Insurance Claims Specialist

4 weeks ago


Naples, Florida, United States SCA Health Full time
Job Summary:

As an Insurance Claims Specialist at SCA Health, you will play a vital role in ensuring the accuracy and efficiency of patient account resolutions. Your primary responsibility will be to research and process credit balances, refunds, and insurance check refunds requests in a timely manner. You will also be responsible for sending overpayment letters to carriers, reviewing and validating written requests from insurances, and submitting payer disputes as needed. Additionally, you will be required to answer calls and inquiries from third-party carriers regarding overpayments or refunds requests, follow up on outstanding credit accounts, and calculate and verify expected pay based on contractual allowances for multiple payers. You will also be responsible for documenting all work performed in the patient accounting system and reviewing patient account history and notes to determine the next step required for resolution.

Key Responsibilities:

Research and process credit balances, refunds, and insurance check refunds requests
Send overpayment letters to carriers
Review and validate written requests from insurances
Submit payer disputes as needed
Answer calls and inquiries from third-party carriers regarding overpayments or refunds requests
Follow up on outstanding credit accounts
Calculate and verify expected pay based on contractual allowances for multiple payers
Document all work performed in the patient accounting system
Review patient account history and notes to determine the next step required for resolution

Requirements:

Excellent telephone skills and customer service skills
High level of self-organization and tracking
Works independently, is a self-starter with a high level of initiative
Strong communication skills, both verbally and in writing
Possesses accurate judgment, especially handling insurance claims and dealing with patient accounts
Versatile and willing to coordinate with and participate in, when necessary, all other aspects of the Business Office
Ability to handle confidential information
Possess basic knowledge of medical terminology
Possess knowledge of health insurance billing
Read and interpret EOBs and can calculate expected allowances based on payer contracts to determine reason for balance
Possess knowledge of typing, word processing, spreadsheet, and computer billing systems
Must be dependable and reliable
Ability to multi-task, think critically, and solve problems
One or more years of experience in a related position working in a medical office, hospital, outpatient surgery center, or related field with core duties related to medical insurance collections, billing, accounts receivable, A/R, collecting payments, collecting re-imbursements, or related training/certificates/diplomas

What We Offer:

Competitive hourly rate of USD $20.00 to USD $25.00

Why Join Us:

SCA Health is a dynamic group of physician-driven, specialty care businesses that allows us to customize solutions, no matter the need or challenge. We connect patients to physicians in new and differentiated ways, and we have pioneered a physician-led, multi-site model of practice solutions that restores physician agency by aligning incentives to support growth and transition to value-based care. We lead the industry in value-based payment solutions through our Global 1 bundled payment convener, that provides easy predictable billing to patients. We help physicians address everything beyond surgical procedures, including anesthesia and ancillary service lines. The new SCA Health represents who we are today and where we are goingand the growing career opportunities for YOU.

  • Naples, Florida, United States Universal Insurance Holdings Full time

    At Universal Insurance Holdings, we're committed to providing exceptional customer service to our policyholders. As a Field Adjuster, you'll play a critical role in managing, investigating, and resolving assigned property claims. Your primary responsibility will be to provide fair and timely resolutions of claims, ensuring that our customers receive the...


  • Naples, Florida, United States Brooks Insurance Services Full time

    Job Title: Insurance Sales SpecialistJob Description: We are seeking a passionate and self-driven salesperson to join our team at Brooks Insurance Services. As an Insurance Sales Specialist, you will be responsible for connecting with customers and selling auto, home, and boat insurance policies.Responsibilities:* Meet new business production goals and...


  • Naples, Florida, United States State Farm Insurance Full time

    State Farm Insurance **Job Summary** As a valued member of our team, you will play a critical role in providing exceptional customer service to our policyholders. Your primary responsibility will be to assist customers with their insurance needs by providing accurate and timely information, processing policy changes and updates, and handling incoming calls...


  • Naples, Florida, United States Brooks Insurance Services Full time

    Job Title: Senior Customer Service Representative LICENCEDJob Description:Are you looking for a rewarding career in customer service? Brooks Insurance Services is seeking a bilingual customer service representative to join our team.As a customer service representative, you will be responsible for cultivating and maintaining strong relationships with clients,...


  • Naples, Florida, United States Brooks Insurance Services Full time

    Job Title: Insurance Customer Service SpecialistAbout the Role:We are seeking an experienced Insurance Customer Service Specialist to join our team at Brooks Insurance Services. As a key member of our customer service team, you will be responsible for providing exceptional service to our clients, ensuring their needs are met efficiently and...


  • Naples, Florida, United States Jobot Full time

    Job OpportunityLeading Insurance Defense Firm in Florida seeks a driven attorney to assist with growth.This is an exceptional opportunity to bring your expertise in first party claims, general liability defense litigation, insurance, defense, products liability, and premises liability defense to a forward-thinking and innovative team.ResponsibilitiesHandling...


  • Naples, Florida, United States Healthcare Network, Inc. Full time

    About the Role:We are seeking a skilled Medical Billing Specialist to join our team at Healthcare Network, Inc. As a Medical Billing Specialist, you will play a critical role in ensuring the accuracy and efficiency of our medical billing processes.Key Responsibilities:Process and manage medical claims and billing informationVerify and correct billing errors...


  • Naples, Florida, United States Jobot Full time

    Job Title: Attorney - Insurance DefenseAbout the Role:We are seeking a dynamic and ambitious Attorney - Insurance Defense to join our thriving Legal team at Jobot. As a key member of our team, you will be responsible for handling a wide variety of first party claims and litigation matters, including general liability defense, product liability, and premises...


  • Naples, Florida, United States Michael Laskin - State Farm Agent Full time

    Position OverviewWe are seeking a highly motivated and customer-focused Insurance Account Specialist to join our dynamic team. As an Insurance Account Specialist, you will be responsible for establishing and maintaining strong relationships with our clients, providing them with expert advice on insurance options, and developing leads to drive business...


  • Naples, Florida, United States Jobot Full time

    Insurance Defense Litigation Attorney OpportunityWe are seeking a dynamic and ambitious attorney to join our thriving legal team at Jobot. As a leading Insurance Defense Firm in Florida, we are committed to providing exceptional legal services to our clients.This is an exceptional opportunity to bring your expertise in first party claims, general liability...


  • Naples, Florida, United States Jobot Full time

    Job SummaryWe are seeking a highly skilled and experienced Senior Insurance Defense Attorney to join our team. As a key member of our legal team, you will be responsible for handling a wide range of first party claims and litigation matters, including general liability defense, product liability, and premises liability defense.Key ResponsibilitiesConduct...


  • Naples, Florida, United States Michael Laskin - State Farm Agent Full time

    About the RoleWe are seeking a highly motivated and customer-focused Insurance Account Representative to join our team. As an Insurance Account Representative, you will be responsible for establishing and maintaining strong relationships with our customers, providing them with personalized insurance solutions, and helping them achieve their financial...


  • Naples, Florida, United States Baldwin Risk Partners Full time

    The Baldwin Group is a leading insurance brokerage firm delivering expertly crafted risk management and employee benefits solutions to clients across the U.S. and abroad. Our award-winning team has a highly differentiated culture that our clients consider an invaluable expansion of their business.Job Summary:The Client Manager, Employee Benefits services the...

  • To Go Team Member

    4 weeks ago


    Naples, Florida, United States Chili's Grill & Bar Full time

    Role OverviewAt Chili's Grill & Bar, we're looking for talented individuals to join our To Go team as To Go Specialists. As a To Go Specialist, you will be responsible for providing fast and friendly service to our To Go guests. If you're a team player who takes pride in delivering exceptional customer experiences, we want to hear from you.Key...


  • Naples, Florida, United States Massa Dental Center Full time

    Job Summary:We are seeking a highly skilled and organized Business Assistant to join our team at Massa Dental Center. As a Business Assistant, you will be responsible for managing front office duties, including answering phones, checking office mail and email, communicating with patients and insurance companies, and utilizing Dentrix for patient scheduling...


  • Naples, Florida, United States USA Labor Full time

    Mail Processing Specialist - A rewarding career opportunity with USA Labor.As a Mail Processing Specialist, you will play a vital role in ensuring the efficient sorting and handling of mail across the nation. This position offers a competitive hourly rate of $24.63 to $39.27, with an average annual salary of $72,400 and comprehensive benefits, including...


  • Naples, Florida, United States First Source Title Full time

    Job OverviewFirst Source Title Agency is seeking a meticulous and detail-oriented individual to fill the role of Escrow Officer. This position involves verifying and updating essential information, conducting thorough reviews of documents, and ensuring seamless property transactions.As an Escrow Officer, you will play a pivotal role in facilitating...


  • Naples, Florida, United States Monzingo | Legal Full time

    Job OverviewMonzingo | Legal is seeking a seasoned attorney to join our team as a Senior Associate Attorney. The ideal candidate will have 2-5 years of experience in litigating complex insurance claims, analyzing and drafting insurance policy language, and providing insurance coverage opinions.Key Responsibilities:Litigate complex insurance claims in state...


  • Naples, Florida, United States CMR Construction and Roofing Full time

    Job Title: Collections SpecialistJob Summary:CMR Construction & Roofing is seeking a skilled Collections Specialist to join its Residential AR Team. As a Collections Specialist, you will be responsible for collecting money owed to CMR from its customers.Responsibilities:Prepare documents for projects as needed and secure customer signaturesSubmit required...


  • Naples, Florida, United States Saxe Doernberger & Vita P.C Full time

    Senior Associate Attorney OpportunitySaxe Doernberger & Vita P.C, a leading national insurance coverage law firm, is seeking a senior associate attorney with 4+ years of experience in litigating complex insurance claims, analyzing and drafting insurance policy language, and providing insurance coverage opinions.Key Responsibilities:JD from an Accredited Law...