Medical Claims Specialist

2 weeks ago


Avondale, United States RPO Inc Full time

Title**:Claims Liaison**

Location**:REMOTE**:

- _can live anywhere in US as long as they can work AZ hours_

Duration**:6 months contract (Temp to hire)**

Target Start Date (based on successful onboarding completion)**:6/17/2024**

Shift**:Anytime between 7:00 AM - 5:00 PM MST - 8 hours/day**

Walk me through the day-to-day responsibilities of this the role and a description of the project:

- Audit check run and send claims to the claims department for corrections.
- Identify any system changes and work notify the Plan CIA Manager to ensure its implementation
- Collaborate with the claims department to price pended claims correctly
- Document, track and resolve all plan providers’ claims projects
- Collaborate with various business units to resolve claims issues to ensure prompt and accurate claims adjudication
- Identify authorization issues and trends and research for potential configuration related work process changes
- Analyze trends in claims processing issues and assist in identifying and quantifying issues and reviewing work processes
- Identify potential and documented eligibility issues and notify applicable departments to resolve
- Research the claims on various reports to determine if appropriate to move forward with recovery due to non-covered items being allowed, etc.
- Run claims reports regularly through provider information systems
- Research verbal and written providers’ claims inquiries as needed
- Experience with Researching and Analyzing healthcare claims
- Strong Excel-Intermediate and above exp required-pivot tables and v-looks are used frequently so they must have this

What previous job titles or background work well in this role?
- Claims, Medical billing,

**Required Skills/Experience/Education**:

- **3+ years of RECENT Claims & Medical Billing Experience in a Managed Care environment.**:

- **Strong Excel Skills - Intermediate and above experience required (pivot tables and v-look up)**:

- **Analytical Skills, Attention to detail, Strong Typing/Data Entry Skills 40 WPM, Strong Proficiency in Microsoft Office, experience with multiple screens, and Multitasking skills.**:

- High School Diploma or GED required.

**Job Type**: Contract

Pay: $25.00 per hour

Expected hours: No less than 40 per week

**Benefits**:

- 401(k)
- 401(k) matching
- Dental insurance
- Flexible schedule
- Health insurance
- Life insurance
- Paid time off
- Vision insurance

Schedule:

- 8 hour shift
- Weekends as needed

Work setting:

- Remote

**Experience**:

- Pivot tables: 3 years (required)
- Microsoft Excel: 3 years (required)
- Medical Claims: 3 years (required)
- Medical billing: 3 years (required)

Work Location: Remote



  • Avondale, United States Southwest Gastroenterology Full time

    **Job Overview**: **Responsibilities & Duties**: - Perform charge entry using the current EMR billing system coding tools. - Review and verify accuracy of billing data and revise any errors - Prepare and submit claims to insurance companies. This involves working on both clinic and procedure visits. - Collect time of service payments, reconcile and deposit...


  • Avondale, United States USAA Full time

    Why USAA?Let’s do something that really matters. We have an important mission: serving the members of the military community and their families. It’s both a chance to say thank you and the opportunity to put your talents to work in a meaningful way. To do it right, we need the right people. We’re looking for those who share our values of honesty,...


  • Avondale, United States JCHCC dba Inclusivcare Full time

    GENERAL SUMMARY OF DUTIES:Provides patient account and reimbursement services for all units of the agency that requires third party and other billing related functions (with the exception of grants and contracts).SUPERVISION EXERCISED: NoneESSENTIAL FUNCTIONS:Ensures accounts receivables (AR) records are maintained in a confidential manner and in accordance...


  • Avondale, United States Community Bridges Full time

    Community Bridges, Inc. (CBI) is an integrated behavioral healthcare agency offering a variety of different programs throughout Arizona. CBI provides residential, outpatient, inpatient, patient-centered medical homes, medication-assisted treatment, and crisis services to individuals experiencing crisis, opioid use disorder, homelessness, and mental illness....


  • Avondale, United States JCHCC dba Inclusivcare Full time

    GENERAL SUMMARY OF DUTIES: General patient support, front desk and general office duties (answering phones, faxing, scanning, filing), and manage scheduling of patients; accepts patient payments and generates daily deposit reports; performs data entry. SUPERVISION EXERCISED: None ESSENTIAL FUNCTIONS:Answer and route incoming calls, as appropriate; Take...

  • Medical Assistant

    5 days ago


    Avondale, United States NextCare Holdings Inc. Full time

    What we are looking for NextCare Urgent Care is looking for an energetic and enthusiastic Medical Assistant / Patient Service Specialist (Medical Front Office Receptionist) that likes the challenge of a fast pace setting and working in a team environment. We are looking for customer-friendly and passionate employees to be a part of our growing...

  • Medical Biller

    4 weeks ago


    Avondale, United States Estrella Health and Rehab Center Full time

    Estrella Health and Rehab, a Skilled Nursing Facility located in Avondale, Arizona, is looking for a Medical Biller. Come join our fun/fast paced environment in an industry that stands the test of time!Pay Range: $15.00 - $18.00/ hrAs the Medical Biller, you will learn the innerworkings of healthcare insurance and also gain a wide knowledge of accounting...

  • Medical Assistant

    4 days ago


    Avondale, United States NextCare Full time

    Job DescriptionJob DescriptionNextCare Introduction NextCare strives to be the leader in high access healthcare, offering urgent care, occupational health, virtual health and primary care services to our patients. With offering services in twelve states (Arizona, Colorado, Kansas, Michigan, Missouri, New Mexico, Nebraska, North Carolina, Oklahoma, Texas,...


  • Avondale, United States Az Pro Signs Full time

    AZPRO // Production Specialist Do you like to work with your hands? Do you hate being stuck behind a desk? Are you the type of person that takes something apart just to see how it works? If any of these are you then AZPRO just might be the place for you. We are a fun, growing, fast paced, stable company that is looking for a Production Specialist. No...


  • Avondale, United States AZ PRO SIGNS, INC. Full time

    Job DescriptionJob DescriptionAZPRO // Production SpecialistDo you like to work with your hands? Do you hate being stuck behind a desk? Are you the type of person that takes something apart just to see how it works? If any of these are you then AZPRO just might be the place for you. We are a fun, growing, fast paced, stable company that is looking for a...


  • Avondale, United States Az Pro Signs Full time

    AZPRO // Production SpecialistDo you like to work with your hands? Do you hate being stuck behind a desk? Are you the type of person that takes something apart just to see how it works? If any of these are you then AZPRO just might be the place for you. We are a fun, growing, fast paced, stable company that is looking for a Production Specialist. No...


  • Avondale, United States Cadia Healthcare Full time

    Benefits * Personal, Vacation, Sick Days & Paid Holidays * Health, Dental, and Vision insurance; Company Paid Life insurance * A 401(k) plan with company match. * Maternity Leave Options, Short and Long Term Disability. * Personal and Family Medical Leave. Employee Perks Program * Tickets At Work/Ticket Monster - Discount Programs * Free and Discounted...

  • Audiologist

    5 days ago


    Avondale Estates, United States Trusted Medical, PLLC Full time

    Job DescriptionJob DescriptionAudiologistTrusted Medical, PLLC About us  Trusted Medical, PLLC is the clinical care delivery affiliate of Edera (www.edera.com). We specialize in serving Veterans by reducing wait times for them to gain access to disability screens and separation health assessments required by the Veteran Affairs (VA) to receive benefits....


  • Avondale, United States Takeda Full time

    Description Please take this to get a sneak peek of one of our Plasma Donation Centers. About BioLife Plasma Services Every day, the donors you meet will motivate you. The high-quality plasma you collect will become life-changing medicines. Here, a commitment to customer service and quality is expected. You will report to the Plasma Center...


  • Avondale, United States Biolife Plasma Services Full time

    By clicking the “Apply” button, I understand that my employment application process with Takeda will commence and that the information I provide in my application will be processed in line with Takeda’s Privacy Notice and Terms of Use . I further attest that all information I submit in my employment application is true to the best of my knowledge. Job...

  • Registered Dietitian

    2 weeks ago


    Avondale, United States Fresenius Medical Care Full time

    PURPOSE AND SCOPE: Provides nutritional services for the facility’s in-center and home patients as applicable in order to maximize the patient’s nutritional status and improve clinical outcomes. Functions as a member of the interdisciplinary healthcare team, supporting the FMCNA commitment to the Quality Enhancement Program (QEP) and Quality Assessment...


  • Avondale, United States Gateway Chevrolet AZ Full time

    Gateway Chevrolet is hiring for a Warranty Administrator. This position was made available due to our current warranty administrator being promoted to a service management position. Gateway is the #1 selling Chevrolet dealer in the Western Region. Gateway continues to expand to accommodate the traffic we are experiencing in Service. Stability — Family...


  • Avondale, Arizona, United States Olesky Associates, Inc Full time

    Healthcare Network in Northeastern Pennsylvania is seeking an employed BC/BE Fellowship-trained Psychiatrist to provide outpatient consults. The Joint Commission accredited organization provides inpatient and outpatient, rehabilitation, crisis and crisis residential rehabilitation, partial hospital programs, medication management, and tele- psychiatry...


  • Avondale, United States Olesky Associates, Inc Full time

    Healthcare Network in Northeastern Pennsylvania is seeking an employed BC/BE  Fellowship-trained Psychiatrist to provide outpatient consults. The Joint Commission accredited organization provides inpatient and outpatient, rehabilitation, crisis and crisis residential rehabilitation, partial hospital programs, medication management, and tele- psychiatry...


  • Avondale, United States Midway Staffing, Inc. Full time

    **$1000 Sign On Bonus!** **Weekly Pay + Monthly Bonus Incentives** **Salary: $80,000** **1**st** Shift Monday - Friday** **Location: Avondale, AZ** The Branch Manager is responsible for the day-to-day operations of the Midway Staffing Branch. This role will build and subsequently oversee the Talent Acquisition team’s performance within the respective...