Medical Claims Processor
4 weeks ago
The Medical Copay Claims Processor plays a critical role in ensuring the smooth and accurate processing of medical copay claims. This position involves meticulous attention to detail, proficiency in handling medical billing software, and excellent communication skills to interact with internal teams, external stakeholders, doctor's and provider's offices, and patients.
Key Responsibilities- Review and validate medical copay claims for completeness and accuracy.
- Ensure all required documentation is included and meets client and regulatory standards.
- Accurately input claim data into the billing system or electronic health records platform.
- Navigate and utilize various software applications to process claims efficiently.
- Apply knowledge of medical coding to ensure accurate benefit is provided.
- Investigate and resolve discrepancies or issues related to claims, including coding errors, eligibility concerns, rejections, and business rules disputes.
- Consult with healthcare providers, pharmacies, HUB partners, and patients to obtain necessary information or resolve claim-related inquiries.
- Collaborate with internal operational and client-facing teams to address claim-related issues.
- Identify opportunities for process improvement and contribute to the development of best practices.
- Receive inbound support calls and conduct routine outbound calls to providers' offices and patients for various reasons.
- Outstanding customer service skills.
- Excellent written and oral communication skills.
- Computer literacy and keyboard typing skills.
- Proficiency in Microsoft Office Suites.
- Ability to work independently and as part of a team in a fast-paced environment.
- Problem-solving skills and the ability to handle challenging situations with professionalism and empathy.
- Bilingual preferred - English/Spanish.
- High school diploma or equivalent.
- Must be 18 years of age.
- Minimum of 1 year of customer service experience.
- Experience in medical billing and electronic health record systems preferred.
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Medical Claims Processor
4 weeks ago
Henderson, Nevada, United States Paysign Inc Full timeJob SummaryPaysign Inc is seeking a highly skilled Medical Claims Processor to join our team. As a Medical Claims Processor, you will play a critical role in ensuring the accurate and timely processing of medical copay claims.Key Responsibilities:Review and validate medical copay claims for completeness and accuracy.Ensure all required documentation is...
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Medical Claims Processor
3 weeks ago
Henderson, Nevada, United States Paysign Inc Full timeJob DescriptionThe Medical Copay Claims Processor plays a critical role in ensuring the smooth and accurate processing of medical copay claims. This position involves meticulous attention to detail, proficiency in handling medical billing software, and excellent communication skills to interact with internal teams, external stakeholders, doctor's and...
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Claims Adjuster
4 weeks ago
Henderson, Nevada, United States Kemper Insurance Full timeJob SummaryKemper Insurance is seeking a skilled Claims Adjuster to join our team. As a Claims Adjuster, you will be responsible for investigating and resolving complex bodily injury claims.Key Responsibilities:Conduct thorough investigations of bodily injury claimsDraft coverage letters and communicate with claimants and attorneysEvaluate and resolve...
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Medical Claims Specialist
4 weeks ago
Henderson, Nevada, United States Oasis Counseling LLC Full timeJob DescriptionWe are seeking a skilled Medical Claims Specialist to join our team at Oasis Counseling LLC. As a Medical Claims Specialist, you will be responsible for processing and managing medical insurance claims for our outpatient mental health clinic. Your primary duties will include:Verifying patient insurance coverage and benefitsProcessing claims...
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Warranty Claims Specialist
4 weeks ago
Henderson, Nevada, United States Findlay Toyota Henderson Full timeFindlay Toyota Henderson is seeking an experienced Warranty Administrator to join our high-volume service department. As a key member of our team, you will be responsible for ensuring seamless warranty claims processing and maintaining accurate records.Key Responsibilities:Properly code warranty repair orders with all possible labor operations.Verify all...
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Clinical Claims Review Nurse
3 weeks ago
Henderson, Nevada, United States UnitedHealth Group Full timeJob SummaryUnitedHealth Group is seeking a skilled Clinical Claims Reviewer RN to join our team. As a Clinical Claims Reviewer RN, you will play a critical role in ensuring the accuracy and quality of medical claims reviews. Key Responsibilities Conduct retrospective reviews of medical claims to evaluate medical necessity and determine appropriate levels of...
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Express Claims Adjuster
4 weeks ago
Henderson, Nevada, United States Kemper Insurance Full timeJob DescriptionKemper Insurance is seeking a skilled Express Claims Adjuster to investigate and resolve first and third-party auto physical damage claims in a fast-paced in-office setting.This entry-level position involves working under direct supervision to confirm and review coverage, and requires a high school diploma or G.E.D. and a valid insurance...
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Experienced Claim Resolution Specialist
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Henderson, Nevada, United States Fidelity National Financial Full timeJob SummaryFidelity National Home Warranty is seeking an Experienced Claim Resolution Specialist to join our team. As a key member of our authorizations team, you will handle advanced inbound customer inquiries, intake vendor diagnosis reports, and resolve complex home warranty claims in a courteous, professional, timely, and appropriate manner.Key...
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Insurance Claim Investigator
4 weeks ago
Henderson, Nevada, United States Allied Universal® Compliance and Investigations Full timeJob DescriptionAdvance Your Career in Insurance Claims with Allied Universal Compliance and Investigation Services.We are seeking a Surveillance Investigator to join our team. As a Surveillance Investigator, you will perform discreet mobile and stationary surveillance of Claimants to confirm current activities and capabilities to assist with the...
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Claims Adjuster
4 weeks ago
Henderson, Nevada, United States Kemper Full timeKemper is a leading specialized insurer seeking an experienced Claims Adjuster to join our team. As a Claims Adjuster, you will be responsible for handling complex and severe first-party and bodily injury claims with high exposures in a multi-state area.The ideal candidate will have a minimum of 5+ years of experience handling complex claims and possess...
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Pediatric Office Biller
3 weeks ago
Henderson, Nevada, United States SUSAN R FERNANDEZ PC Full timeJob SummaryWe are seeking a highly skilled and detail-oriented Pediatric Office Biller to join our team at SUSAN R FERNANDEZ PC. As a key member of our back office team, you will be responsible for ensuring timely payment for medical services, managing accounts receivable reports, and accurately filing claims with insurance carriers and third-party...
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Personal Injury Case Manager
3 weeks ago
Henderson, Nevada, United States Hale Injury Law Full timeJob Title: Personal Injury Case ManagerJob Summary: We are seeking an experienced Pre-Litigation Case Manager to join our team at Hale Injury Law. The ideal candidate will have 5+ years of experience in Personal Injury case management and possess excellent communication skills.Key Responsibilities:Provide essential administrative support to attorneysManage...
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Pharmacy Department Team Member
3 weeks ago
Henderson, Nevada, United States Walgreens Full timeJob Description:In accordance with state and federal regulations, this role assists the pharmacist in the practice of pharmacy, under direct supervision. The Senior Pharmacy Technician is responsible for operating pharmacy systems to obtain patient and drug information and process prescriptions.Key Responsibilities:Assists the pharmacist in the performance...
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Pharmacy Technician Senior
4 weeks ago
Henderson, Nevada, United States Walgreens Full timeJob Description:In accordance with state and federal regulations, this role assists the pharmacist in the practice of pharmacy, under direct supervision. The Senior Pharmacy Technician is responsible for operating pharmacy systems to obtain patient and drug information and process prescriptions. They assist with and coach pharmacy technicians in the...
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Personal Injury Case Manager
4 weeks ago
Henderson, Nevada, United States MNCP Staffing Full timeJob OverviewWe are seeking an experienced Personal Injury Case Manager to join our team at MNCP Staffing. The ideal candidate will have extensive knowledge and experience managing personal injury and car accident cases, providing exceptional client service, and supporting attorneys throughout the case lifecycle.Key ResponsibilitiesCase Management: Oversee...
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Occupational Health Nurse
4 weeks ago
Henderson, Nevada, United States Environmental and Safety Solutions, Inc. Full timeJob Title: Occupational Health NurseAbout the Role:We are seeking a highly skilled Occupational Health Nurse to join our team at Environmental and Safety Solutions, Inc. As an Occupational Health Nurse, you will be responsible for providing medical and first-aid treatment programs on projects or facilities. You will perform nursing duties in accordance with...
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Pharmacy Graduate Intern
4 weeks ago
Henderson, Nevada, United States Walgreens Full timeJob Description:Job Summary:As a Pharmacy Graduate Intern at Walgreens, you will engage in post-graduate pharmacy activities under the direct supervision of a licensed pharmacist to fulfill State Board of Pharmacy requirements. You will provide pharmacy consulting services to customers, offering guidance on medication usage, awareness of drug interactions,...
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Collector - Loan Recovery Specialist
4 weeks ago
Henderson, Nevada, United States Credit Union 1 Full timeJob SummaryCredit Union 1 is seeking a highly motivated and detail-oriented Collector to join our team. As a Collector, you will be responsible for recovering delinquent loans and credit card accounts, minimizing Credit Union 1 losses and delinquency.Key Responsibilities:Recover accounts that are 11 to approximately 180 days delinquent, utilizing a...
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Category Manager
4 weeks ago
Henderson, Nevada, United States Xcel Energy Full timeJob SummaryXcel Energy is seeking a skilled Category Manager to develop and execute sourcing category, supplier, and risk management strategies that align with business stakeholder priorities for key categories.The successful candidate will lead cross-functional teams from the business and Supply Chain to drive successful project and category...
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Insurance Professional
4 weeks ago
Henderson, Nevada, United States Field & Main Bank Full timeJob SummaryField & Main Bank is seeking a highly skilled Insurance Professional to join our team. As a Senior Account Manager, you will be responsible for selling life, property, casualty, health, automotive, or other types of insurance to businesses and individuals. This is a full-time exempt position that requires a minimum of 10 years' experience in an...