issues and credit balance resolution with payors. This position is responsible to know all state/federal regulations that relate to contracts and to the appeal process and/or government payor billing and follow-up regulations to include CCI, LCD/NCD and medical necessity rules.</p><br>
</div></div><br>
</div></div></div></div><br>
</div></div></div></div><br>
</div></div><p></p><div><div><div><div><p><b>Nature and Scope</b></p><br>
</div></div><br>
<div><div><div><div><div><div><div><div><div><div><p>The Insurance and Claims Specialist is responsible for:</p><br>
<p></p><ul><li>Work assigned Work Queues to correct errors, ensuring accurate claims and reimbursement on first claim submission.</li></ul>
<ul><li>Audit denials and payment variances to determine root cause and correction as required.
</li></ul><ul><li>Auditing payment variances ensuring appropriate reimbursement.</li></ul>
<ul><li>Provide specific and in depth contract knowledge to ensure maximum reimbursement of healthcare claims.</li></ul>
<ul><li>Resolve credit balances by reviewing payments, adjustments or transfers correcting the patient account to reflect an accurate account receivable balance.
</li></ul><ul><li>Work with leadership and other internal departments to improve processes, increase accuracy, create efficiencies and decrease denials to achieve the overall goals of Renown Health.</li></ul>
<ul><li>Maintain a current knowledge of CPT/HCPCS, ICD, DRG, HCFA forms, ability to manipulate and analyze 837 and all other HIPAA transaction sets.</li></ul><br>
<p></p><p>This position is required to operate within policy and procedural guidelines that will ensure accurate accounts receivable reporting and is compliant with policy and procedural guidelines consistent with Renown Health goals and objectives.</p><br>
<p></p><p>This position does not provide patient care.<br>
</p></div></div><br>
</div></div></div></div><br>
</div></div></div></div><br>
<div><div><div><div><div><div><p><b>Disclaimer</b></p><br>
</div></div><br>
<div><div><div><div><div><div><p>The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.</p><br>
</div></div><br>
</div></div></div></div><br>
</div></div></div></div><br>
</div></div><p></p><div><div><div><div><p><b>Minimum Qualifications</b><br>
Requirements - Required and/or Preferred</p><br>
</div></div><br>
<div><div><div><div><div><div><div><div><div><div><p><b>Name</b></p><br>
</div><div><p><b>Description</b></p><br>
</div></div><br>
<div><div><p>Education:</p><br>
</div><div><p>Must have working-level knowledge of the English language, including reading, writing and speaking English. Associates degree preferred.</p><br>
</div></div><br>
<div><div><p>Experience:</p><br>
</div><div><p>One year healthcare billing office experience with extensive knowledge of healthcare billing, government and third party payor requirements. Associate degree or certification in accredited billing certification may be accepted in lieu of years of experience.</p><br>
</div></div><br>
<div><div><p>License(s):</p><br>
</div><div><p>None.</p><br>
</div></div><br>
<div><div><p>Certification(s):</p><br>
</div><div><p>None.</p><br>
</div></div><br>
<div><div><p>Computer / Typing:</p><br>
</div><div><p>Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.</p><br>
</div></div><br>
</div></div></div></div><br>
</div></div></div></div><br>
</div></div></div></div></div></div><br>
<p></p>Location: Renown Health &middot; 100620 Hospital Billing Services<br>
Schedule: Full Time - Eligible for Benefits, Day, 8am-4:30pm</div>

Insurance and Claims Specialist - Hybrid

Integrated Health 21, LLC

<div></div><div><div><div><b>About Integrated Health 21</b></div><div>
Integrated Health 21 (IH21) is a leading provider of worksite wellness screenings and vaccination clinics across the continental United States. Headquartered in Pittsburgh, PA, with offices in New York, Wisconsin, and Ohio, IH21 partners with employers and insurance companies to deliver customized health and wellness events. Our mission is simple: to help employees better understand their health and support healthier workplaces.</div><p></p><p><b><br>
PURPOSE OF POSITION:</b></p><p>
The Claims and Billing Specialist will manage the full revenue cycle by reviewing, coding, and submitting medical claims to insurance and third-party billing company. The individual will work closely with the Data and Finance teams and is responsible for preparation and submission of claims, either directly to insurance carriers or through a third-party billing company to ensure all third-party billing claims, invoices and payments are processed in a timely manner. This position will also be responsible for reviewing client contracts for processing of an invoice to direct clients.</p><p><b>
PRIMARY DUTIES AND RESPONSIBILITIES:</b></p><ul><li>
Prepare, review, and transmit clean claims to insurance providers or third-party billing company as required.</li><li>
Process direct client invoices and send them promptly to client.</li><li>
Reconcile and post direct and third-party payments to the appropriate accounts.</li><li>
Communicate with client or third-party billing company on any issues, denials, or follow-ups to facilitate the prompt payment of accounts receivable.</li><li>
Responsible for tracking and resolving denied claims, as well as analyzing reimbursements according to contractual agreements.</li><li>
Respond timely to any client inquiries or requests.</li><li>
Maintain the client master.</li><li>
Demonstrate general knowledge of accounting and understanding of the general ledger accounts.</li><li>
Perform other general accounting duties as deemed necessary.</li></ul><p></p><p><b><br>
PHYSICAL DEMANDS:</b></p><ul><li>
Prolonged periods sitting at a desk and working on a computer.</li><li>
Involves speaking to customers on the phone.</li></ul><div></div><p><b><br>
QUALIFICATIONS:</b></p><ul><li>
Associate or bachelor&rsquo;s degree in accounting or equivalent job experience. Must have claims experience.</li><li>
Must have strong Microsoft skills, especially Excel. QuickBooks knowledge is a plus.</li><li>
Experience with Electronic Health Records and billing software</li><li>
Must have the ability to organize with excellent attention to detail.</li><li>
Excellent communication skills (oral and written) necessary.</li></ul></div></div>

Claims and Billing Specialist

BRAS AND HONEY LINGERIE LIMITED

<p><b>Job Overview</b><br/>We are seeking a detail-oriented and proactive Medical Billing Specialist with expertise in Durable Medical Equipment (DME) and insurance claims processing. In this vital role, you will manage the end-to-end billing cycle, ensuring accurate submission of claims, prompt follow-up on unpaid accounts, and compliance with insurance regulations. Your energy and precision will help streamline revenue cycles, improve cash flow, and enhance patient satisfaction. If you thrive in a fast-paced environment and are passionate about healthcare administration, this is your opportunity to make a meaningful impact!</p><p><b>Duties</b></p><ul><li>Prepare and submit accurate insurance claims for DME products using appropriate coding standards such as CPT (Current Procedural Terminology), ICD-9, ICD-10, DRG (Diagnosis-Related Group), and ICD coding.</li><li>Review medical records and documentation to verify the accuracy of billing information and ensure compliance with insurance policies.</li><li>Follow up on unpaid or denied claims promptly, communicating effectively with insurance companies to resolve discrepancies.</li><li>Manage medical collections by contacting patients and insurers to secure payments while maintaining professional rapport.</li><li>Maintain detailed records within Electronic Medical Record (EMR) and Electronic Health Record (EHR) systems to track claim status, payments, and patient information.</li><li>Stay updated on changes in medical billing regulations, coding standards, and insurance policies to ensure ongoing compliance.</li><li>Collaborate with healthcare providers to clarify documentation requirements and improve billing accuracy.</li></ul><p><b>Skills</b></p><ul><li>Extensive knowledge of medical billing processes specific to DME products and insurance claims procedures.</li><li>Proficiency in CPT coding, ICD-9/ICD-10 coding, DRG classification, and ICD coding systems.</li><li>Strong understanding of medical terminology, medical records management, and healthcare documentation standards.</li><li>Experience working with EMR/EHR systems for efficient claim processing and record keeping.</li><li>Excellent communication skills for effective interactions with insurance companies, patients, and healthcare providers.</li><li>Ability to analyze complex medical bills and resolve discrepancies quickly.</li><li>Familiarity with medical collection practices and strategies for maximizing reimbursement. Join us in delivering exceptional healthcare administration services! Your dedication will support our mission to provide seamless billing experiences while ensuring compliance with industry standards. If you&rsquo;re energized by detail-oriented work in a dynamic environment, we want to hear from you!</li></ul><p>Pay: $17.75 - $30.52 per hour</p><p>Benefits:</p><ul><li>Flexible schedule</li><li>Health insurance</li></ul><p>Application Question(s):</p><ul><li>What experience do you have working with insurance claims (Medicare, Medicaid/Medi-Cal, or commercial payers)? Please describe your role.</li><li>What experience do you have working with HCPCS codes or billing for medical equipment or supplies?</li></ul><p>Experience:</p><ul><li>Medical billing: 2 years (Preferred)</li></ul><p>Work Location: Hybrid remote in San Diego, CA 92108</p>

Medical Billing Specialist – DME / Insurance Claims

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