Medical Claim Specialist
1 week ago
Job Summary
Responsible for collecting accounts receivables on patient accounts, non-government
and contracted insurances government payers and secondary billing. Responsibilities include routine follow-up on accounts, working the Rejection Report for contracted insurances, analyzing aged trial balance report for assigned chargeto's, working the Antrim, Rhodes reports and miscellaneous accounts receivable reports.
ESSENTIAL FUNCTIONS:
1. Collects outstanding accounts receivables on patient accounts from patient, commercial, non-government, contracted insurances or government payors via phone call to the patient or insurance company or by means of written appeal or reconsideration.
2. Pursues collection activities on assigned accounts from primary and secondary payors until worked to resolution to include claims resubmission, appeal or reconsideration.
3. Works account receivables reports (i.e. aged-trial-balance report), focusing attention on accounts over 60 days.
4. Researches adjustments and pull all necessary backup to support adjustments.
5. Utilizes on-line insurance resources to obtain and maintain current information.
6. Develops and maintains a professional working rapport with internal and external customers to include contacts with insurance company representatives.
7. Identifies trends in payment or non-payment of claims. Communicates findings to leadership and co-workers as appropriate.
8. Customizes reports in Antrim and or Excel to prioritize accounts for collecting.
The above statements describe the general nature and level of work being performed by individuals assigned to this classification. This is not intended to be an exhaustive list of all responsibilities and duties required of personnel so classified.
Minimum Qualifications
MINIMUM EDUCATION:
• High school diploma or equivalent
MINIMUM EXPERIENCE:
Must have one of the following:
• Six (6) months as an Apprentice in the Business Office at TriCore
• Minimum of one (1) year of laboratory or medical claims follow-up/collections
experience
• Minimum of three (3) years of medical billing or claims processing experience
OTHER REQUIREMENTS:
• Must be able to type 30 words per minute (typing test required)
• Must have basic PC knowledge and working expertise with keyboard, mouse,
Internet, and Windows based applications
PREFERENCES:
Basic knowledge of Excel and Word
Knowledge of medical terminology
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.
-
Medical Claims Specialist
2 weeks ago
Albuquerque, New Mexico, United States Jobot Full timeJoin Jobot as a Medical Billing SpecialistJobot, a leader in healthcare finance consulting, is seeking a talented and experienced Medical Billing Specialist to enhance our vibrant team. The successful candidate will be integral in delivering financial solutions to our clients within the healthcare industry. If you possess a robust background in medical...
-
Medical Claims Specialist
3 days ago
Albuquerque, New Mexico, United States TriCore Reference Laboratories Full timeJob SummaryAs a Medical Claims Specialist at TriCore Reference Laboratories, you will play a critical role in collecting accounts receivables on patient accounts, non-government and contracted insurances government payers and secondary billing. Your responsibilities will include routine follow-up on accounts, working the Rejection Report for contracted...
-
Medical Claims Specialist
2 weeks ago
Albuquerque, New Mexico, United States CCMSI Full timeAbout the RoleThis is a unique opportunity to join CCMSI as a Medical Claims Specialist in our Albuquerque office. As a key member of our team, you will be responsible for handling designated medical-only claims and providing support to claim staff.Key ResponsibilitiesManage medical-only claims with attention to detail and adherence to corporate claim...
-
Medical Claims Specialist
1 week ago
Albuquerque, New Mexico, United States CCMSI Full timeAbout the RoleThis is a unique opportunity to join CCMSI as a Medical Claims Specialist in our Albuquerque office. As a key member of our team, you will be responsible for handling designated medical-only claims and providing support to claim staff.Key ResponsibilitiesManage medical-only claims with attention to detail and adherence to corporate claim...
-
Medical Claims Specialist
7 days ago
Albuquerque, New Mexico, United States Innova Solutions Full timeJob SummaryWe are seeking a highly skilled Medical Claims Specialist to join our team at Innova Solutions. As a Medical Claims Specialist, you will play a critical role in ensuring the smooth operation of our healthcare networks and providing exceptional service to our clients.Key ResponsibilitiesProvide information and assistance to resolve problems...
-
Medical Claim Specialist
3 months ago
Albuquerque, United States TriCore Reference Laboratories Full timeJob Summary Responsible for collecting accounts receivables on patient accounts, non-government and contracted insurances government payers and secondary billing. Responsibilities include routine follow-up on accounts, working the Rejection Report for contracted insurances, analyzing aged trial balance report for assigned charge To’s. Working...
-
Claims Processing Specialist
7 days ago
Albuquerque, New Mexico, United States Innova Solutions Full timeJob SummaryWe are seeking a highly skilled Medical Claims Specialist to join our team at Innova Solutions. As a Medical Claims Specialist, you will play a critical role in ensuring the smooth operation of our healthcare networks and providing exceptional service to our clients.Key ResponsibilitiesProvide information and assistance to resolve problems...
-
Claims Intake Specialist
1 week ago
Albuquerque, United States New Mexico Mutual Full timeJob Type Full-timeDescriptionJob Title: Claims Intake Specialist - BilingualDepartment: Provider Relations Reports to: Claims Administration SupervisorPosition Summary:The Claims Intake Specialist will function in a fast-paced and high-volume environment, providing administrative support to the Claims Department through intake of claims, filing, copying,...
-
Claims Intake Specialist
5 days ago
Albuquerque, New Mexico, United States New Mexico Mutual Full timeJob SummaryNew Mexico Mutual is seeking a highly organized and detail-oriented Claims Intake Specialist to join our team. As a Claims Intake Specialist, you will play a critical role in the claims process, ensuring that all claims are properly documented and processed in a timely manner.Key ResponsibilitiesIntake and Data Entry: Perform data entry of new...
-
Claims Intake Specialist
3 days ago
Albuquerque, New Mexico, United States New Mexico Mutual Full timeJob SummaryNew Mexico Mutual is seeking a highly organized and detail-oriented Claims Intake Specialist to join our team. As a Claims Intake Specialist, you will play a critical role in the claims process, ensuring that all claims are properly documented and processed in a timely manner.Key ResponsibilitiesIntake and Data Entry: Perform data entry of new...
-
Claims Intake Specialist
2 weeks ago
Albuquerque, United States New Mexico Mutual Full timeJob Type Full-time Description Job Title: Claims Intake Specialist - Bilingual Department: Provider Relations Reports to: Claims Administration Supervisor Position Summary: The Claims Intake Specialist will function in a fast-paced and high-volume environment, providing administrative support to the Claims Department through intake of claims, filing,...
-
Claims Intake Specialist
1 week ago
Albuquerque, New Mexico, United States New Mexico Mutual Full timeClaims Intake Specialist - BilingualNew Mexico Mutual is seeking a highly skilled and detail-oriented Claims Intake Specialist to fill a critical role in our Claims Department.Key Responsibilities:Provide administrative support to the Claims Department through claim intake, filing, copying, data entry, and responding to requests.Perform other clerical and...
-
Administrative Claims Specialist Role
1 week ago
Albuquerque, New Mexico, United States New Mexico Mutual Full timeClaims Intake Specialist Job SummaryNew Mexico Mutual is seeking a highly skilled and detail-oriented Claims Intake Specialist to support the smooth operation of our Claims Department.Key Responsibilities:Provide administrative support to the Claims Department through claim intake, filing, copying, data entry, and responding to requests.Perform other...
-
Claims Processing Specialist
2 weeks ago
Albuquerque, New Mexico, United States CCMSI Full timeOverview:At CCMSI, we seek talented individuals to become part of our professional team. As a prominent Third Party Administrator in self-insurance services, we are driven by a shared commitment to providing outstanding service to our clients. Being an Employee-Owned Company, we prioritize the growth of our employees through structured career development...
-
Medical Billing Specialist
5 days ago
Albuquerque, New Mexico, United States Jobot Full timeJob Summary:We are seeking a highly skilled and experienced Medical Billing Specialist to join our finance team at Jobot. As a Medical Billing Specialist, you will play a critical role in ensuring the accuracy and efficiency of our medical billing processes.Key Responsibilities:Consulting and Client Management: Collaborate with healthcare providers to...
-
Healthcare Claims Analyst
2 weeks ago
Albuquerque, New Mexico, United States TriCore Reference Laboratories Full timePosition OverviewAs a key member of the financial team, the Medical Claim Specialist is accountable for the effective management of patient account receivables, including non-government and contracted insurance claims, as well as secondary billing processes.Key Responsibilities• Conduct routine follow-ups on outstanding accounts to ensure timely...
-
Experienced Medical Billing Specialist
2 weeks ago
Albuquerque, New Mexico, United States Jobot Full timeDynamic Medical Billing Specialist Required This opportunity with Jobot Consulting is hosted by: Daniel Gonzalez Compensation: $18 - $25 per hour We are looking for a skilled and knowledgeable Medical Billing Specialist to enhance our finance team. This position is crucial to our dedication to delivering exceptional financial services to our clients in the...
-
Claims System Liaison
7 days ago
Albuquerque, New Mexico, United States Presbyterian Healthcare Services Full timeAbout the RoleWe are seeking a highly skilled Claims System Liaison to join our team at Presbyterian Healthcare Services. As a Claims System Liaison, you will play a critical role in providing technical claims analysis, resolving complex claims problems, and serving as a liaison between claims areas and other functional areas within our organization.Key...
-
Medical Billing Specialist
4 weeks ago
Albuquerque, United States Jobot Full timeStrong Medical Biller Needed!This Jobot Consulting Job is hosted by: Daniel GonzalezAre you a fit? Easy Apply now by clicking the "Apply" buttonand sending us your resume.Salary: $18 - $25 per hourA bit about us:We are seeking a dynamic and experienced Consulting Medical Billing Specialist to join our finance team. This role is integral to our commitment to...
-
Medical Billing Specialist
2 months ago
Albuquerque, United States Jobot Full timeStrong Medical Biller Needed!This Jobot Consulting Job is hosted by: Daniel GonzalezAre you a fit? Easy Apply now by clicking the "Apply Now" button and sending us your resume.Salary: $18 - $25 per hourA bit about us:We are seeking a dynamic and experienced Consulting Medical Billing Specialist to join our finance team. This role is integral to our...