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Liberty Mutual Insurance
Plano, TX, United States
Schedule: Full-Time Salary Range: USD $59400.00 - $110400.00 Job Category: Claims Pay Philosophy The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees
Job Source: Liberty Mutual InsuranceAnderson Merchandisers
Plano, TX, United States
WE ARE LOOKING FOR GREAT PEOPLE TO JOIN OUR TEAM- just like you! Our associates have a lot in common. They have great interpersonal skills, enjoy working independently, are self-motivated, and have a relentless drive. Did we mention that while they are working hard, they also like to have fun? We offer flexible hours, competitive pay, and great b
Job Source: Anderson MerchandisersAllen Lund Company, LLC
Plano
Job Description Job Description Our Story With $1,000 in his pocket, Allen Lund made the brave decision to start his own transportation brokerage company. It was 1976, when Allen Lund Company formally opened the first office in Los Angeles. Now, we have 41 offices and continue to grow! We are always looking for exceptional people to join our fa
Job Source: Allen Lund Company, LLCCorVel Enterprise Comp, Inc.
Dallas
Job Description Job Description CorVel in Dallas, TX is seeking a Claims Specialist for their Indemnity department. We are looking for experience handling Workers Compensation Indemnity claims in Texas, Oklahoma and Arkansas and a willingness to learn or have experience in additional states including Louisiana, Mississippi and Alabama. The Claims
Job Source: CorVel Enterprise Comp, Inc.Zelis
Plano, TX, United States
Position Overview: The Claims Settlement Specialist supports claim settlement with providers through post payment negotiation. The Claims Settlement Specialist will be responsible for handling provider telephone calls regarding the payment amount paid to a provider by a payor based on Zelis data points. During this call, the Claims Settlement Spec
Job Source: ZelisAllen Lund Company, LLC
Plano
Job Description Job Description Our Story With $1,000 in his pocket, Allen Lund made the brave decision to start his own transportation brokerage company. It was 1976, when Allen Lund Company formally opened the first office in Los Angeles. Now, we have 41 offices and continue to grow! We are always looking for exceptional people to join our fa
Job Source: Allen Lund Company, LLCZurich NA
Dallas
Claims Specialist I, General Liability 112465 At Zurich North America Claims we acknowledge that work life-balance and flexibility are a priority when it comes to choosing your next career move. Designed with our employees' needs in mind, the ZNA Claims hybrid work model emphasizes flexibility, allowing claims employees to conduct individual work i
Job Source: Zurich NALonestar
Richardson
Job Description Job Description If you are an experienced Non-Standard Auto CLAIMS PROFFESSIONAL (with many years of auto and especially nonstandard auto related experience) we'll make sure you are COMPENSATED AS A PROFFESSIONAL!! We are seeking an experienced Auto Liability Claims Specialist to join our growing team in Richardson! We pay
Job Source: LonestarPlano
Job Description Job Description Salary:
Job Summary:
Reimbursement Advocate will work with Medicare, Medicaid, Commercial Insurance companies and customers to ensure medical claims are submitted timely, processed, and paid accurately. This includes working payor rejections and denials, obtaining qualifying documentation and authorizations, providing high level customer support, RUL’s, updating patient file within all billing systems as required, and following all applicable compliance and regulatory processes, payor guidelines, policies and procedures.
*This is a 6-month contract, hybrid position. * (3 days/week onsite in Plano, TX)
Responsibilities (Specific tasks, duties, essential functions of the job)
Collect payments for outstanding open accounts receivable balances.
Works with Medicare, Medicaid, Commercial Insurance, and Private Pay to ensure medical claims are being processed timely and paid accurately.
Must meet/exceed daily/weekly production & quality KPI standards.
Ensures all billing systems are updated timely with patient demographics, payer information, and notated appropriately.
Analyzes payer claim rejections & denials to help determine root cause and prevention of future rejections & denials from reoccurring.
Gathers, prepares, and submits required information and/or documentation to appeal claim denials.
Uses appropriate write off reason code(s) for writing off balances that are deemed uncollectable.
Responsible for assisting our patients, doctors, customers, and coworkers with billing inquiries at the highest-level support possible. This includes logging into phone queue and updating statuses appropriately.
Ensures the billing of all claims via electronic or paper to Medicare, Medicaid, and Commercial Insurance payers are being submitted accurately and timely in accordance with policy.
Ensures RUL (Reasonable Usable Lifetime) patients exiting the monthly cap period are in a billable status.
Responsible for working NME’s (New Medicare Eligibility), Payor Changes, Pending Pick-ups, and Stop patients timely. Verifies and evaluates insurance benefits to determine the policy's compatibility with services.
Ensures the timely procurement of all required documentation and obtain authorizations in order to prevent future denials.
Ensures that appropriate medical records are maintained according to HIPPA guidelines.
Ensures compliance with all state and federal regulations.
Assists junior team members with general work-related issues and/or questions about departmental processes.
Assist with monitoring team production & quality is meeting/exceeding KPI.
Able to Identify process improvement opportunities and recommend potential solutions to improve departmental workflow.
Responsible for reporting & analysis of daily/weekly/monthly reporting of department.
Supports the B2B (Business to Business) rental program, to include billing, tracking units deployed & returned, and collecting past due payments.
Maintain regular and punctual attendance.
Comply with all company policies and procedures.
Assist with any other duties as assigned.
Knowledge, Skills, and Abilities
A comprehensive understanding of Medicare, Medicaid, and/or Commercial Insurance program rules as it pertains to DME billing.
Ability to take direction and communicate effectively with customers and employees at all level of organization.
Ability to thrive in a fast-paced and dynamically changing organization.
Must have strong work ethic.
Excellent oral and written communication skills required.
Attention to detail is required.
Effective conflict resolution.
Ability to maintain confidentiality and exercise extreme discretion.
Solutions-oriented problem solver.
Excellent planning, communication and organizational skills.
Qualifications (Experience and Education)
Operates at a task + project level for select projects which are specifically assigned
Some supervision required.
High School diploma or equivalent, required.
Some College and/or medical billing certificate, preferred
2 years of Medicare, Medicaid and/or Commercial Insurance experience, required.
2 years’ experience in oxygen or HME billing, preferred.
Intermediate knowledge/proficiency in Microsoft Office, Oracle, Brightree, Salesforce and New Voice Media, highly preferred.
A combination of training, education and experience that is equivalent to the qualifications listed above and that provides the required knowledge, skills, and abilities.
Email Alert for Medical Claims Specialist jobs in Plano
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