Current jobs related to Medical Claims Specialist - Cincinnati, Ohio - S&S Healthcare
-
Medical Claims Specialist
4 weeks ago
Cincinnati, Ohio, United States Insight Global Healthcare Full timeJob OpportunityInsight Global Healthcare is seeking a skilled Medical Claims Specialist to join their team in the Blue Ash area of Cincinnati. This role will involve working with a Business Office team that specializes in hospice-related claims for a large health system.Key Responsibilities:Medicare billing and follow-upRouting self-pay and residential...
-
Medical Claims Specialist
4 weeks ago
Cincinnati, Ohio, United States Vaco Full timeJob SummaryVaco is seeking a skilled Insurance Follow-up Specialist to join our team. As a key member of our team, you will be responsible for reviewing patient bills for accuracy and completeness, preparing and transmitting claims, and following up on unpaid claims within standard billing cycle timeframes.Key ResponsibilitiesReview patient bills for...
-
Medical Claims Examiner
1 week ago
Cincinnati, Ohio, United States Vaco Full timeJob SummaryVaco is seeking a Medical Billing Specialist to join our team. As a Medical Billing Specialist, you will be responsible for reviewing patient bills for accuracy and completeness, preparing and transmitting claims, and following up on unpaid claims.Key ResponsibilitiesReview patient bills for accuracy and completenessPrepare and transmit claims...
-
Medical Claims Specialist
2 weeks ago
Cincinnati, Ohio, United States Vaco Full time{"title": "Insurance Follow-up Specialist", "description": "Job Summary: Vaco is seeking an Insurance Follow-up Specialist to join our team. As a key member of our team, you will be responsible for reviewing patient bills for accuracy and completeness, obtaining missing information, and preparing, reviewing, and transmitting claims using billing software....
-
Claims Resolution Specialist
2 weeks ago
Cincinnati, Ohio, United States Tri State Urologic Services Full timeJob Title: Claims Resolution SpecialistTri State Urologic Services is seeking a highly skilled Claims Resolution Specialist to join our team. As a Claims Resolution Specialist, you will be responsible for following up and resolving claims submitted to third-party insurance payers.Key Responsibilities:Conduct follow-up on no-response third-party receivables...
-
Medical Claims Specialist
1 week ago
Cincinnati, Ohio, United States TriHealth Full timeJob DescriptionThe Medical Biller II plays a crucial role in ensuring the timely and accurate submission of medical claims. This position requires strong analytical and communication skills, as well as the ability to work effectively in a team environment.Key Responsibilities:Assist the lead medical biller and fellow billing staff in submitting accurate and...
-
Insurance Claims Specialist
4 weeks ago
Cincinnati, Ohio, United States Insight Global Full timeJob OpportunityWe are seeking a skilled Insurance Claims Specialist to join our team at Insight Global in Cincinnati, OH. As a key member of our client's team, you will be responsible for managing a queue of claims, ensuring accuracy and compliance with company policies and regulatory requirements.This role involves detailed documentation, customer...
-
Annuity Claims Specialist
2 weeks ago
Cincinnati, Ohio, United States Ohio National Financial Services Full timeJob Title: Annuity Claims Processor Job Summary: We are seeking a highly skilled Annuity Claims Processor to join our team at Ohio National Financial Services. As an Annuity Claims Processor, you will play a critical role in managing and processing death claim transactions on annuity contracts. Your attention to detail and care will ensure that each claim...
-
Annuity Claims Specialist
2 weeks ago
Cincinnati, Ohio, United States Ohio National Financial Services Full timeJob SummaryThe Annuity Claims Processor will play a vital role in helping families navigate the death claim process for annuity contracts. This position requires attention to detail, strong communication skills, and the ability to work efficiently to ensure each claim is handled with compassion.Key ResponsibilitiesInitial claim notification...
-
Commercial Property Claims Specialist
2 weeks ago
Cincinnati, Ohio, United States Great American Insurance Group Full timeWe are seeking a skilled Commercial Property Claims Specialist to join our team at Great American Insurance Group. As a key member of our Property Inland Marine Division, you will be responsible for investigating and maintaining claims, reviewing coverage and liability, and working towards the resolution of claims files.The ideal candidate will have...
-
Medical Claims Examiner
2 weeks ago
Cincinnati, Ohio, United States Western & Southern Life Full time{"title": "Medical Claims Examiner", "content": "Job SummaryWestern & Southern Life is seeking a skilled Medical Claims Examiner to join our team. As a Medical Claims Examiner, you will be responsible for processing medical and flexible spending account claims in accordance with the provisions of multiple welfare plans administered by the Benefits...
-
Medical Claims Examiner
2 weeks ago
Cincinnati, Ohio, United States Western & Southern Financial Group Full timeWelcome to Western & Southern Financial Group, where we strive to create value for our customers through meaningful and challenging work. Our focus on integrity, top-notch performance, collaboration, and teamwork drives our company forward.With 135 years of operating history, we've built a reputation as a best company for career growth, ranked No. 29 among...
-
Cincinnati, Ohio, United States Tri State Urologic Services Full timeJob DescriptionWe are seeking a Claims Resolution Specialist to join our team at Tri State Urologic Services. The position is part time, Monday-Friday in our Norwood billing office.The Claims Resolution Specialist will focus on following up and resolving claims submitted to third-party insurance payers. This includes claims that have yet to be adjudicated...
-
Medical Claims Examiner
1 week ago
Cincinnati, Ohio, United States Western & Southern Life Full timeJob SummaryWestern & Southern Life is seeking a skilled Medical Claims Examiner to join our team. As a key member of our Benefits Department, you will be responsible for processing medical and flexible spending account claims in accordance with the provisions of multiple welfare plans. Key ResponsibilitiesProcess medical and flexible spending account claims...
-
Claims Specialist
2 weeks ago
Cincinnati, Ohio, United States Great American Insurance Group Full timeAbout the RoleAt Great American Insurance Group, we're committed to fostering a culture of excellence and innovation. As a Claims Representative/Senior Claims Representative, you'll play a vital role in helping us achieve our mission.Key ResponsibilitiesInvestigate and manage claims with precision and attention to detail.Review and evaluate coverage and...
-
Benefits Claims Specialist
2 weeks ago
Cincinnati, Ohio, United States Western & Southern Life Full timeAbout Western & Southern LifeWelcome to Western & Southern Life, a company that has been creating value for our customers through everything we do for over 135 years. Our focus on building a strong culture that supports our associates is foundational to who we are.We provide meaningful and challenging work for our professionals, which is a key facet of our...
-
Claims Specialist
2 days ago
Cincinnati, Ohio, United States Great American Insurance Group (DBA) Full timeAbout the RoleAt Great American Insurance Group (DBA), we are seeking a talented individual to support our Trucking Division as a Claims Intern. This role will provide opportunities to learn about the claims process, work with a dynamic team, and gain valuable experience in the insurance industry.ResponsibilitiesParticipate in special projects within the...
-
Medical Billing Specialist
3 weeks ago
Cincinnati, Ohio, United States Insight Global Full timeMedical Billing Account SpecialistInsight Global is seeking a skilled Medical Billing Account Specialist to join our Business Office team in the Blue Ash area. This role involves billing, follow-up, routing self-pay and residential contracts, and accounts payable for a large health system. The ideal candidate will have experience with Epic certification,...
-
Medical Billing Specialist
1 week ago
Cincinnati, Ohio, United States TriHealth Full timeJob Overview:The Medical Billing Specialist will assist the lead medical biller and fellow billing staff in submitting accurate and clean claims, ensuring timely follow-up. Collaboration with other teams will be necessary to ensure denied claims are appealed as needed. The Medical Billing Specialist should be cross-trained to work with different payers to...
-
Freight Claims Specialist
2 weeks ago
Cincinnati, Ohio, United States Reliable Transportation Solutions Full timeJob Title: Freight Claims LeadJob Summary:Reliable Transportation Solutions is seeking a highly skilled Freight Claims Lead to join our team. As a key member of our claims department, you will be responsible for leading our freight claims process from start to finish, ensuring timely and effective resolution of cargo claims.Key Responsibilities:Receive,...
Medical Claims Specialist
2 months ago
S&S Health is a leading organization in healthcare administration, dedicated to providing innovative solutions that enhance efficiency and improve patient outcomes. Our comprehensive platform integrates benefits, services, and technology tailored to meet the diverse needs of Employers, Third-Party Administrators (TPAs), and Health Systems across the nation.
The Medical Claims Specialist plays a crucial role in ensuring the precise and timely evaluation of medical claims and associated documentation. This position requires exceptional attention to detail, accuracy, and a thorough approach to claim adjudication. The Medical Claims Specialist will operate both independently and collaboratively to resolve claims and address inquiries from providers or clients in a professional manner.
Primary Responsibilities:
- Efficiently process claims and related documentation with accuracy.
- Develop and maintain a thorough understanding of various plan designs and apply this knowledge effectively.
- Handle claims across multiple lines of business, including complex cases.
- Verify claims for necessary prior authorization or pre-certification of services.
- Assess claims for required information and solicit additional details when necessary.
- Manage adjustments and inquiries from Customer Service promptly.
- Process third-party invoices with efficiency.
- Demonstrate effective multitasking abilities while consistently meeting deadlines.
- Adhere to established quality and production standards.
- Collaborate effectively with team members while also working independently.
- Achieve and maintain performance metrics set by our clients.
Required Qualifications:
- Familiarity with medical terminology, HIPAA regulations, standard claims forms (HCFA and UB), and physician billing codes.
- Ability to interpret contracts and standard reference materials (PDR, CPT, ICD-9, ICD-10, and HCPCS).
- Understanding of Coordination of Benefits (COB).
- Proficiency in Microsoft Word, Excel, and Outlook.
- Strong self-motivation, productivity, attention to detail, and organizational skills.
- Excellent verbal and written communication abilities.
We prioritize creating a safe and secure work environment for all employees. Please be aware that all final candidates will undergo a comprehensive background check and drug screening as part of our hiring process.
