Medical Claims Specialist
5 days ago
We are seeking a skilled Medicaid Billing Specialist to join our team at St. Josephs Medical Center. As a key member of our revenue cycle department, you will play a crucial role in ensuring the accurate and timely submission of Medicaid claims.
Responsibilities:
- Review claims for accuracy and completeness before submission
- Validate and correct claim edits on the UB04 form
- Verify pharmacy quantities on claims and resolve discrepancies
- Ensure accurate billing of procedures by validating claims against coding abstracts
- Split inpatient claims according to carrier guidelines
- Submit claims with relevant remarks and attachments
- Run insurance eligibility checks and resolve claim issues as needed
- Pull supporting documents for audits and resolve Medicaid credit balances
Requirements
To succeed in this role, you should have a minimum of 2 years of experience in Medicaid billing, preferably in an acute care facility. You must possess a working knowledge of CPT and ICD10 codes, as well as Federal, State, and Commercial billing guidelines.
Compensation
The estimated annual salary for this position is approximately $65,000-$80,000, depending on experience. Our hospital offers a competitive benefits package, including medical, dental, and vision coverage, as well as a 401(k) retirement plan.
-
Medical Claims Specialist
5 days ago
Houston, Texas, United States St. Josephs Medical Center Full timeAt St. Joseph Medical Center, we are seeking a skilled Medical Claims Specialist to join our team.Job Summary:We are looking for a detail-oriented individual to review and process medical claims for accuracy and completeness. The successful candidate will have a strong understanding of Medicaid billing guidelines and regulations.Key Responsibilities:Review...
-
Medical Claims Specialist
4 days ago
Houston, Texas, United States ABETTERHOMECARE Full timeAbout the RoleWe are seeking a skilled Medical Claims Specialist to join our team at ABETTERHOMECARE. This is an exciting opportunity for a detail-oriented individual with a passion for medical billing and collections.As a Medical Claims Specialist, you will play a critical role in ensuring accurate and timely claims processing, patient communication, and...
-
Medical Claims Specialist
1 week ago
Houston, Texas, United States IASIS Healthcare Full timeJob Title: Medical Claims SpecialistAbout the Job:At IASIS Healthcare, we're committed to delivering high-quality patient care. We're seeking a detail-oriented and organized Medical Claims Specialist to join our team.Key Responsibilities:Review claims before submission for missing modifiers, charges, and/or implantsValidate and make corrections on the UB04...
-
Medical Claims Specialist
5 days ago
Houston, Texas, United States ABETTERHOMECARE Full timeJob OverviewABETTERHOMECARE seeks a skilled Medical Claims Specialist to join our team. This role is responsible for the day-to-day operations related to billing and collections.Key Responsibilities:Billing Operations: Computes patient fees and charges, prepares and submits electronic claims to third-party payers, and investigates and follows up with...
-
Commercial Claims Analyst
4 days ago
Houston, Texas, United States Sedgwick Claims Management Services Full timeAbout UsSedgwick Claims Management Services is a leading provider of claims management services.Job SummaryWe are seeking a highly skilled Commercial Claims Analyst to join our team. The successful candidate will be responsible for analyzing mid-level commercial General Liability/Bodily Injury claims on behalf of our valued clients, determining benefits due,...
-
General Liability Specialist
4 days ago
Houston, Texas, United States Sedgwick Claims Management Services Full timeAbout the RoleThe General Liability Specialist will be responsible for analyzing mid-level commercial General Liability/Bodily Injury claims to determine benefits due.Responsibilities:Review and analyze complex claim files to determine benefits dueDevelop and implement effective claim resolution strategiesCollaborate with internal stakeholders to ensure...
-
Medical Claims Specialist I-Hybrid Renegotiator
1 month ago
Houston, Texas, United States MET Healthcare Solutions Full timeAbout the RoleWe are seeking a highly skilled Claims Eligibility Specialist I to join our team at MET Healthcare Solutions in Houston, Texas. This is a full-time position requiring your presence in our corporate office 2-3 times per week.Estimated Salary: $62,000 - $72,000 per year, based on experience and qualifications.The ideal candidate will have...
-
Claims Investigation Specialist
7 days ago
Houston, Texas, United States Constitution General Agency Llc Full timeJob Title: Claims Investigation SpecialistSalary: $19.55 - $23.55 per hourThe role of a Claims Investigation Specialist at Constitution General Agency Llc involves receiving and documenting initial reports of loss or damage from policyholders. They gather essential information about the incident, such as date, time, and cause, while ensuring accurate and...
-
Insurance Claims Specialist
7 days ago
Houston, Texas, United States Affordable One Home Services Full timeAbout the JobAffordable One Home Services is currently looking for skilled professionals to fill the role of Insurance Claims Specialist. As a specialist, you will play a crucial part in handling insurance claims related to storm damage, working closely with homeowners to provide exceptional customer service.In this role, you will have the opportunity to...
-
Insurance Claims Specialist
7 days ago
Houston, Texas, United States Angelica Vasquez - State Farm Agent Full timeAt Angelica Vasquez - State Farm Agent, we're seeking a highly skilled Insurance Claims Specialist to join our team. This role involves resolving customer inquiries, processing insurance claims, and maintaining accurate records of customer interactions.Key Responsibilities:Answer customer inquiries and provide policy information.Process insurance claims and...
-
Medical Claims Specialist
4 weeks ago
Houston, Texas, United States St. Josephs Medical Center Full timeCompany Overview:St. Joseph Medical Center is a world-class healthcare provider, dedicated to delivering exceptional care to the community of Houston for over 137 years.We pride ourselves on our tradition of compassion and innovation, ensuring that every patient receives personalized attention and top-notch treatment.About the Role:This exciting opportunity...
-
Medical Claims Reconciliation Expert
2 weeks ago
Houston, Texas, United States Medical AR Management Services, LLC Full timeJob Title: Medical Claims Reconciliation ExpertEstimated Salary: $50,000 - $65,000 per yearAbout Medical AR Management Services, LLCWe are a reputable medical billing and accounts receivable management company serving various healthcare providers. Our mission is to provide reliable and efficient claims resolution services.Job DescriptionThe Medical Claims...
-
Senior Claims Specialist
1 week ago
Houston, Texas, United States Law Firm Full timeJob ResponsibilitiesWe are seeking a highly skilled Senior Claims Specialist to join our team. The successful candidate will have extensive experience in personal injury case screening, intake, and processing of new cases. Key responsibilities include opening cases with adjusters, clearing liability, and assisting clients with property damage. The ideal...
-
Commercial Liability Specialist
4 days ago
Houston, Texas, United States Sedgwick Claims Management Services Full timeWe are seeking a highly skilled Commercial Liability Specialist to join our team at Sedgwick Claims Management Services. In this role, you will analyze mid-level commercial General Liability/Bodily Injury claims, working closely with clients to determine benefits due.About the Role:The successful candidate will have excellent analytical skills, a strong...
-
Claims Auditor Specialist
7 days ago
Houston, Texas, United States AMS Staffing, Inc. Full timeAbout the JobJob Title: Claims Auditor SpecialistLocation: Houston, TexasSalary: Up to 85K/yearWe have partnered with a Personal Injury Firm in the Greenway area in search of a Claims Auditor Specialist. The ideal candidate will have at least 5+ years of experience handling Personal Injury matters from intake to settlement and/or trial.Key...
-
Dental Claims Specialist
1 week ago
Houston, Texas, United States ZEB F POINDEXTER DDS INC Full timeJob DescriptionWe are seeking an experienced Dental Claims Specialist to join our team at ZEB F POINDEXTER DDS INC. This is a part-time position working Monday-Thursday 7:30 am to 5:00 PM, with administrative work on Fridays from 9am-12noon.The ideal candidate must have a minimum of three years experience in dental billing and claims, with expertise in...
-
Litigation Claims Specialist
4 days ago
Houston, Texas, United States Constitution General Agency Llc Full timeJob Summary: We are seeking an experienced Litigation Claims Specialist to join our team at Constitution General Agency Llc. The ideal candidate will have a strong background in managing and resolving complex litigation claims related to auto insurance.About Us: As a leading insurance agency, we provide top-notch services to our policyholders. Our team is...
-
Healthcare Claims Specialist
1 week ago
Houston, Texas, United States Total Care 2 U Full timeJob DescriptionTotal Care 2 U seeks an experienced healthcare claims specialist to join our team. In this role, you will be responsible for submitting billing data to insurance providers, achieving maximum reimbursement, and resolving denial instances.The ideal candidate will have excellent technical skills, including proficiency in medical billing software...
-
Claims Management Specialist
1 week ago
Houston, Texas, United States Brady, Chapman, Holland & Associates, Inc Full timeJob OverviewWe are seeking an experienced Claims Management Specialist to join our team at Brady, Chapman, Holland & Associates, Inc. As a key member of our team, you will be responsible for managing the day-to-day claims process for our clients.The ideal candidate will have a minimum of 5 years of experience in commercial lines account management and...
-
Claims Resolution Expert
7 days ago
Houston, Texas, United States Castle Biosciences Full timeAbout the RoleCastle Biosciences is seeking a Claims Resolution Expert to work remotely as part of their growing team. As a Reimbursement Specialist, you will play a critical role in ensuring that patients receive timely and accurate reimbursement for medical services.Your primary responsibilities will include analyzing insurance claims, communicating with...