medical insurance specialist

HCA Healthcare

<div>Hourly Wage Estimate: $17.13 - $23.98 / hour 
Learn more about the benefits offered for this job. 
The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range.
Do you want to join an organization that invests in you as a Medical Insurance Collections Specialist? At HCA Healthcare, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years.<ul><li>This position is Full-time with required on-site orientation/training in our Las Vegas, NV office and the possibility to work from home after meeting and maintaining productivity standards. Experience in ASC or Surgical collections is strongly recommended.</li></ul><h5 class="jobSectionHeader">
Job Summary and Qualifications</h5>
As the Collections Specialist, you will contribute to the company&rsquo;s mission, vision, and values by completing follow-up and collections for patient services. Under the supervision of the Business Office Manager/Business Office Supervisor, you will obtain payment from third party payers and self-pay accounts to enhance cash flow and gather reimbursement based on established contracts.
What you will do in this role:<ul><li>
You will perform follow up activities on accounts to ensure prompt payment</li><li>
You will identify coding or billing errors from EOBs and work to correct them</li><li>
You will monitor insurance claims and contact insurance companies to resolve claims</li><li>
You will update the patient account record to identify actions taken</li><li>
You will assign bad debt accounts to the collection agency</li><li>
You will act as a liaison and administer contracts in collection of third party accounts (Medicare and Medicaid)</li><li>
You will complete account reconciliation of accounts turned over to outside agencies</li><li>
You will negotiate payment plans on self-pay accounts</li><li>
You are responsible for maintaining accounts receivable and creating a reduction in bad debt</li></ul>
Qualifications you will need:<ul><li>
Minimum (1) year of collections experience in a medical office setting (i.e. ambulatory surgery center, hospital, doctors office) strongly preferred</li><li>
Knowledge of managed care payers and medical terminology</li></ul>
<h5 class="jobSectionHeader">Benefits</h5>
HCA Healthcare, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:<ul><li>
Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services</li><li>
Wellbeing support, including free counseling and referral services</li><li>
Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence</li><li>
Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling</li><li>
Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing</li><li>
Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts</li></ul>
Learn more about Employee Benefits
Note: Eligibility for benefits may vary by location.
HCA Healthcare has been recognized as one of the World&rsquo;s Most Ethical Companies&reg; by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses. 
 
&quot;Good people beget good people.&quot;- Dr. Thomas Frist, Sr. 
HCA Healthcare Co-Founder
We are a family 270,000 dedicated professionals! Our Talent Acquisition team is reviewing applications for our Medical Insurance Collections Specialist opening. Qualified candidates will be contacted for interviews. Submit your resume today to join our community of caring!
We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.</div>

Medical Insurance Collections Specialist

ECLARO

<div>
 
 Job Number: 26-00468
 
 
 
 Be at the forefront of innovation. ECLARO is looking for an
 
 Insurance Specialist
 
 for our client in
 
 Chapel Hill, NC.
 
 
 
 ECLARO&rsquo;s client is notable public research university. If you&rsquo;re up to the challenge, then take a chance at this rewarding opportunity!
 
 
 
 Position Overview:
 
 
 
 <ul>
 <li>
 This Insurance Specialist position offers both dental and medical insurance services for the Client.
 </li>
 <li>
 The Insurance Specialist works in all areas of billing and reimbursement, including private dental insurance companies and managed care organizations.
 </li>
 <li>
 This role requires specialized knowledge of insurance industry standards related to billing and reimbursement, along with a strong understanding of accounts receivable.
 </li>
 <li>
 This position collaborates closely with private insurance carriers, particularly those contracted with the clinics.
 </li>
 <li>
 It also requires a comprehensive understanding of dental and medical terminology, dental procedural and diagnostic coding, medical-dental cross-coding, electronic claims processing, and the policies and contracts of multiple insurance vendors.
 
 
 </li>
 </ul>
 
 Pay Rate:
 
 $24.00/Hour
 
 
 
 Responsibilities:
 
 
 
 <ul>
 <li>
 The responsibilities of this role include filing dental insurance claims and pre-treatment estimates for privately insured patients.
 </li>
 <li>
 Obtaining and providing the clinical documentation necessary for claims processing, such as x-rays, chart notes, and letters of necessity.
 </li>
 <li>
 Investigating denied claims, following up on those investigations, and submitting appeals for those denied claims.
 </li>
 <li>
 Verifying essential documentation including insurance cards, insurance explanations of payment, provider narratives, and insurance consent.
 </li>
 <li>
 Regularly auditing patient records for accuracy and completeness of billing, coding, and clinical documentation.
 </li>
 <li>
 This position will require extensive communication with various insurance companies, along with effective use of insurance portals.
 </li>
 <li>
 Effective communication and deductive reasoning are essential skills.
 </li>
 <li>
 Compliance with HIPAA regulations is mandatory.
 </li>
 <li>
 Other duties as assigned.
 
 
 </li>
 </ul>
 
 If hired, you will enjoy the following ECLARO Benefits:
 
 
 
 <ul>
 <li>
 401k Retirement Savings Plan administered by Merrill Lynch
 </li>
 <li>
 Commuter Check Pretax Commuter Benefits
 </li>
 <li>
 Eligibility to purchase Medical, Dental &amp; Vision Insurance through ECLARO
 
 
 </li>
 </ul>
 If interested, you may contact:
 
 
 
 Lester Candilado
 
 
 
 
 jan.candilado@eclaro.com
 
 
 
 
 6466800168
 
 
 
 
 Lester Candilado | LinkedIn
 
 
 
 
 Equal Opportunity Employer:
 
 ECLARO values diversity and does not discriminate based on Race, Color, Religion, Sex, Sexual Orientation, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status, in compliance with all applicable laws.
</div>

Insurance Specialist

Beacon Health System

<div><div><div><div><div><div>Beacon Health System is hiring a full-time day Patient Access Insurance Specialist, in our Verification of Benefits Department at Beacon Health System in South Bend, IN. 
 
Be a Beacon. Make a Difference.
At Beacon Health System, you&rsquo;re not just part of a team, you&rsquo;re part of something bigger. Every patient interaction is a chance to lead with compassion, build trust, and create lasting impact. Here, your expertise supports healing, and your heart connects us to the communities we serve.
<ul><li>Medical, Dental, &amp; Vision Insurance through Cigna</li>
</ul><ul><li>Life Insurance</li>
</ul><ul><li>403(b) Matching Retirement Fund</li>
</ul><ul><li>Competitive Paid Time Off (PTO)</li>
</ul><ul><li>Shift Differentials</li>
</ul><ul><li>Employee Assistance Program (EAP)</li>
</ul><ul><li>Tuition and Certification Reimbursement</li>
</ul><ul><li>Clinical Ladder Program</li>
</ul><ul><li>Local and National Discounts</li>
</ul><ul><li>Beacon Academy Educational Courses</li>
</ul><ul><li>Gym Membership Discount</li>
</ul>
About Beacon Health System
Headquartered in South Bend, Indiana, as a not-for-profit, community-governed health system, Beacon Health System provides care to more than 4,000 patients each day in northern Indiana and southern Michigan.
What You&rsquo;ll Do
As a Patient Access Insurance Specialist, you will report to the Patient Access Director or the Insurance Specialist Supervisor. Follows established Beacon policies and procedures to verify insurance coverage to ensure necessary procedures and hospitalizations are covered by an individual's provider. The Insurance Verification Authorization Specialist will assure authorization is obtained for all procedures and diagnostic testing to services being rendered. The Authorization Specialist will also initiate the authorization for direct admissions, emergency admissions, and emergency procedures. They will work closely with medical staff, clinical staff, referring clinics, Beacon Outpatient Scheduling Surgery Scheduling, Social Services, and Utilization Review departments. They will be responsible for communication with insurance carriers and/or providers for purposes of obtaining approval for services requiring authorization, pre-certification, and prior approval for admissions to Beacon or Epworth Center by using web-based tools, other electronic means where possible, or by telephoning and faxing when necessary. Coordinating those visits with the correct paperwork and insurance verification, along with accurate documentation in the patient's medical record is essential. They will answer high volume of incoming phone calls as well as making high volume of outbound phone calls, with constant communication to the Utilization Review, Social Services, Beacon Outpatient Scheduling and Surgery Scheduling departments. Performs other clerical duties as necessary.
Patient Access Insurance Specialist Job Responsibilities:
<ul><li>Verify and update patient demographic and financial information to ensure accuracy in the registration system.</li>
<li>Obtain and validate insurance coverage using online eligibility systems, payer portals, and telephone verification.</li>
<li>Utilize Cerner systems and reports (e.g., PHS, SurgiNet, Medical Necessity Checker) to review scheduled patients, procedures, and medical necessity requirements.</li>
<li>Audit and complete required documentation, including MSP questionnaires and insurance verification records.</li>
<li>Coordinate verification of benefits (VOB) by confirming co-pays, deductibles, coinsurance, out-of-pocket limits, and rehabilitation benefits with insurance providers.</li>
<li>Secure and document pre-authorizations and pre-certifications for ancillary, surgical, outpatient, and inpatient procedures.</li>
<li>Collaborate with physician offices, scheduling teams, and referring facilities to ensure required authorizations are obtained and procedures are properly scheduled.</li>
<li>Validate CPT and ICD-10 codes and confirm compliance with Medicare Inpatient Only Procedure (MIPO) requirements when applicable.</li>
<li>Identify out-of-network insurance plans and follow established policies and procedures.</li>
<li>Refer patients to Financial Counselors or Eligibility Specialists when financial clearance or payment arrangements are required.</li>
<li>Maintain accurate worklists, documentation, and records to support timely claim submission and reimbursement.</li>
<li>Calculate and communicate estimated patient financial responsibility, including co-payments and coinsurance.</li>
<li>Prepare reports, patient statistics, and documentation to support departmental operations and leadership requests.</li>
<li>Provide professional customer service by answering calls, communicating with patients and internal departments, and maintaining positive patient relations.</li>
<li>Collaborate with departments such as Utilization Review, Surgery Scheduling, Social Services, and Outpatient Scheduling to ensure accurate and timely patient processing.</li>
<li>Support departmental quality goals by maintaining productivity, accuracy, and compliance with Beacon policies and procedures.</li>
<li>Maintain professionalism while representing Beacon Health System and perform other duties as assigned.</li>
</ul>
What You Bring
As a Patient Access Insurance Specialist, it requires strong office and computer skills, including keyboarding (minimum 40 wpm), data entry, and proficiency with systems such as Cerner, Pathways Healthcare Scheduling, Experian, and MCA Compliance Checker. Demonstrates knowledge of medical terminology, insurance coverage, managed care networks, ICD-10 and CPT codes, and time-of-service collections, including the ability to clearly communicate financial responsibilities to patients. You will possess strong telephone, verbal communication, and listening skills to effectively interact with patients, insurance companies, physicians, and internal departments. You will maintains professionalism and sensitivity when working with diverse populations, follows strict confidentiality policies, exercises sound judgment in stressful situations, and applies basic math skills to calculate patient financial responsibilities such as deductibles, coinsurance, and out-of-pocket costs.
Required Qualifications
<ul><li>The knowledge, skills and abilities as indicated below are normally acquired through the successful completion of a high school diploma (or equivalent).
</li><li>A minimum of two years of experience in a hospital or physician practice business office is required.
</li><li>Excellent time management, organizational skills, research/analytical skills, negotiation, communication (written and verbal), and interpersonal skills required.</li>
<li>A medical terminology course must be successfully completed prior to employment.
</li><li>Associate's degree preferred.
</li><li>Medical prior authorizations or claims experience in a managed care setting and CHAA certification are highly preferred.</li>
</ul>
The Beacon Way
At Beacon Health System, our approach to care goes beyond clinical excellence because it&rsquo;s built on meaningful connections. Guided by our core values of Trust, Respect, Integrity, and Compassion, we strive to create an environment where patients feel heard, employees feel valued, and innovation thrives.
We call this commitment The Beacon Way&mdash;a six-point operating system that empowers every team member to lead with purpose, communicate clearly, cultivate talent, embrace performance improvement, leverage innovation, and build greatness through accountability. Whether at the bedside or behind the scenes, everyone at Beacon plays a role in moving health forward.</div> 
</div>
</div></div></div> 
Location: Beacon Health System &middot; Verification of Benefits 
Schedule: Full-time, Day, 0830-5pm M-F</div>

Patient Access Insurance Specialist, Verification of Benefits Department, Full-Time Days

Inner Illumination Therapy and Counseling, LLC

Overview Join our dynamic healthcare team as an Insurance Verification Specialist, where your expertise will be essential in ensuring seamless insurance processing and patient care. In this vital role, you&rsquo;ll be the first point of contact for verifying patient insurance coverage, managing medical records, and coordinating with insurance providers to facilitate accurate billing and reimbursement. Your energetic approach and attention to detail will help streamline operations and support our mission of delivering exceptional healthcare services.Responsibilities<ul><li>Verify patient insurance coverage accurately by contacting insurance companies and reviewing policy details.</li><li>Obtain pre-authorizations and referrals as required by managed care plans to ensure timely patient access to services.</li><li>Review and update medical records, ensuring all documentation complies with HIPAA regulations and confidentiality standards.</li><li>Utilize medical terminology, CPT coding, ICD-9, ICD-10, and ICD coding to interpret clinical information for billing purposes.</li><li>Communicate effectively with medical offices, dental offices, and other healthcare providers to confirm patient eligibility and coverage details.</li><li>Maintain detailed records of insurance verification activities, updates, and correspondence for audit readiness.</li><li>Collaborate with the billing department to resolve any discrepancies or issues related to insurance claims or coverage.</li></ul>Requirements<ul><li>Proven experience in medical office administration or healthcare insurance verification.</li><li>Strong knowledge of managed care processes, medical terminology, and medical coding systems including CPT, ICD-9, ICD-10, and ICD coding.</li><li>Familiarity with HIPAA regulations to ensure patient privacy and data security at all times.</li><li>Prior office experience in a healthcare setting, preferably in dental or general medical offices.</li><li>Excellent communication skills for liaising with insurance companies, healthcare providers, and patients.</li><li>Ability to handle sensitive information with professionalism and accuracy.</li><li>Knowledge of medical records management and insurance verification procedures is highly desirable. Embrace this opportunity to energize your career while making a meaningful difference in patient care! We&rsquo;re dedicated to fostering a supportive environment where your skills thrive as you help us deliver top-tier healthcare services efficiently and confidently.</li></ul>Pay: $23.81 - $28.67 per hourBenefits:<ul><li>401(k)</li><li>401(k) matching</li><li>Flexible schedule</li><li>Health insurance</li><li>Paid time off</li><li>Professional development assistance</li></ul>Work Location: Remote

Insurance Verification Specialist

Clinical Data Specialist

Ivinson Memorial Hospital

<div>At Ivinson Memorial Hospital we are committed to excellence, trust, healing, and integrity. We pride ourselves in providing compassionate, world-class care to our community. At Ivinson we offer a competitive total rewards package including; full medical, dental, and vision insurance, retirement plans, paid time off and tuition reimbursement opportunities. Ivinson aims to improve the care provided for our patients and create a work-life balance for our employees by creating a culture of transparency, teamwork, accountability, and trust.

Base salary starts at $17.30/hr. 


E S S E N T I A L F U N C T I O N S
<ul>
<li>Compiles and communicates accurate and pertinent clinical data and demographics to the patient&rsquo;s insurance company.</li>
<li>Keeps current on insurance regulations to obtain and record patient data; and maintain knowledge of system requirements.</li>
<li>Follow-up with insurance carriers to obtain certification/authorization numbers for outpatient services.
</li><li>Performs on-line data entry of certification/authorization or denials and pre-authorization status.
</li><li>Facilitates resolution of pre-authorization or referral issues for scheduled patients and same day add-ons to insure payment from the insurance company on the patient&rsquo;s behalf.</li>
<li>Works closely with Utilization Review to ensure all notifications, prior authorizations and continued stay reviews are completed as needed.
</li><li>Coordinates with Social Worker when needed.</li>
<li>Ensures that all prior authorizations and ongoing authorizations documentation, databases, and records are maintained clearly and accurately, within a timely manner and meet HIPPAA requirements.</li>
<li>Coordinates peer to peer reviews with providers for denied requests.</li>
<li>Perform clinical reviews of authorization requests using appropriate criteria.</li>
<li>Serves as a resource for staff, APP&rsquo;s and physicians regarding prior authorizations.</li>
<li>Collaborates with clinical staff to resolve any problematic authorization issues.
</li><li>Creates payment arrangement forms for uninsured patients and effectively communicates payment requirements to patients.
</li><li>Ensures mail is documented and filed for all patient authorizations.</li>
<li>Performs other duties as assigned.</li>
<li>Demonstrates consistent use of AIDET (Acknowledge patient, Introduce yourself, provide duration/timeline for test, Explain the process &amp; Thank them for choosing IMH) and HEAL (Hear them out, Empathize, Apologize, &amp; Leap into action to solve) when interacting with patients/customers).</li>
<li>Collaborates with all departmental staff to facilitate timely patient care.</li>
<li>Participates in performance improvement activities.</li>
<li>Attends/participates in staff meetings, in-services, &amp; facility wide meetings as scheduled.</li></ul> 


E D U C A T I O N
<ul>
<li>High school diploma or equivalent required.</li>
<li>Clinical experienced preferred as a CNA, Medical Assistant, Patient Care Technician or Billing coder etc.</li></ul> 


E X P E R I E N C E
<ul>
<li>Clinical experience preferred.</li>
<li>Previous experience in insurance verification preferred.</li> 
</ul>
C R E D E N T I A L S
<ul>
<li>Must have current, valid Basic Life Support (BLS) certification or must obtain within 6 months of hire and maintain credentials throughout employment with IMH.</li></ul> 


K N O W L E D G E , S K I L L S A N D A B I L I T I E S
<ul>
<li>Excellent customer service skills, including but not limited to: a friendly personality, tact, patience, empathy and a helpful, professional attitude both in person and on the telephone.</li>
<li>Ability to effectively communicate with staff, managers and the general public verbally and in writing.</li>
<li>Demonstrate effective listening skills.</li>
<li>Excellent organization and time management skills and ability to establish priorities effectively.
</li><li>Possess exceptional problem solving skills.</li>
<li>Ability to work effectively without immediate supervision.</li>
<li>Ability to learn new computer software programs.</li>
<li>Ability to recognize and protect confidential information.</li>
<li> Demonstrate ethical and legal accountability for the position.</li></ul> 


At Ivinson Memorial Hospital, we believe that our employees are our greatest investment. That&rsquo;s why we are committed to fostering a supportive, empowering environment where every team member has the resources and opportunities to thrive. We know that providing world-class healthcare starts with investing in our employees, ensuring they have the tools to grow, excel, and provide exceptional care.

Our competitive and comprehensive total rewards package includes: 


For benefits eligible employees:
<ul>
<li>Medical, dental, and vision insurance</li>
<li>Paid time off: take the time you need to recharge</li>
<li>Retirement plans, including 403(b) matching</li>
<li>Employer-paid life and long-term disability insurance: Peace of mind for you and your family</li></ul> 


For all employees:
<ul>
<li>Yearly work anniversary pay increases</li>
<li>Education Reimbursement; up to $2,500 annually</li>
<li>Retirement plan participation</li>
<li>Free certification classes: enhance your skills at no cost to you</li>
<li>Health and Wellness discounts at local gyms</li>
<li>Discounts at select mobile networks, local vendors, and Elitch Gardens</li>
<li>Mental Health: 6 free confidential, in-person counseling sessions offered by Pathways annually</li>
<li>Financial Counseling: free services through WellCents to help you take control of your financial journey</li>
<li>Legal assistance and will preparation services</li>
<li>Student Loan Forgiveness: Ivinson Memorial Hospital is a qualifying employer for the federal Public Service Loan Forgiveness (PSLF) program</li></ul> 


Please use this link for more information regarding our rewards package and benefits: Benefits Guide.

At Ivinson Memorial Hospital, we are more than just a workplace &ndash; we are a community where your growth and well-being matter. Join us in making a difference in the lives of the Laramie community and help us provide world-class care.</div>

Pre Auth Financial Specialist - Admitting

Clevanoo LLC

<div>
 
 We have an immediate need for an
 
 Medical Billing Specialist.
 
 
 
 
 
 Job Title: Medical Billing Specialist
 
 
 Location: Onsite (San Mateo, CA)
 
 
 Duration: Full Time/Direct Hire
 
 
 
 
 
 Role Description:
 
 
 
 This is a full-time, on-site role for a Medical Billing Specialist in San Mateo, CA. The Medical Billing Specialist will be responsible for processing medical billing claims, handling insurance verifications, addressing billing discrepancies and denials, and managing payments from patients and insurance providers. The role involves ensuring accurate use of medical codes and adherence to billing regulations.
 
 
 
 
 
 Qualifications:
 
 
 
 &bull;Proficiency in Medical Terminology and an understanding of Insurance processes
 
 
 &bull;Experience managing Denials and working with Medicare claims
 
 
 &bull;Knowledge of ICD-10 for accurate coding and billing practices
 
 
 &bull;Strong attention to detail and organizational skills
 
 
 &bull;Effective communication and problem-solving abilities
 
 
 &bull;Knowledge of billing software or systems is a plus
 
 
 &bull;High school diploma or equivalent; certification in medical billing or coding is preferred
 
 
 
 
 --
 
 
 Maaz Ali
 
 
 Specialist - Talent Acquisition
 
 
 Clevanoo LLC
 
 
 Desk: 475-216-2328
 
 
 Email: Maaz.a@clevanoollc.com
 
</div>

Medical Biller

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