Senior Claims Research Specialist

2 weeks ago

Pensacola, Florida, United States West Florida Medical Center Clinic PA Full time
Job Overview

POSITION SUMMARY

Under the supervision of the Claims Research Supervisor, the Senior Claims Research Specialist is tasked with executing responsibilities related to insurance follow-up and the management of accounts receivable.

KEY RESPONSIBILITIES

  • Demonstrate proficiency in handling all insurance carriers, including specialized accounts (e.g., Workers' Compensation, Motor Vehicle Accidents).
  • Manage weekly task lists effectively:
  1. Daily worklist tailored to specific carriers
  2. Address accounts with no recent activity
  3. Respond to managerial inquiries (Target: within 48 hours)
  • Efficiently process client-specific claims as per agreements with West Florida Medical Center Clinic PA.
  • Handle insurance inquiries and requests.
  • Manage correspondence related to claims.
  • Process rebilled HCFA claim forms.
  • Provide courteous and professional responses to inquiries from clients and billing personnel regarding insurance or account activity.
  • Communicate emerging trends in claims processing to the Claims Research Supervisor.
  • Execute error corrections as necessary.
  • Document claims accurately in accordance with established policies and procedures.
  • Update patient accounts with accurate insurance details.
  • Refile coding denials with relevant documentation received from management.
  • Complete designated projects within specified timelines as directed by the Claims Research Supervisor.
  • Perform daily tasks with minimal oversight from the Claims Research Supervisor.
  • Adhere to both written and verbal instructions meticulously.
  • Accept additional responsibilities assigned by management with a positive attitude.

CORPORATE CULTURE EXPECTATIONS

  • Adhere to established corporate and departmental policies and procedures.
  • Participate in all required training sessions.
  • Uphold the core values and vision of the organization.
  • Comply with corporate culture responsibilities.
  • Willingly undertake other assigned duties.

EDUCATION AND EXPERIENCE REQUIREMENTS

  • High school diploma or equivalent is required.
  • At least one year of experience in insurance billing or a related field.
  • Minimum one year of experience with medical billing software or equivalent.

SKILLS AND ABILITIES

  • Ability to prioritize and manage multiple responsibilities effectively.
  • Exhibit strong customer service skills, interpersonal abilities, attention to detail, and excellent verbal and written communication skills.
  • Demonstrate integrity and a willingness to adapt and positively influence the workplace.
  • Collaborate effectively with colleagues at all organizational levels.
  • Proficient in computer applications (e.g., Windows, MS Office) and quick to learn new software.
  • Maintain acceptable typing speed and accuracy, with proficiency in ten-key operations.
  • Fluent in English, both written and spoken.
  • Ability to communicate with individuals from diverse socio-economic backgrounds.
  • Commitment to maintaining confidentiality of sensitive information.
  • Possess strong analytical and critical thinking skills.

PHYSICAL DEMANDS

  • Physical strength: Sedentary work (up to 10 pounds of force occasionally).
  • Occasional standing/walking: Activity may occur up to 1/3 of the time.
  • Frequent keyboarding and dexterity: Activity may occur from 3/4 of the time.
  • Ability to focus on a computer screen for extended periods.
  • Capable of performing repetitive hand and finger motions.
  • Ability to maintain concentration while working in close proximity to others.
  • Effective verbal communication skills are essential.
  • Visual and auditory capabilities are required.

EMOTIONAL DEMANDS

  • Exhibit stable work behaviors consistently.
  • Possess effective coping mechanisms.
  • Maintain professionalism and composure under pressure.
  • Ability to work efficiently under stress.

WORK ENVIRONMENT

  • Office setting.
  • Frequent interruptions may occur during daily tasks.
  • Extended hours may be necessary to fulfill departmental requirements.

  • Insurance Claims Specialist

    2 weeks ago

    Pensacola, Florida, United States Marsh LLC Full time

    Our Unique Approach. At Marsh LLC, we pride ourselves on fostering an award-winning, inclusive workplace culture that is built on the dedication of our exceptional team. With over 11,000 talented professionals, we are committed to delivering impactful work that resonates with our clients. Discover how you can excel as a Claims Consultant within our...

  • Medical Claims Processing Representative I

    7 days ago

    Pensacola, Florida, United States Baptist Health Care Full time

    Job OverviewThe Healthcare Billing Specialist is tasked with a variety of responsibilities within the Accounts Receivable reconciliation framework. This includes, but is not limited to, the following duties: meticulously reviewing, amending, and regularly updating Patient Health Information to guarantee precise insurance billing, payment, and follow-up;...

  • **Healthcare Coding and Billing Specialist**

    1 day ago

    Pensacola, Florida, United States Community Health Northwest Florida Full time

    Job DescriptionThe **Healthcare Coding and Billing Specialist** is responsible for ensuring the accuracy and completeness of medical claims data systems utilized by Community Health Northwest Florida. This includes coordinating with patients, insurance companies, providers, and the CHNWF billing and collections vendor to ensure prompt payment of services...

  • Senior Planning Specialist

    4 days ago

    Pensacola, Florida, United States National Association Of Development Organizations Full time

    Job SummaryThe National Association Of Development Organizations is seeking a highly skilled Transportation Planner III to join our team. As a key member of our planning department, you will be responsible for performing senior-level planning work, developing planning studies and reports, and providing professional planning assistance to our member...

  • Senior UNIX Training Specialist

    2 weeks ago

    Pensacola, Florida, United States ComTech Telecommunication Corporation Full time

    Position Overview:As a Senior UNIX Training Specialist, you will be responsible for conducting advanced training sessions in a military educational setting. Your role will involve delivering in-depth technical instruction through various methods including lectures, hands-on labs, and practical exercises. Key Responsibilities:1. Deliver comprehensive training...

  • Medical Billing Specialist I

    2 weeks ago

    Pensacola, Florida, United States Baptist Health Care Full time

    Job OverviewThe Medical Billing Specialist is tasked with essential duties in the reconciliation of Accounts Receivables. This role encompasses a variety of responsibilities including, but not limited to: reviewing, amending, and consistently updating Patient Health Information to guarantee precise insurance billing, payment, and follow-up; electronically...

  • Healthcare Coding and Managed Care Specialist

    2 weeks ago

    Pensacola, Florida, United States West Florida Medical Center Clinic PA Full time

    Job TypeFull-timePosition OverviewThe Healthcare Coding and Managed Care Specialist is tasked with the critical responsibility of securing preauthorization for various medical services, including inpatient admissions, outpatient procedures, and advanced imaging. This role involves diligent follow-up on insurance claims, particularly those related to coding...

  • Senior Associate Attorney

    12 hours ago

    Pensacola, Florida, United States Kubicki Draper Full time

    About the RoleWe are seeking a highly skilled and motivated Associate Attorney to join our team at Kubicki Draper. As a key member of our team, you will be responsible for providing exceptional legal services to our clients.Key ResponsibilitiesLegal Research and Writing: Conduct thorough legal research and draft high-quality pleadings, motions, and other...

  • Senior Avionics Specialist

    2 weeks ago

    Pensacola, Florida, United States Amentum Full time

    The Senior Avionics Specialist is responsible for conducting comprehensive aircraft maintenance, which encompasses inspection, operational testing, repair, modification, and replacement of aircraft electrical and avionics systems and components. This role requires applying advanced technical knowledge and skills to diagnose intricate electrical and avionics...

  • Senior Direct Sourcing Specialist, Pensacola FL/Hauppauge NY

    1 month ago

    Pensacola, Florida, United States Danaher Full time

    Be part of something altogether life-changingWorking at Cytiva means being at the forefront of providing new solutions to transform human health. Our incredible customers undertake life-saving activities ranging from fundamental biological research to developing innovative vaccines, new medicines, and cell and gene therapies.At Cytiva you will be able to...

  • Healthcare Account Management Specialist

    2 weeks ago

    Pensacola, Florida, United States West Florida Medical Center Clinic PA Full time

    Job OverviewPOSITION SUMMARYThe Practice Account Specialist I plays a crucial role in the efficient management of medical practice billing and accounts receivable. This position is designed for individuals who are skilled in processing medical charges and facilitating financial transactions within a healthcare setting. The specialist collaborates with...

  • Senior Aircraft Maintenance Specialist 135

    2 weeks ago

    Pensacola, Florida, United States Air Methods Full time

    Position Overview:Job Summary****Experience with high-performance pressurized turboprop aircraft is essential, with a preference for PC-12 and a solid background in avionics****This role is accountable for conducting maintenance, repairs, inspections, and modifications on Company-operated aircraft and related components as designated, adhering to Air...

  • Recruitment Specialist

    2 weeks ago

    Pensacola, Florida, United States INSPYR Solutions Full time

    Position: Recruitment Specialist / Entry-Level Recruiter This role involves managing a significant volume of candidate applications, so it is essential to submit your resume and application promptly.Location: Remote (Hybrid Work Available)Contract Length: Initial 6-month term with opportunities for extension Salary Range: $25.00/hour - $38.00/hour...

  • Patient Account Billing Coordinator I

    7 days ago

    Pensacola, Florida, United States Baptist Health Care Full time

    Job OverviewThe Healthcare Billing Specialist is tasked with a variety of responsibilities within the Accounts Receivable reconciliation framework. Key duties include: meticulously reviewing, amending, and regularly updating Patient Health Information to guarantee precise insurance billing and payment follow-up; electronically submitting claims to payers...

  • Patient Care Specialist

    4 days ago

    Pensacola, Florida, United States Ascension Full time

    Join Our Team at Ascension LivingWe are committed to providing exceptional care and services to our seniors, and we are seeking a dedicated and compassionate Patient Care Specialist to join our team.About the RoleAs a Patient Care Specialist, you will play a vital role in ensuring the health and well-being of our residents. Your primary responsibilities will...

  • Senior Litigation Paralegal

    2 days ago

    Pensacola, Florida, United States DeNovo Staffing Full time

    Job DescriptionDeNovo Staffing is seeking a highly skilled and experienced Senior Litigation Paralegal to join our team. As a Senior Litigation Paralegal, you will work closely with our lead attorneys and legal assistants to assist in all phases of the litigation process.Responsibilities:Document Preparation: Prepare legal documents, including pleadings,...

  • Family Medicine Specialist

    1 day ago

    Pensacola, Florida, United States HCA North Florida Division Full time

    About the RoleWe are seeking a highly skilled Family Medicine specialist to join our team at HCA North Florida Division. As a Family Medicine specialist, you will be responsible for providing high-quality patient care and leading our medical team.Key ResponsibilitiesProvide primary care to patients of all ages, from infants to geriatric patientsDiagnose and...

  • Pediatric Nurse Specialist

    1 day ago

    Pensacola, Florida, United States Sacred Heart Hospital Full time

    Pediatric Nurse Specialist Job DescriptionJob Summary:We are seeking a highly skilled Pediatric Nurse Specialist to join our team at Sacred Heart Hospital. As a Pediatric Nurse Specialist, you will be responsible for providing high-quality patient care to children and families in our Pediatric Observation Unit.Key Responsibilities:Provide direct nursing care...

  • Healthcare Relations Specialist

    2 weeks ago

    Pensacola, Florida, United States KureSmart Pain Management Full time

    Position Overview:The Healthcare Relations Specialist plays a crucial role in advocating for KureSmart Pain Management's services to both new and established referral sources within a designated area. This individual will significantly influence the company's branding and public perception while serving as a key contact for essential partnerships. Daily...

  • Healthcare Support Specialist

    2 weeks ago

    Pensacola, Florida, United States West Florida Medical Center Clinic PA Full time

    Job OverviewPOSITION SUMMARYA Healthcare Support Specialist is responsible for executing administrative and select clinical tasks under the guidance of a licensed physician. The administrative responsibilities may encompass organizing appointments, managing patient records, and processing information for insurance claims. Clinical responsibilities may...