Top 1262 Healthcare Jobs in Fremont, Ne

Medical Claims Processor I
Detego Health —Omaha, NE
- From $24 an hour
- Full-time
- Background check
- Anatomy knowledge
- Microsoft Excel
- Health insurance
- Dental insurance
Quick Apply
8d
Qualified Medication Administration Personnel
The Belleview Senior Living —Omaha, NE
- $19 - $22 an hour
- Part-time
- Serving
- Vital signs
- HIPAA
- AD&D insurance
- Health insurance
Hospice CNA
Peaceful Hearts Hospice, LLC —Elkhorn, NE
- $20 - $25 an hour
- Full-time
- Hybrid work
- Background check
- 18 years or older
- Skilled nursing facility
- Paid training
- Mileage reimbursement
Quick Apply
4d
Certified Medication Aide/CMA
Hillcrest Health Services —Gretna, NE
- Overnight shift
- English
- High school diploma or GED
- Older adults
- Health insurance
- Dental insurance
Quick Apply
Certified Nursing Assistant/Medication Aide (CNA & CMA)
Heritage Communities —Fremont, NE
- Part-time
- Ability to lift 50 pounds
- CNA
- Entry level
- Disability insurance
- Health insurance
Quick Apply
Medical Office Specialist (Front Office)
East Central District Health Department/Good Neighbor Community Health Center —Fremont, NE
- $18 - $21 an hour
- Full-time
- Spanish
- English
- High school diploma or GED
- Paid holidays
- Health insurance
Quick Apply
Laboratory Assistant
CHI Health Lakeside —Omaha, NE
- $18.51 - $26.15 an hour
- Full-time
- Hospital
- Customer service
- High school diploma or GED
9d
Appointment Scheduler
CHI Health Clinic —Omaha, NE
- $16.42 - $23.19 an hour
- Extended hours
- Mid-level
- 2 years
9d
Clinic Receptionist
CHI Health Clinic —Omaha, NE
- $15.67 - $22.14 an hour
- Extended hours
- Clinic
- 1 year
- Outpatient
Patient Access Professional I - Registration - Casual/PRN
Nebraska Methodist Health System —Fremont, NE
- Part-time
- Microsoft Outlook
- BLS Certification
- Basic math
Surgery Scheduler (Part-Time)
OrthoNebraska —Omaha, NE
- Part-time
- Microsoft Excel
- Microsoft Outlook
- Surgery
Quick Apply
Pharmacy Cashier
Walgreens —Fremont, NE
- $16 - $18 an hour
- Part-time
- Maintenance
- English
- Fair chance
Centralized Scheduler (Full-Time)
OrthoNebraska —Omaha, NE
- Full-time
- HIPAA
- Mid-level
- High school diploma or GED
Quick Apply
11d
Social Services/Discharge Planner-Brookestone Meadows
Vetter Senior Living —Elkhorn, NE
- Entry level
- Paid holidays
- 401(k) matching
Rehab Aide - Elkhorn (Full-Time)
OrthoNebraska —Omaha, NE
- Full-time
- OSHA
- High school diploma or GED
- Clinic
Quick Apply
Optical Sales Associate
Shopko Optical —Fremont, NE
- Weekends as needed
- Merchandising
- No experience needed
- High school diploma or GED
- Paid holidays
- Disability insurance
Quick Apply
Scheduling Coordinator
Fremont Dental Group —Fremont, NE
- Full-time
- Spanish
- Dental office
- English
- Paid holidays
- Health insurance
Credentialing Specialist
Prime Time Healthcare —Elkhorn, NE
- Microsoft Excel
- Microsoft Outlook
- Customer service
- Paid parental leave
- Paid holidays
2d
Clinic Experience Associate
ROCK VALLEY PHYSICAL THERAPY CENTER —Blair, NE
- Full-time
- Clinic
- Entry level
- Health insurance
- 401(k)
Quick Apply
3d
Customer Service Member Support Rep
Detego Health —Omaha, NE
- $21 - $24 an hour
- Full-time
- Background check
- HIPAA
- Analysis skills
- Health insurance
- Dental insurance
Quick Apply
9d

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Medical Claims Processor I

Detego Health -
Omaha, NE

Quick Apply

Job Details

Full-time
From $24 an hour
8 days ago

Benefits

Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance

Qualifications

Anatomy knowledge
Microsoft Excel
Professional ethics
Health insurance policy knowledge
Data analysis skills
HIPAA
Research
Bachelor's degree
Business Administration
Productivity software
Medical terminology
Cross-functional communication

Full Job Description

Job Summary
We are seeking a detail-oriented and knowledgeable Medical Claims Processor I to join our team. The Medical Claims Processor I role is a multi-faceted position for the research and processing of healthcare benefits claims for inpatient, outpatient facilities and professional services. This person will use independent judgement and discretion to review, analyze, and make determinations regarding payment, partial payment, or denial of medical claims, as well as various types of invoices, based upon specific knowledge and application of each client’s customized plan(s). The Medical Claims Processor I will record and maintain insurance policies through the Plan Documents and claim information in the database systems and determine policy coverage while calculating claim amounts.

Responsibilities

Analyze, review and adjudicate medical claims in our Healthvue360 and HRP systems
Read, analyze, understand, and ensure compliance with clients’ customized plans
Learn, adhere to, and apply all applicable privacy and security laws, including, but not limited to; HIPAA, HITECH and any regulations promulgated thereto
Independently review, analyze and make determinations of claims for:

- reasonableness of cost;

- unnecessary treatment by physician and hospitals; and

- fraud

Review, analyze and add applicable notes in our Healthvue360 and HRP systems
Review billed procedure and diagnosis codes on claims for billing irregularities
Analyze claims for billing inconsistencies and medical necessity
Authorize payment, partial payment, or denial of claim based upon individual investigation and analysis
Review workflow and release pended claims, if applicable
Review, Pend, and Suspend claim reports to finalize all claim determinations timely
Assist and support other Medical Claim Processors as needed and when requested by leadership
Attend continuing education classes as required, including but not limited to HIPAA training
Review stop loss and notification process
Process claims with a proficiency of 98% or higher of production goals, based on benefit plans worked
Maintain an average of 95% or higher of accuracy of claims processed, tracked as a quality score

Requirements

Experience with overseeing processes and workflow of medical claims analysis
Knowledge of the TPA and health benefits industry
Strong attention to detail and ability to build out operational processes
Superb communication, organizational, and leadership skills
Knowledge of medical terminology and anatomy
PC proficiency to include Microsoft Word and Excel
Ability to multi-task and prioritize
Strong analytical skills and knowledge of computer systems
A natural demonstration of integrity, ethical conduct, and trustworthiness
Ability to communicate ideas effectively and work with a wide range of internal stakeholders, including senior leaders
Respectful to coworkers and conducts himself/herself in work-settings in a manner that is consistent with Detego Health’s core values

Preferred Skills:

Bachelor’s degree in business administration or related field
5+ years industry experience working with national and regional healthcare brands
5+ years data entry experience working in a high-volume production setting

This role is foundational for those seeking to advance in the healthcare and insurance industries, offering valuable experience in claims management and processing.

Pay: From $24.00 per hour

Benefits:

401(k)
Dental insurance
Health insurance
Paid time off
Vision insurance

Work Location: In person

Quick Apply

Refine Your Search

healthcare jobs in fremont, ne

Medical Claims Processor I

Qualified Medication Administration Personnel

Hospice CNA

Certified Medication Aide/CMA

Certified Nursing Assistant/Medication Aide (CNA & CMA)

Medical Office Specialist (Front Office)

Laboratory Assistant

Appointment Scheduler

Clinic Receptionist

Patient Access Professional I - Registration - Casual/PRN

Surgery Scheduler (Part-Time)

Pharmacy Cashier

Centralized Scheduler (Full-Time)

Social Services/Discharge Planner-Brookestone Meadows

Rehab Aide - Elkhorn (Full-Time)

Optical Sales Associate

Scheduling Coordinator

Credentialing Specialist

Clinic Experience Associate

Customer Service Member Support Rep

I want to receive the latest job alert for healthcare in fremont, ne

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