Top 396 Claims processing Jobs in Bedford, Tx

Claims Examiner Senior - Health Plan Admin
Christus Health —Irving, TX
- 8 hour shift
- Microsoft Outlook
- HIPAA
- Research
Pharmacy Claims Representative (remote)
Dragonfly Health —Arlington, TX
- From $22 an hour
- 12 hour shift
- Remote
- HIPAA
- Mid-level
- High school diploma or GED
- Health insurance
- Dental insurance
Quick Apply
Claims & Risk Analyst
HelloFresh —Irving, TX
- $68,040 - $81,000 a year
- Mid-level
- High school diploma or GED
- Bachelor's degree
- Health insurance
- Paid time off
Quick Apply
Home Care Billing Specialist
Rehab at Home Healthcare Services —Arlington, TX
- $22 an hour
- 8 hour shift
- Mid-level
- Office
- High school diploma or GED
- Disability insurance
- Health insurance
Quick Apply
Claims Research Specialist - State National
Markel Service Inc. —Bedford, TX
- Email
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- Research
- AD&D insurance
- Employee stock purchase plan
Quick Apply
6d
Appeals Representative II
CorVel Corporation —Fort Worth, TX
- $20.08 - $30.06 an hour
- Full-time
- Remote
- HIPAA
- Mid-level
- High school diploma or GED
- Health savings account
- Disability insurance
Quick Apply
Claims Technician - State National
Markel Service Inc. —Bedford, TX
- Email
- Hybrid work
- Research
- Office
- Administrative experience
- AD&D insurance
- Employee stock purchase plan
Quick Apply
12d
Payer Compliance Specialist I - Remote
US Anesthesia Partners, Inc. —Dallas, TX
- $16.49 - $26.39 an hour
- Full-time
- Microsoft Word
- Writing skills
- Basic math
Claims Specialist II
Komodo Claims US —Dallas, TX
- $65,000 - $68,000 a year
- Full-time
- Hybrid work
- Customer service
- Mid-level
- Office
- Commuter assistance
- Paid parental leave
Quick Apply
5d
Government Revenue Cycle Accounts Receivable
TridentCare —Carrollton, TX
- $0.01 - $999.00 an hour
- Remote
- Computer literacy
- Writing skills
- English
Processor I, Gap Claims
CareGard Warranty Services, Inc. —Grapevine, TX
- $16 - $23 an hour
- Full-time
- Spanish
- Writing skills
- Basic math
- Paid holidays
- Disability insurance
Quick Apply
Damage Review Specialist-REMOTE
Dimont & Associates, LLC —Dallas, TX
- $18 an hour
- Full-time
- Remote
- Organizational skills
- 1 year
- Entry level
Quick Apply
5d
Billing Specialist
TMI Sports Medicine and Orthopedic Surgery, P.A. —Arlington, TX
- $19 - $22 an hour
- Full-time
- Computer literacy
- Mid-level
- High school diploma or GED
Quick Apply
Provider Research & Resolution Specialist - Remote
NTT DATA —Dallas, TX
- $16.75 an hour
- Remote
- Microsoft Excel
- Microsoft Outlook
- HIPAA
- Health savings account
- AD&D insurance
Quick Apply
Claims In-take Specialist
OMS MEDICAL BILLING LLC —Addison, TX
- $20 - $25 an hour
- Full-time
- Mid-level
- Office
- High school diploma or GED
- Dental insurance
- 401(k)
Quick Apply
Revenue Cycle Specialist I
CorVel Corporation —Fort Worth, TX
- $19.21 - $28.73 an hour
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- Mid-level
- Health savings account
- Disability insurance
Quick Apply
Medical Collections Specialist
SCP Health —Dallas, TX
- $18 - $26 an hour
- Full-time
- Customer service
- Word processing
- Mid-level
- Paid holidays
- Health insurance
Assistant Operations Manager
Ethos Risk Services —Irving, TX
- $41,600 - $52,000 a year
- Full-time
- Remote
- Mid-level
- Administrative experience
- High school diploma or GED
- Disability insurance
- Health insurance
Quick Apply
Medical Billing Specialist
Physical Medicine Consultants —Dallas, TX
- $20 - $25 an hour
- Part-time
- Mid-level
- In-person
- Communication skills
- Health insurance
- Paid time off
Quick Apply
Medical Billing/AR Specialist
Ophthalmology Associates —Fort Worth, TX
- Microsoft Outlook
- Mid-level
- High school diploma or GED
- 401(k) matching
Quick Apply

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claims processing jobs near bedford, tx

Claims Examiner Senior - Health Plan Admin

Christus Health -
Irving, TX

Apply Now

Job Details

Full-time

Qualifications

Customer communication
Microsoft Outlook
Spreadsheets
ICD-10
HCPCS
Centers for Medicare & Medicaid Services (CMS) billing regulations
Medical terminology
Database software proficiency

Full Job Description

Description

Summary:

The Claims Examiner Senior is responsible for reviewing, analyzing, researching, and resolving complex medical claims in accordance with claims processing guidelines and desktops, as well as, ensuring compliance with federal regulations. This role works in conjunction with Business Configuration, Network Management, Provider Data, Complaints, Appeals and Grievances as well as other operational departments to ensure validation and quality assurance of claims processing.

Responsibilities:

Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
Analyze medical claim information and take appropriate action for payment resolution in accordance with policies and procedures, desktops, processing guidelines, and federal regulations.
Process medical claims submitted on CMS-1500 and CMS-1450/UB-04 claim forms from facilities, physicians, Home Health, Durable Medical Equipment providers, laboratories, etc.
Work claim projects resulting from overpayments or underpayments related to manual processing errors, benefit updates, and/or contract, fee schedule changes.
Process provider refunds, reconsiderations, and direct member reimbursements.
Process medical claim adjustments, recovery of claim overpayments, and execution of claim batch adjudication.
Solve moderately complex claims and escalate issues to the Claims Team Lead, Supervisor or Manager.
Assist with database improvements and testing for system upgrades, conversions, or implementation of new processes.
Serves as a resource to assist with training new associates, retraining current associates on new/updated desktops/policies and reports staff progress, deficiencies, and training needs to management.
Sets high standards of performance and promotes teamwork to achieve established team goals, while maintaining a positive, professional attitude.
Contacting/responding to internal and external customers for resolution on claim issues.
Assist claims leadership to identify claim trends, gaps in workflow and create/update desktops and policies and procedures.
Collaborate with and maintain open communication with all departments within CHRISTUS Health to ensure effective and efficient workflow and facilitate completion of tasks/goals.
Must be able to organize and prioritize work to meet deadlines.
Have good judgment, initiative, and problem-solving abilities.
Attention to detail is critical to ensure timely and accurate processing of claims.
Consistently meet established productivity and quality standards.
Follow CHRISTUS Guidelines related to the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent, or detect unauthorized disclosure of Protected Health Information (PHI).
Performs other duties as assigned by management to support claims functions, which are focused on achieving both departmental and organizational objectives.
Must be knowledgeable about medical terminology, CPT, HCPCS, ICD-10, Revenue Codes, CMS-1500 and CMS-1450/UB-04 claim forms and reimbursement methodologies.
Must have excellent written, verbal, organizational and interpersonal communication skills.
Must be proficient in Microsoft Office, Power Point, Excel, Word, Outlook, spreadsheet, and database skills.

Job Requirements:

Education/Skills

Associate's degree or equivalent job-related experience required.

Experience

Minimum of 3 years’ experience processing medical claims in the healthcare industry.
Prior experience working with managed care, Medicare, Medicare Advantage, Health Exchange, and TRICARE are highly desirable.

Licenses, Registrations, or Certifications

None required.

Work Schedule:

5 Days - 8 Hours

Work Type:

Full Time

Apply Now

Refine Your Search

claims processing jobs in bedford, tx

Claims Examiner Senior - Health Plan Admin

Pharmacy Claims Representative (remote)

Claims & Risk Analyst

Home Care Billing Specialist

Claims Research Specialist - State National

Appeals Representative II

Claims Technician - State National

Payer Compliance Specialist I - Remote

Claims Specialist II

Government Revenue Cycle Accounts Receivable

Processor I, Gap Claims

Damage Review Specialist-REMOTE

Billing Specialist

Provider Research & Resolution Specialist - Remote

Claims In-take Specialist

Revenue Cycle Specialist I

Medical Collections Specialist

Assistant Operations Manager

Medical Billing Specialist

Medical Billing/AR Specialist

I want to receive the latest job alert for claims processing in bedford, tx

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