Top 152 Claims representative Jobs in North Wales Pa

Insurance and Denials Specialist
Careers at Gentell —Morrisville, PA
- $23 - $25 an hour
- Full-time
- Customer service
- Research
- Mid-level
Quick Apply
Accounts Receivable/Medical Biller
Ophthalmic Partners PC —Bala-Cynwyd, PA
- $23 - $25 an hour
- Full-time
- Mid-level
- In-person
- 4 years
- Health insurance
- Dental insurance
Quick Apply
Insurance Patient Account Representative
Bryn Mawr Medical Specialists Association —Bryn Mawr, PA
- $20 an hour
- Full-time
- Mid-level
- Office
- High school diploma or GED
- Profit sharing
- Paid holidays
Quick Apply
13d
Account Specialist III
Moove NA Distribution Holdings, Inc. —King of Prussia, PA
- $40,000 - $55,000 a year
- Full-time
- Hybrid work
- Microsoft Word
- Background check
- Computer literacy
- Health savings account
- Health insurance
Quick Apply
Service Rep Claim Initiation
Lincoln Financial —Radnor, PA
- $20.10 - $27.41 an hour
- Overtime
- Remote
- Research
- Mid-level
- High school diploma or GED
- Tuition reimbursement
- Paid time off
5d
Billing Representative
Trident Care —Horsham, PA
- $18 an hour
- Remote
- Microsoft Excel
- Computer literacy
- 3 years
Senior Claims Specialist I
Liberty Mutual —Bala-Cynwyd, PA
- $67,000 - $126,000 a year
- Full-time
- Hybrid work
- Mid-level
- Office
- 3 years
13d
Commercial Claims Representative
CIBA Insurance Services —Narberth, PA
- $90,000 - $100,000 a year
- Full-time
- Remote
- Clean driving record
- 5 years
- Residential
- Health insurance
- Dental insurance
Quick Apply
Client Services Representative
Hibu —King of Prussia, PA
- Online Application
- Hybrid work
- Microsoft Outlook
- Research
- Mid-level
Quick Apply
14d
Customer Service Rep (Premier)
Independence Blue Cross —Philadelphia, PA
- Remote
- Bilingual
- Research
- Mid-level
1d
Customer Service Representative - State Farm Agent Team Member
Henry Nace - State Farm Agent —Plymouth Meeting, PA
- $50,000 - $65,000 a year
- Full-time
- Office
- Communication skills
- Entry level
- Health insurance
- Paid time off
Quick Apply
Customer Service Representative- Insurance office
Evergreene Partners —Ambler, PA
- $42,500 - $55,000 a year
- Full-time
- Office
- In-person
- Entry level
- Paid time off
Quick Apply
Claim Examiner
A-G Specialty Insurance, LLC —Berwyn, PA
- $50,000 a year
- Weekends as needed
- Remote
- Mid-level
- Bachelor's degree
- Travel
Customer Service Representative - State Farm Agent Team Member
Richard D'Antonio - State Farm Agent —Souderton, PA
- $40,000 - $60,000 a year
- Full-time
- Sales
- Office
- Children
- Profit sharing
- Health insurance
Quick Apply
Authorization Representative
Thomas Jefferson University and Hospitals —Abington, PA
- Full-time
- HIPAA
- Mid-level
- High school diploma or GED
- AD&D insurance
- Disability insurance
Patient Access Representative (Part Time, Days)
St. Luke's University Health Network —Harleysville, PA
- Part-time
- Computer literacy
- Administrative experience
- High school diploma or GED
Customer Service Representative - State Farm Agent Team Member
Bret Webster - State Farm Agent —Willow Grove, PA
- $20 - $30 an hour
- Full-time
- Office
- Communication skills
- Entry level
- Paid time off
- Opportunities for advancement
Quick Apply
Stop Loss Claims Specialist
Marsh McLennan Agency —Conshohocken, PA
- $57,738 - $65,000 a year
- Full-time
- Hybrid work
- Microsoft Outlook
- Mid-level
- Office
- Health insurance
- 401(k)
Commercial Auto No Fault / PIP Claims Examiner III _ Temp
TRISTAR RISK MANAGEMENT —Philadelphia, PA
- $85,000 - $95,000 a year
- Temporary
- Remote
- Computer literacy
- Basic math
- Mid-level
Quick Apply
Claims Representative
Penn Lumbermens Mut Ins Co —Philadelphia, PA
- Spanish
- Writing skills
- Mid-level

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Insurance and Denials Specialist

Careers at Gentell -
Morrisville, PA

Quick Apply

Job Details

Full-time
$23 - $25 an hour

Qualifications

Medicare
Insurance verification
Customer service
High school diploma or GED
ICD-10
Medicare regulations
Centers for Medicare and Medicaid Services (CMS)
Medical billing
Patient interaction
Cross-functional collaboration
Medical debt collection accounts

Full Job Description

Insurance and Denials Specialist

POSITION SUMMARY

Under the direction and support of the Insurance and Denials Manager, the Insurance and

Denials Specialist will initiate billing claims, actively process all denials, and ensure follow up on collection efforts to ensure timely reimbursement for services provided.

The Insurance and Denials Specialist require critical thinking skills, ability to identify

trends, and achieve departmental revenue goals. We are looking for someone who can

confidently gather the required information to submit and resolve health insurance claims

to multiple payers.

SUPERVISION RECEIVED

Insurance and Denials Manager

DIRECT REPORTS

Director of Compliance

ESSENTIAL DUTIES AND RESPONSIBILITIES

To perform this job successfully, an individual must be able to perform each essential duty

satisfactorily.

Registration of patients, insurance verification, HCPCS coding and ICD-10 coding
Verify all insurance orders for accuracy and completeness
Review clinical documentation to ensure compliance with payors guidelines
Apply correct modifiers and HCPCS to claims
Communicate with Gentell clinicians and customer facilities as needed to expedite claims processing
Transmit/submit claims (paper or electronic) to insurance payors for reimbursement
Contact insurance companies on outstanding claims
Maintain supporting chronological notes that detail actions taken to resolve outstanding account balances
Resolve insurance problems and patient issues that may have resulted from incorrect or incomplete information
Review received insurance payments for underpayment
Call insurance companies regarding any discrepancy in payments as needed
Process all appeal requests within the time frame required
Process approved adjustments
Maintain patient demographic information and data collection systems, including all billing/collection reports, queues, or diversions while remaining in accordance with payor and company policy guidelines
Research and resolve discrepancies, denials, and appeals. Use initiative and critical thinking to identify problems, recommend solutions to management, and set priorities.
Perform miscellaneous job-related duties as assigned

DESIRED MINIMUM QUALIFICATIONS

The requirements listed below are representative of the knowledge, skill and/or ability required for this position.

High school diploma or GED required; Associate degree preferred
2 years minimum experience in healthcare insurance billing, collections, and/or denials and appeals
Knowledge of HMO/PPO, Medicare, Medicaid, and other payer requirements and systems
Thorough knowledge of all private insurance rules and regulations as it relates to claims submission and/or denials and appeals
Knowledge of LCDs, Medicare Guidelines for DME, supplier standards for DME
Must be able to work effectively with patients/customers, company staff, and outside parties, such as insurance company representatives
Strong customer service orientation
Ability to work in strong collaboration with all internal and external team members, inside and outside of the Revenue Cycle department
Strong attention to detail and accuracy
Task oriented while performing in a fast-paced environment
Certification in Medical Billing/Coding a plus
1 year of Durable Medical Equipment billing experience preferred
Experience with wound care orders billing a plus
Knowledge of Brightree a plus

Pay: $23.00 - $25.00 per hour

Work Location: In person

Quick Apply

Refine Your Search

claims representative jobs in north wales pa

Insurance and Denials Specialist

Accounts Receivable/Medical Biller

Insurance Patient Account Representative

Account Specialist III

Service Rep Claim Initiation

Billing Representative

Senior Claims Specialist I

Commercial Claims Representative

Client Services Representative

Customer Service Rep (Premier)

Customer Service Representative - State Farm Agent Team Member

Customer Service Representative- Insurance office

Claim Examiner

Customer Service Representative - State Farm Agent Team Member

Authorization Representative

Patient Access Representative (Part Time, Days)

Customer Service Representative - State Farm Agent Team Member

Stop Loss Claims Specialist

Commercial Auto No Fault / PIP Claims Examiner III _ Temp

Claims Representative

I want to receive the latest job alert for claims representative in north wales pa

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