Insurance Claims Spec

4 weeks ago


New Martinsville, United States WVU Medicine Full time
Welcome We're excited you're considering an opportunity with us To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you'll find other important information about this position.

Responsible for the process of patient account review, correction, adjustment, and filing to third party payers and/or patients. Works directly with patients and third party payers as it relates to information distribution.

MINIMUM QUALIFICATIONS:
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1. High school diploma or equivalent.2. West Virginia state criminal background check required, and Federal, if applicable, for DHHR BMS regulated area.

PREFERRED QUALIFICATIONS:
EXPERIENCE: 1. Previous hospital billing and/or credit and collection experience.

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.

1. Performs claims processing to third party payer according to payer guidelines.2. Reviews and corrects billing edits prior to submitting claims.3. Reviews edits to ensure proper billing and verifies edits with the appropriate Department leaders, if needed.4. Works denials thoroughly and timely with little back-log.5. Performs follow up on account, working with third party payers, patient, employer, and physician office to resolve unpaid or underpaid accounts. Works follow-up reports thoroughly within the month.6. Communicates problems hindering workflow to management in a timely manner.7. Posts copays collected at Medical Offices to vouchers. Maintains unassigned payments.8. Processes collections accounts.9. Processes patient and insurance refund documentation.

PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Prolonged periods of sitting.2. Manual dexterity required to operate standard office equipment.

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Standard office environment.

SKILLS AND ABILITIES:

1. Excellent oral and written communication skills.2. Basic knowledge of medical terminology.3. General knowledge of accounts receivable and collections procedures.

Additional Job Description:

Scheduled Weekly Hours:
32

Shift:

Exempt/Non-Exempt:
United States of America (Non-Exempt)

Company:
WTZ Wetzel County Hospital

Cost Center:
7361 WTZ Family Medicine Paden City

Address:
3 East Benjamin Drive

New Martinsville

West Virginia

WVU Medicine is proud to be an Equal Opportunity employer. We value diversity among our workforce and invite applications from all qualified applicants regardless of race, ethnicity, culture, gender, sexual orientation, sexual identity, gender identity and expression, socioeconomic status, language, national origin, religious affiliation, spiritual practice, age, mental and physical ability/disability or Veteran status.

  • Martinsville, Illinois, United States State Farm Insurance Full time

    About State Farm InsuranceState Farm Insurance is a leading provider of insurance products and services. As an Insurance Claims Specialist, you will play a vital role in delivering exceptional customer experiences.


  • New Gloucester, Maine, United States Cross Insurance Full time

    About the RoleWe are seeking a skilled Insurance Claims Examiner to join our team at Cross Insurance. As an Insurance Claims Examiner, you will be responsible for assessing and processing workers' compensation claims in a fair and timely manner.Key ResponsibilitiesReview and analyze loss information to determine compensability of claimsInvestigate claims...


  • New York, New York, United States GNY Insurance Companies Full time

    We are seeking a skilled professional to examine, adjust and defend claims against our insureds.Key Responsibilities:Verify coverage for each claim by reviewing policies and comparing allegations made by the claimant.Conduct factual investigations directly or with investigator assistance.Analyze various documents, including contracts, leases, and business...

  • Claims Technician

    2 weeks ago


    New Gloucester, United States Cross Insurance Full time

    The Cross Family of Agencies welcomes you. We need your talent and expertise. POSITION: Claims Technician DEPARTMENT: Claims Management Division REPORTS TO: Medical Only Supervisor Position Requirements: High school graduate or equivalent; higher education beneficial. Workers' Compensation claims experience and/or knowledge preferred but not...


  • New Bedford, Massachusetts, United States Concord Group Insurance Full time

    Job SummaryWe are seeking a skilled Field Claims Representative to join our team at Concord Group Insurance. As a key member of our claims department, you will be responsible for investigating, evaluating, and settling assigned claims involving property damage.Key ResponsibilitiesConduct field appraisals to assess and document property damageInvestigate...


  • New York, United States Diedre Moire Corp. Full time

    Job Title: Insurance Claims SpecialistAbout the Role:We are seeking an experienced Insurance Claims Specialist to join our team at Diedre Moire Corp. in New York City, NY.About Us:Diedre Moire Corp. is a dynamic and innovative company that offers unique opportunities for career growth and development.Job Description:The Insurance Claims Specialist will be...


  • New York, New York, United States C. Winchell Agency, Inc. Full time

    Job OverviewC. Winchell Agency, Inc. seeks a highly skilled Senior Insurance Claims Manager to oversee the handling of complex national General Liability claims.Key ResponsibilitiesThe ideal candidate will manage and direct TPA teams in the investigation, evaluation, and resolution of claims involving special event/entertainment coverage.Responsibilities...


  • New York, New York, United States Impact Recruiting Solutions Full time

    Job SummaryWe are seeking a detail-oriented Insurance Claims Processor to join our team at Impact Recruiting Solutions.


  • New Orleans, Louisiana, United States Gentilly Family Dental Full time

    Job Title: Dental Insurance Billing SpecialistWe are seeking a highly skilled and experienced Dental Insurance Billing Specialist to join our team at Gentilly Family Dental. As a key member of our team, you will be responsible for ensuring the accurate and timely submission of dental insurance claims, as well as maintaining strong relationships with...


  • New York, New York, United States Vitreous-Retina-Macula Consultants of New York PC Full time

    We are seeking an experienced Medical Insurance Claims Examiner to join our team at Vitreous-Retina-Macula Consultants of New York PC.About the RoleThis is a challenging and rewarding opportunity for a detail-oriented professional to analyze and process medical insurance claims with accuracy and efficiency.The ideal candidate will possess excellent...


  • New York, New York, United States Allstate Insurance Full time

    Exciting Opportunity at Allstate InsuranceWe are seeking a skilled Auto Claims Adjuster to join our team in Brooklyn/Queens NY. As an Auto Claims Adjuster, you will play a crucial role in our claims handling process by assessing and finalizing estimates directly at customer homes, repair shops, or tow yards.About the RoleYou will be responsible for writing...


  • New York, New York, United States Allstate Insurance Company Full time

    Represented Bodily Injury Adjuster Role at Allstate Insurance CompanyWe are seeking an experienced Claims Negotiator and Customer Service Expert to join our team at Allstate Insurance Company.About the RoleThis is a dynamic opportunity for a skilled professional to work as a Represented Bodily Injury Adjuster, investigating automobile accidents involving...

  • Claims Specialist

    7 days ago


    New York, New York, United States Allstate Insurance Full time

    About the Role:At Allstate, our innovative drive has kept us ahead of customers' evolving needs for over 90 years. We're looking for a Claims Specialist - Property Adjuster to join our team in this exciting opportunity.Key Responsibilities:Conduct on-site inspections, investigate coverage, and prepare estimates for property claimsTravel to customers' homes...


  • New York, United States Country-Wide Insurance Company Full time

    Country-Wide Insurance Company is seeking new employees for its upcoming claims training class. Our training program offers a rare opportunity for individuals to receive intensive, hands-on training from expert professionals that can be directly transferred to the field. We are looking for the next generation of exceptional leaders. Essential Functions and...


  • New York, New York, United States PHYSICAL THERAPY OF THE BRONX P C Full time

    Job DescriptionAt PHYSICAL THERAPY OF THE BRONX P C, we are seeking a skilled professional to join our team as an Insurance Verification Specialist.Key Responsibilities:Verify patient insurance coverage and benefitsCommunicate with patients and insurance providers to resolve coverage issuesProcess and manage patient claimsWork Schedule:Monday, Wednesday,...

  • Claims Examiner

    7 days ago


    New York, New York, United States CCMS & Associates Full time

    We are seeking a professional Claims Examiner to join our team at CCMS & Associates. This role is based in the New York City area and requires a strong background in property and liability insurance claims examination.Key Responsibilities:Examine claims for damages and losses, ensuring accurate assessments and fair settlementsInvestigate claims by obtaining...


  • New York, New York, United States Allstate Insurance Full time

    We're seeking a skilled Compensation and Benefits Specialist to join our team in the Eastern or Central time zones. This role is ideal for individuals with experience in homeowner liability claims who are tech-savvy and confident handling BI litigation and liability claims.Key Responsibilities:Recognize and identify body parts of a vehicle or other potential...


  • New York, New York, United States C. Winchell Agency, Inc. Full time

    C. Winchell Agency, Inc. Job OpportunityWe are seeking an experienced Senior Claims/TPA Oversight professional to join our team in NYC.The ideal candidate will have a strong background in managing and overseeing TPA handling of complex national GL claims, with expertise in special event/entertainment claims and coverage.A minimum of 10+ years of experience...


  • New York, United States Zurich Insurance Company Ltd. Full time

     Zurich is currently looking for a Legal Claims Professional for our Management Solutions group to work out of any of our Claims offices throughout the US. If you are ready for a career move, consider working for a company with a global footprint that offers terrific benefits including an incentive plan, 401K match and an additional 401K contribution,...


  • New York, New York, United States GREATER NEW YORK MUTUAL INSURANCE COMPANY Full time

    Job OverviewThe Greater New York Mutual Insurance Company is seeking a highly skilled and experienced Senior Claims Investigator to join our team. In this role, you will be responsible for investigating premises liability claims, interviewing witnesses, and preparing detailed reports.ResponsibilitiesInvestigate claims promptly and thoroughly, gathering...