Claims Specialist

3 weeks ago


Bethesda, United States Illumination Foundation Full time

Location field must contain 'city, state' or a zip code to perform a radius search (e.g.,

Denver, CO

or

46122 ). City and state must be separated by a comma followed by a space (e.g.,

Houston, TX ) ILLUMINATION FOUNDATION

Claims Specialist

in

Santa Ana ,

California

“Every person deserves compassion, dignity, and the safety of a place to call home.” Homelessness is the largest social and public health crisis in California. Illumination Foundation (IF) is a growing non-profit organization dedicated towards disrupting the cycle of homelessness by providing targeted, interdisciplinary services in our recuperative care centers, emergency shelters, housing services and children's and family programs. IF currently has 13+ facilities with 22+ micro-communities scattered across Orange County, Los Angeles County and the Inland Empire. Job Description The Claims Specialist is responsible for accuracy of claims submission, benefits and eligibility verification, accuracy of client information. In addition, the Claims Specialist is also responsible for keeping up to date accounts receivable for both CalAIM and IFMG, claim follow-up, and must have knowledge of billing codes. The pay range for this position is $25.00 - $27.00 per hour, depending on experience. This position can be based out of Santa Ana or Riverside. After successful completion of 90-day probation period, this position will be eligible for Hybrid schedule with 2days in office and 3days working from home. Responsibilities CalAIM Billing and Follow up Reviewing data and creating Claims for services rendered Review client records to extract applicable data necessary for billing purposes, including but limited to ICD 10 Diagnosis codes, CPT codes for services rendered etc. Review any rejected or denied claims and conduct proper follow up procedures. Ensure claims meet the standards of our contracts and programs. Verify eligibility of each client prior to creating and submitting claims. Have knowledge in understanding, reading EOB’s and Remittance Advice Posting payment accurately to claims and continuing with the claim close out process. Assist Manager and Associate Director in any projects related to billing that may come up. IFMG Billing and Follow up Reviewing encounters for PCP, Psychiatry, and behavioral health, ensuring CPT codes, and ICD 10 codes used by Dr are applicable to the service rendered before submitting encounter as a claim. Familiar with Athena or similar EHR system Verifying client's insurance falls into one our contracted insurance prior to billing Following up on claims that were denied, rejected, or held in the EHR system which includes appeals, corrections, resubmissions Preferred Experience/Minimum Qualifications Required: High School Diploma or equivalent. 1-2 years' relevant experience. Basic computer skills, including the ability to send and receive emails and summarize data in spreadsheets. Valid CA Driver’s License and eligibility for company vehicle insurance. Prior experience work in Electronic Billing Platforms and EHR systems Prior experience working with claims and communication with health networks Preferred: Proficiency in Microsoft (Outlook, Word, Excel, Teams). Associate’s Degree Experience in Medical Billing and Primary Care Billing Medical Billing Certification Hybrid schedule with 2days in office and 3days working from home (After successful completion of 90-day probation period) Medical Insurance funded up to 91% by Illumination Foundation (Kaiser and Blue Shield), depending on the plan Dental and Vision Insurance Life, AD&D and LTD Insurance funded 100% by Illumination Foundation Employee Assistance Program Professional Development Reimbursement 401K with Company Matching 10days vacation PTO/year 10 days holiday PTO/year Potential eligibility for the Public Service Loan Forgiveness Program (PSFL) for federally qualified loans

#J-18808-Ljbffr


  • Appeals Specialist

    5 days ago


    Bethesda, United States Nesco Resource Full time

    Job SummaryThe Claims Specialist-Appeals assesses and facilitates ongoing support for *** Government Solutions (SGS) Claims OperationsResponsibilities include assessing and handling appeals; serves as the subject matter expert for claims appeals; and to serve as the liaison between claims operation and the client. Duties and ResponsibilitiesGathers and...


  • Bethesda, United States Cynet Systems Full time

    Description: Job Summary The Claims Specialist-Appeals assesses and facilitates ongoing support for *** Government Solutions (SGS) Claims Operations. Responsibilities include assessing and handling appeals; serves as the subject matter expert for claims appeals; and to serve as the liaison between claims operation and the client. Job Description Essential...


  • Bethesda, Maryland, United States Randstad USA Full time

    Are you someone who thrives in a fast paced environment and always loves a good challenge? Do you view yourself as meticulous and adaptable to change? If this is you, and you are seeking your next professional role then we would love to speak with you Our client in Bethesda, MD is growing their team and we are seeking qualified Resolutions Payable Specialist...


  • Bethesda, United States Bethesda Family Dentistry Full time

    Immediate opportunity! Our practice is growing and we're looking for just the right person to join our highly motivated team. We are seeking a Dental Insurance Specialist. The position offers a great opportunity to grow with the practice and offers great pay and benefits.. Responsibilities include verifying and billing insurance, posting payments, following...

  • Collateral Specialist

    3 weeks ago


    Bethesda, United States TalentRemedy Full time

    Job DescriptionJob DescriptionCollateral Specialists work very closely with the Account Executives to monitor the collateral being assigned or purchased by and are the primary point of contact with the operations personnel of the client. Collateral Specialists are KCC’s first line of defense. They are responsible for monitoring and proving the validity of...

  • Benefit Specialist

    1 month ago


    Bethesda, United States Rapid Financial Services, LLC Full time

    Are you seeking an opportunity to join an established HR team for a growing company in downtown Bethesda? If you are looking to grow your HR career path, we have an awesome opportunity for you in our corporate office inBethesda, MD, which is just a couple of city blocks from the Bethesda Metro. Recognized as one of DC's Top Workplaces, Rapid Financial...

  • Benefit Specialist

    1 week ago


    Bethesda, United States Rapid Finance Full time

    Are you seeking an opportunity to join an established HR team for a growing company in downtown Bethesda? If you are looking to grow your HR career path, we have an awesome opportunity for you in our corporate office in Bethesda, MD, which is just a couple of city blocks from the Bethesda Metro. Recognized as one of DC's Top Workplaces, Rapid Financial...

  • Benefit Specialist

    1 month ago


    Bethesda, United States Rapid Finance Full time

    Job DescriptionJob DescriptionAre you seeking an opportunity to join an established HR team for a growing company in downtown Bethesda?   If you are looking to grow your HR career path, we have an awesome opportunity for you in our corporate office in Bethesda, MD, which is just a couple of city blocks from the Bethesda Metro. Recognized as one of...


  • Bethesda, Maryland, United States Naval Medical Command Full time

    Summary You will serve as a SUPERVISORY PHYSICAL SECURITY SPECIALIST (ANTI-TERRORISM) in the PUBLIC SAFETY OFFICE of NSA BETHESDA SECURITY DETACHMENT. This job carries a significant amount of responsibility. Please read the entire job announcement before applying. This job is open to Career transition (CTAP, ICTAP, RPL) Federal employees who meet the...


  • Bethesda, United States Two Little Windows LLC Full time

    **About us** Two Little Windows LLC is a small business in Bethesda, MD. We are professional, agile, professional and our goal is to Correct your vision in ways you never thought possible. Our work environment includes: - Modern office setting - Food provided - On-the-job training Job Overview: We are seeking a skilled and detail-oriented Medical Biller...


  • Bethesda, United States BRP Group, Inc. Full time

    AHT Insurance is an award-winning entrepreneur-led and inspired insurance brokerage firm delivering expertly crafted Commercial Insurance and Risk Management, Private Insurance and Risk Management, Employee Benefits and Benefit Administration, Asset and Income Protection, and Risk Mitigation strategies to clients wherever their passions and businesses take...

  • Benefit Specialist

    1 month ago


    Bethesda, United States Turn2Partners Full time

    Responsibilities: Responding to HR-related inquiries on benefits enrollment, policies, and HRIS assistance. Managing employee benefits programs, including medical, dental, vision, FSA, HRA, 401(k), etc. Updating and maintaining confidential team member records,.. Making decisions on eligibility, continuation of benefits, and tracking leave for FMLA-eligible...


  • Bethesda, Maryland, United States ERIMAX Inc. Full time

    Job Description Job Description The Senior Closeout Specialist reviews highly specialized contracts monitor all acquisition and assistance strategies. The Senior Closeout Specialist supports the Contracting Officer by providing contract/agreement administration, ensuring terms and conditions are complied with and the recipient delivers services and/or goods...


  • Bethesda, United States ERIMAX Full time

    Job DescriptionJob DescriptionThe Senior Closeout Specialist reviews highly specialized contracts monitor all acquisition and assistance strategies. The Senior Closeout Specialist supports the Contracting Officer by providing contract/agreement administration, ensuring terms and conditions are complied with and the recipient delivers services and/or goods in...


  • Bethesda, United States U.S. Army Medical Command Full time

    **Duties**: - Analyze military data to determine its validity to prepare reports using a variety of automated systems, databases, spreadsheets, and/or word processing software. - Oversee the writing of Standard Operating Procedures (SOPs) and information papers to be used for daily operations. - Prepare, review and track military personnel actions until...

  • Client Manager

    2 weeks ago


    Bethesda, United States AHT a Baldwin Risk Partner Full time

    AHT Insurance is an award-winning entrepreneur-led and inspired insurance brokerage firm delivering expertly crafted Commercial Insurance and Risk Management, Private Insurance and Risk Management, Employee Benefits and Benefit Administration, Asset and Income Protection, and Risk Mitigation strategies to clients wherever their passions and businesses take...

  • Client Manager

    3 weeks ago


    Bethesda, United States Vibrant Full time

    Client Manager - AHT Insurance page is loaded Client Manager - AHT Insurance Apply locations Bethesda, Maryland, US time type Full time posted on Posted 5 Days Ago job requisition id JR105978 AHT Insurance is an award-winning entrepreneur-led and inspired insurance brokerage firm delivering expertly crafted Commercial Insurance and Risk Management, Private...

  • Office Representative

    4 weeks ago


    Bethesda, United States Charles Sumpter - State Farm Agent Full time

    **ROLE DESCRIPTION**: The Charles Sumpter Insurance Agency is seeking an organized and efficient specialist to fulfill administrative duties and support insurance agents in gaining and keeping customers. As Office Representative with our agency, your attention to detail, dedication to client relations, and sales-mindedness equip you for this versatile...

  • Office Representative

    4 weeks ago


    Bethesda, United States Charles Sumpter - State Farm Agent Full time

    Job DescriptionJob DescriptionROLE DESCRIPTION:The Charles Sumpter Insurance Agency is seeking an organized and efficient specialist to fulfill administrative duties and support insurance agents in gaining and keeping customers. As Office Representative with our agency, your attention to detail, dedication to client relations, and sales-mindedness equip you...


  • Bethesda, United States Charles Sumpter - State Farm Agent Full time

    Job DescriptionJob DescriptionBenefits:Bonus based on performanceTraining & developmentROLE DESCRIPTION:The Charles Sumpter Insurance Agency is seeking an organized and efficient specialist to fulfill administrative duties and support insurance agents in gaining and keeping customers. As a Customer Service Representative with our agency, your attention to...