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10 Insurance Claim Representative jobs match your search criteria.

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Job Description: Accounts Receivable Representative Accounts Receivable Representative Location: Wall, NJ Salary: $17-$20 per hour Experience: 2.0 year(s) Job Type: Temporary / Consulting Job ID: U1014346       About the Opportunity An established healthcare company located in Wall, NJ is actively seeking a self-motivated and analytical individual for a promising opportunity on their staff as an Accounts Receivable Representative. In this role, the Accounts Receivable Representative will follow-up on all claims from billing through final resolution. Apply today! Company Description Healthcare Company Job Description The Accounts Receivable Representative will: Review and prepare claims for electronic and hard copy billing submission Identify and correct billing errors and resubmit claims to insurance carriers Review Remittance advice for payment errors, denials and under payments Initiate appeals when necessary Act cooperatively and courteously with patients, visitors, co-workers, management, and clients Maintain confidentiality at all times Required Skills At least 2 years of hospital billing experience with knowledge of: Insurance contract interpretations with an ability to identify and dispute insurance underpayments Electronic billing systems Medicaid HMO, Medicare HMO, BC, and commercial payers   Explanation of benefits Payer websites UB04 claim forms Collections / follow-up Microsoft Office Desired Skills Experience with Epremis and Siemens software

Job Description: Accounts Receivable Representative Accounts Receivable Representative Location: Parsippany, NJ Salary:  Experience: 1.0 year(s) Job Type: Temporary / Consulting Job ID: 1005218       About the Opportunity A premier healthcare company headquartered in Parsippany, NJ, is actively seeking a qualified and diligent individual for a promising opportunity on their staff as an Accounts Receivable Representative. In this role, the Accounts Receivable Representative will follow-up on all claims from billing through final resolution. Company Description Healthcare Company Job Description The Accounts Receivable Representative will: Review and prepare claims for electronic and hard copy billing submission Identify and correct billing errors and resubmit claims to insurance carriers Review Remittance advice for payment errors, denials and under payments Initiate appeals when necessary Act cooperatively and courteously with patients, visitors, co-workers, management and clients Maintain confidentiality at all times Maintain a professional attitude Required Skills 1+ year of Accounts Receivable experience in a Healthcare, Physician's Office, and/or Hospital setting High School Diploma / GED Previous experience with Hospital /Facility billing Microsoft Office/Suite proficient Great interpersonal skills Excellent communication skills (verbal and written) Highly organized Able to multitask efficiently and effectively Desired Skills Commercial Insurance Collections experience

Job Description: Oncology Accounts Receivable Representative Oncology Accounts Receivable Representative Location: Princeton, NJ Salary: $15-$17 per hour Experience: 1.0 year(s) Job Type: Temporary / Consulting Job ID: U1006254       About the Opportunity A healthcare practice in New Jersey is looking to fill an immediate need with the addition of a new Oncology Accounts Receivable Representative to their staff. This is a great opportunity for a diligent and highly organized professional to gain valuable work experience and further their career with an established practice. Company Description Healthcare Practice Job Description The Oncology Accounts Receivable Representative will be responsible for handling claims and dealing with the insurance company Required Skills 1+ year of Accounts Receivable experience High School Diploma / GED Computer savvy Microsoft Office/Suite proficient Solid time management and problem solving skills Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized Desired Skills Experience working in a Medical Office or Company doing Accounts Receivable Working knowledge of NextGen

Job Description: Patient Services Representative Patient Services Representative Location: Fairfield County, CT Salary:  Experience: 2. year(s) Job Type: Temporary / Consulting Job ID: U1005693       About the Opportunity A premier magnet healthcare facility in Connecticut is looking for a personable and dedicated Patient Services Representative to join their growing team. In this role, the Patient Services Representative will be responsible for processing and following up on all nongovernment accounts, correspondence and appeals for the facility until paid in full. This is a fantastic opportunity for the right candidate to play an integral part in the expansion of the new facility scheduled to open later this year. Company Description Healthcare Facility Job Description The Patient Services Representative will be responsible for: Handling inquiries from patients, third parties and agencies regarding any aspect of services received or status of account Ensuring prompt, accurate, and compliant billing and payments for all third party payer patient claims Accurate billing and/or follow-up of patient accounts according to established departmental guidelines based upon regulation requirements for specific insurance carriers Monitoring and reconciling daily reports as well as assigned worklist for appropriate account resolution inclusive to credit, debit and adjustments Maintaining provider rep relationships and responsible for upkeep of spreadsheets in order to communicate with third party payers Documentation of all action taken on an account. Maintaining department standards of productivity Accurate analysis of accounts and contracts to recover underpayments/resolve outstanding accounts receivable Analyzing all accounts and contacts appropriate party of unpaid accounts and updates all accounts appropriately Facilitating patients' and departments in the health system by providing excellent customer service skills and serving as an advocate for the patient in explaining third party payer coverage's, referral and pre-certification requirements Providing timely and accurate information regarding patient data / status to other health system departments, physicians, physician office staffs and other publics while insuring patient confidentiality is not breached Required Skills 2+ years of prior experience in a Hospital setting Associate's Degree in a related field Experience in revenue cycle Familiarity with Hospital Billing and Coding Computer savvy Solid analytical and research skills Exceptional phone etiquette Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized Able to multitask efficiently and effectively Desired Skills Bachelor's Degree in a related field

Job Description: Accounts Receivable / Follow Up Representative Accounts Receivable / Follow Up Representative Location: Parsippany, NJ Salary: $17-$20 per hour Experience: 2.0 year(s) Job Type: Temporary / Consulting Job ID: U1014439       About the Opportunity A healthcare company in New Jersey is currently seeking an analytical and detail oriented professional to joint heir growing team as their new Accounts Receivable / Follow Up Representative. In this role, the Accounts Receivable / Follow Up Representative will be responsible for following up on all claims from billing through final resolution. Apply today! Company Description Healthcare Company Job Description The Accounts Receivable / Follow Up Representative will: Review and prepare claims for electronic and hard copy billing submission Identify and correct billing errors and resubmit claims to insurance carriers Review remittance advice for payment errors, denials and under payments Initiate appeals, when necessary Act cooperatively and courteously with patients, visitors, co-workers, management and clients. Required Skills 2+ years of Hospital Billing experience High School Diploma / GED Accounts Receivable experience Previous experience with: Explanation of benefits; Payer websites; UB04 claim forms; Medicaid / Medicare HMOs; and Commercial payers  Working knowledge of Electronic Billing Systems Microsoft Office/Suite proficient Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized Desired Skills Associate's and/or Bachelor's Degree in a related field Experience with Epremis and Siemens software

Job Description: Accounts Receivable Representative / Medical Biller Accounts Receivable Representative / Medical Biller Location: Parsippany, NJ Salary: $18-$20 per hour Experience: 1.0 year(s) Job Type: Temporary / Consulting Job ID: U1012491       About the Opportunity A recognized medical clinic in New Jersey is looking to fill an immediate need with the addition of a new Accounts Receivable Representative / Medical Biller to their growing staff. In this role, the Accounts Receivable Representative / Medical Biller will be responsible for following up on all claims from billing through final resolution. Apply today! Company Description Medical Clinic Job Description The Accounts Receivable Representative / Medical Biller will: Review and prepare claims for electronic and hard copy billing submission Identify and correct billing errors and resubmit claims to insurance carriers Review remittance advice for payment errors, denials and under payments Initiate appeals, when necessary Act cooperatively and courteously with patients, visitors, co-workers, management and clients Required Skills 1+ year of Billing experience High School Diploma / GED Previous experience with Accounts Receivable and Collections Ability to identify and dispute insurance underpayments. Previous experience with: Electronic billing systems; Medicaid HMO, Medicare HMO, BC and commercial payers; and, Payer websites (iNavinet) Microsoft Excel proficient Solid analytical and research skills Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized Desired Skills 2+ years of Hospital Billing experience Associate's and/or Bachelor's Degree in a related field Working knowledge of Epremis and Siemens

Job Description: Complaints and Appeals Associate Complaints and Appeals Associate Location: Wall, NJ Salary:  Experience: 5.0 year(s) Job Type: Temporary / Consulting Job ID: U1011139       About the Opportunity A respected healthcare facility located in Wall, NJ is actively seeking an organized and self-motivated individual for a promising opportunity on their staff as a Complaints and Appeals Associate. In this role, the Complaints and Appeals Associate manages resolution of complaints and/or appeals that have been escalated to executives or regulatory entities within prescribed timeframes as mandated by the regulatory entity and per designated quality standards. Apply today! Company Description Healthcare Facility Job Description The Complaints and Appeals Associate: Assesses cause(s) of complaint/appeal, conducts thorough research of issue(s), and determines required course of action and final disposition Interacts with relevant parties to facilitate timely and accurate complaint/appeal resolution Authorizes administrative exceptions, which may involve claim adjustment Contacts relevant party(ies) to acknowledge receipt of the complaint/appeal and uses probing techniques Reviews business team representative/vendor representative telephone calls with customers to verify accuracy of information related to complaint/appeal Develops customized, timely, accurate, detailed correspondence, for delivery to relevant party(ies), detailing case and final resolution Responds to regulatory entity or members/providers Partners with Legal Department to review and finalize appeal determinations Prepares materials for and may attend case study meetings facilitated by designated internal or external parties Required Skills College degree in Journalism, Communications, or related field, or equivalent in experience 5 years of business experience, which must include 2+ years of correspondence and/or telephone customer service experience screening, investigating and examining inquiries Experience in claims processing necessary Ability to navigate the various claims and service operations systems Knowledge of Microsoft Office Suite Ability to perform basic arithmetical calculations Ability to analyze information and to understand and apply rules and procedures Ability to compose business letters   Desired Skills Healthcare industry experience Knowledge of insurance claim and membership systems Knowledge of medical terminology, COB, Medicare procedures Knowledge of UCSW Knowledge of Claims Policy guidelines

Job Description: Complaints and Appeals Associate Complaints and Appeals Associate Location: Wall, NJ Salary:  Experience: 5. year(s) Job Type: Temporary / Consulting Job ID: U1006774       About the Opportunity A healthcare organization in New Jersey is looking to fill an immediate need with the addition of a new Complaints and Appeals Associate to their growing staff. In this role, the Complaints and Appeals Associate will be responsible for managing the resolution of complaints and/or appeals that have been escalated to the organization's Executives or regulatory entities within prescribed timeframes as mandated by the regulatory entity and per designated quality standards. This is a great opportunity for a detail oriented and diligent professional to gain valuable work experience and further their career with an established organization. Apply today! Company Description Healthcare Organization Job Description The Complaints and Appeals Associate: Assesses cause(s) of complaint/appeal, conducts thorough research of issue(s), determines required course of action and final disposition. Interacts with relevant parties to facilitate timely and accurate complaint/appeal resolution Authorizes administrative exceptions which may involve claim adjustment resulting in payments at higher threshold levels so as to bring closure to the complaint/appeal Contacts relevant party(ies) to acknowledge receipt of the complaint/appeal and uses probing techniques to clarify open issues, obtain additional relevant information and/or secure records necessary to complete investigation and bring issue to final resolution Review business team representative/vendor representative telephone calls with customers to verify accuracy of information related to complaint / appeal Develops customized, timely, accurate, detailed correspondence, for delivery to relevant party(ies), detailing case and final resolution Responds to regulatory entity or members/providers, both verbally and in writing, regarding issue details and final determination made by the organization to close the complaint / appeal Partners with Legal Department to review and finalize appeal determinations Prepares materials for and attends case study meetings facilitated by designated internal or external parties Required Skills 5+ years of Business experience, including 2+ years of Correspondence and/or Telephone Customer Service experience screening, investigating and examining inquiries College Degree in Journalism, Communications, or related field Experience in Claims Processing Microsoft Office/Suite proficient Solid research, investigative, analytical, decision making and problem solving skills Exceptional phone etiquette Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized Desired Skills Healthcare industry experience Knowledge of Insurance Claim and Membership Systems Knowledge of Medical terminology, COB, and Medicare procedures Knowledge of UCSW Knowledge of Claims Policy guidelines

Job Description: Legal Nurse (RN) Legal Nurse (RN) Location: Hamilton, NJ Salary: $25-$27 per hour Experience: 5.0 year(s) Job Type: Temporary / Consulting Job ID: U1003953       About the Opportunity A social services organization in New Jersey is currently seeking a licensed Registered Nurse (RN) for a promising Legal Nurse position with their growing staff. In this role, the Legal Nurse (RN) will be responsible for managing all tasks involved with the organization's tort & estate cases. Company Description Social Services Organization Job Description The Legal Nurse (RN) will be responsible for: Phone interaction with Medicaid clients, families & attorney's as cases warrant Daily case related correspondence to appropriate parties Working daily with Attorney's who represent tort and estate cases of Medicaid recipients Analyzing claims related to tort actions Generating appropriate correspondence to Estate Representative and providing claims, as necessary Required Skills 5+ years of related experience Graduation from an approved School for Professional Nursing or Practical Nursing NJ Registered Nurse (RN) license Insurance or Medicaid background Criminal History Background Check clearance Solid documentation and assessment skills Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized Desired Skills BSN

Job Description: Cost Outlier Auditor (RN) Cost Outlier Auditor (RN) Location: New York, NY Salary: $80,000-$85,000 Experience: 2.0 year(s) Job Type: Full-Time Job ID: J133091       About the Opportunity The Review Operations Department of a recognized healthcare company is currently seeking a licensed Registered Nurse (RN) for a promising Cost Outlier Auditor position with their growing staff. Reporting to the Vice President of Review Operations, the Cost Outlier Auditor (RN) will be responsible for handling cost outliers and special projects and insuring their completion. Apply today! Company Description Healthcare Company Job Description The Cost Outlier Auditor (RN) will: Complete all aspects of cost outlier work independently Maintain and update training materials as needed Maintain and update all hospital profiles as needed Assist with the training and orientation of all new staff Communicate with External Liaisons on issues specific to projects and with account representatives specific to program process Perform Quality Assurance of reviewers as assigned Perform various reviews such as Cost Outliers, Day Outliers, Pre and Post payment Utilization review, Quality Reviews and review of outpatient claims Assist the Operations department with data abstraction for special studies Required Skills 2+ years of Utilization Review and Managed Care experience; 2+ years of experience in a Hospital setting BSN NYS Registered Nurse (RN) Experience reviewing charts Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized Able to multitask efficiently and effectively

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