Top 17 Claims specialist Jobs in Champaign Il

Accounts Receivable Insurance Specialist 1- Commercial, Denials, Payer and Portal experience
Carle Health —Champaign, IL
- $17.26 - $27.96 an hour
- Full-time
- HIPAA
- Research
- Mid-level
- Health insurance
Benefits Specialist
Cunningham Children's Home —Urbana, IL
- $23.63 - $35.44 an hour
- 8 hour shift
- Mid-level
- Office
- Driver's License
- Wellness program
- Paid holidays
Quick Apply
Group Benefits Account Specialist
Loman-Ray Insurance Group, LLC —Urbana, IL
- $45,000 - $55,000 a year
- Full-time
- HIPAA
- Mid-level
- Office
- Health savings account
- Paid holidays
Customer Service Specialist
Mobile Communications America Inc —Urbana, IL
- $15 - $17 an hour
- Full-time
- Microsoft Outlook
- Ability to walk for extended periods
- ERP systems
- Paid holidays
- Health insurance
Customer Service Representative/Sales Specialist
Steve Tarrant State Farm —Champaign, IL
- $50,000 - $85,000 a year
- Full-time
- Bilingual
- Background check
- Computer literacy
- Health insurance
- Paid time off
Quick Apply
10d
Casualty Specialist II
First Acceptance Services Inc —United States
- Remote
- Microsoft Excel
- Mid-level
- High school diploma or GED

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Benefits Specialist
Cunningham Children's Home —Urbana, IL
Associate’s degree in HR or related field (equivalent experience/certifications may substitute). Associates or better in Human Resource Administration or…
$23.63 - $35.44 an hour
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Benefits Specialist
Heritage Behavioral Health Center —Decatur, IL
Valid driver’s license, reliable transportation, and proof of current auto insurance may be required. Associate’s or Bachelor’s degree in HR, Business, or a…
$25 - $32 an hour
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6d

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State Farm Mutual Automobile Insurance Company —Chillicothe, OH
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13d

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Accounts Receivable Insurance Specialist 1- Commercial, Denials, Payer and Portal experience

Carle Health -
Champaign, IL

Apply Now

Job Details

Full-time
$17.26 - $27.96 an hour

Benefits

Health insurance

Qualifications

Appeals
Account maintenance
Account analysis
Regulatory compliance in claims processing
HIPAA
Research
Mid-level
Refund processing
Financial issue resolution
Healthcare privacy protection
Medical billing and coding communication with insurance companies
Invoice reconciliation
Health information regulatory compliance
Medical insurance appeals management
Medical claims submission
Medical billing account reconciliation
Handling account queries
Handling patient inquiries
Phone call management
Invoice exception handling
Faxing
Accounting error correction
Insurance claims appeal handling
Medical debt collection accounts
Healthcare software applications
Medical claim status updates
Invoice dispute resolution
Collections account management

Full Job Description

Overview: The Accounts Receivables Insurance Specialist 1 manages the accounts receivable in accordance with compliance, regulatory and billing guidelines and specific payer rules. Responsible for collection of outstanding receivables through payer portals and/or phone lines. Responsible for the accurate billing of insurance claims by validating coverage, resolving charge review edits, claim edits and front-end clearinghouse and payer rejections. In addition, follows up on outstanding receivables; completes basic appeals; answers, documents and completes inquiries from, insurance companies, internal departments, and 3rd party payers. Works collaboratively with other departments such as Billing, Coding, Cash Posting, etc. to ensure claims are processed/paid correctly. Responsibilities: Ability to take initiative but also accept direction and seek guidance appropriately.
Ability to manage confidential information with sensitivity and discretion (in a HIPAA-compliant way). Strong problem-solving and critical thinking skills.
Timely and accurate claims submissions to health insurance carriers for community, government and commercial health plans as assigned, in the form of electronic and paper billing. Timely and accurate submissions of non-complex reconsiderations and/or appeals to health insurance carriers for community, government and commercial health plans as assigned, via paper, fax or web portal. Monitoring, researching, and resolving unpaid, rejected, denied and/or allowance discrepancy claims. Responsible for all aspects of account follow up and collections, as assigned. Ability to analyze accounts and determine the next appropriate action for account resolution. Accurately and thoroughly document the pertinent collection activities in the billing system. Determines and initiates appropriate action to resolve denied and/or rejected invoices, or invoices in allowance discrepancy and prepares payer corrections and/or appeals in accordance with payer plan requirements using electronic and paper processes. Utilizes clinical applications, payer websites and other systems as a research tool to retrieve medical documentation, patient eligibility information, billing guidelines, patient referrals, and hospital or procedure code authorizations to substantiate corrected claims submissions, through written appeals, and coding reviews, etc. Review account level undistributed payments for application to open balances as it applies to assigned payer(s). Reviews and resolves incoming correspondence.
Identifies, prepares and appropriately requests adjustments. Responds to inquiries from patients, insurance companies, public agencies, internal departments and 3rd party payers.
Identifies and resolves insurance set up errors to facilitate timely billing. Resolves charge review edits, claim edits and clearinghouse and payer rejections to facilitate accurate billing, as assigned. Evaluates Credit/Balance accounts and performs appropriate action to resolve, including but not limited to sending refunds and/or initiating payer recoupments via web portal. Evaluates accounts in an allowance discrepancy status against system loaded contract. Meticulously prepares appeals for appropriate reimbursement from payers. May prepare adjusted and corrected bills, adjust accounts receivable entries, or prepare refunds in accordance with existing operating procedures. May be required to answer calls coming into the department through a rotation line. Will assist or direct callers to the appropriate representative to resolve issues. Performs other duties as assigned. Qualifications: Certifications: , Education: , Work Experience: Carle Health Company Overview:

Find it here.

Discover the job, the career, the purpose you were meant for. At Carle Health, we're committed to fostering a workplace where every team member feels valued, respected and empowered, where passion and purpose come together to positively impact the lives of our patients and our communities. Find it all at Carle Health.

Our nearly 17,000 team members and providers work together to support patient care across central and southeastern Illinois. We’ve grown to include eight, award-winning hospitals and a multispecialty provider group with more than 1,500 doctors and advanced practice providers. We’re developing the next generation of providers and healthcare professionals through Carle Illinois College of Medicine, the world’s first engineering-based medical school, and Methodist College. Carle BroMenn Medical Center, Carle Foundation Hospital, Carle Health Methodist Hospital, Carle Health Proctor Hospital, Carle Health Pekin Hospital, and Carle Hoopeston Regional Health Center hold Magnet® designations, the nation’s highest honor for nursing care. We offer opportunities in several communities throughout central Illinois with potential for growth and life-long careers at Carle Health.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. Carle Health participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization. | For more information: [email protected].

Salary Range: The compensation range for this position is $17.26per hour - $27.96per hour. This represents a good faith minimum and maximum range for the role at the time of posting by Carle Health. The actual compensation offered a candidate will be dependent on a variety of factors including, but not limited to, the candidate’s experience, qualifications, location, training, licenses, shifts worked and compensation model. Carle Health offers a comprehensive benefits package for team members and providers. To learn more visit careers.carlehealth.org/benefits.

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claims specialist jobs in champaign il

Accounts Receivable Insurance Specialist 1- Commercial, Denials, Payer and Portal experience

Benefits Specialist

Group Benefits Account Specialist

Customer Service Specialist

Customer Service Representative/Sales Specialist

Casualty Specialist II

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