Top 51 Claims representative Jobs in Westmoreland County Pa

Billing Assistant/EVV Coordinator
Ideal Home Health Agency —Pittsburgh, PA
- Full-time
- Spanish
- Microsoft Excel
- Microsoft Outlook
9d
Storm Restoration Roof Inspector | Become A Public Adjuster
Allclaims Pro —Pittsburgh, PA
- $100,000 - $150,000 a year
- Full-time
- Background check
- Mid-level
- Communication skills
- Paid training
Quick Apply
5d
Customer Service Representative- Health Care Concierge - Must be located in Pittsburgh, or Surrounding Area
UPMC —Pittsburgh, PA
- $19.67 - $30.40 an hour
- Overtime
- Hybrid work
- Computer literacy
- Writing skills
- High school diploma or GED
- Paid training
- Health insurance
Work from Home - Pharmacy Tech Support/Call Center Rep (8a-5p ET) - National
IQVIA —Pittsburgh, PA
- $18 an hour
- Full-time
- Remote
- Spanish
- HIPAA
- English
- Work from home
9d
Claims Processing Specialist - Tarentum, PA
Blackburn's Physicians Pharmacy, Inc. —Tarentum, PA
- Full-time
- Computer literacy
- Mid-level
- Office
- Profit sharing
- Paid holidays
Quick Apply
Workers Compensation Claims Specialist, Sr
NJM Insurance Group —Pittsburgh, PA
- $79,129 - $91,834 a year
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- 5 years
- Paid parental leave
- Disability insurance
Customer Service Representative
Advance Sourcing Concepts LLC —Pittsburgh, PA
- $18.25 an hour
- Contract
- Hybrid work
- Spanish
- High school diploma or GED
- Computer skills
- Work from home
Quick Apply
Field Claims Representative (Field Liability Claims Adjuster) - Pittsburgh
ACUITY, A Mutual Insurance Company —Pittsburgh, PA
- $75,000 - $150,000 a year
- Anatomy knowledge
- 5 years
- Driver's License
- Disability insurance
- Health insurance
Casualty Claims Representative
Auto-Owners Insurance Company —Pittsburgh, PA
- Full-time
- Bachelor's degree
- Travel
- US work authorization
- Paid holidays
- Paid time off
Quick Apply
1d
Claim Rep Outside Liability
The Travelers Companies, Inc. —Pittsburgh, PA
- $67,000 - $110,600 a year
- Clean driving record
- Mid-level
- Driver's License
- Wellness program
- Paid holidays
Temporary Customer Service Representative (Onsite)
UPMC —Pittsburgh, PA
- $19.67 - $30.40 an hour
- 8 hour shift
- Writing skills
- High school diploma or GED
- Analysis skills
- Health insurance
- On-the-job training
Liability Specialist
Erie Insurance —Pittsburgh, PA
- $63,130 - $100,843 a year
- Full-time
- Adults
- Mid-level
- High school diploma or GED
- Disability insurance
- Health insurance
8d
Workers Comp Senior Claims Rep Remote-NJ PA MA
National Interstate —Pittsburgh, PA
- $72,000 - $82,000 a year
- Full-time
- Hybrid work
- 5 years
- Office
- Finance
- Commuter assistance
- Employee stock purchase plan
Patient Access Coordinator II / ED - Full Time - Rotational - West Penn
Allegheny Health Network —Pittsburgh, PA
- Weekends as needed
- HIPAA
- Mid-level
- High school diploma or GED
Customer Service Representative - State Farm Agent Team Member
Anthony Hunt - State Farm Agent —North Versailles, PA
- $40,000 - $60,000 a year
- Full-time
- Office
- Communication skills
- Entry level
- Health insurance
- Paid time off
Quick Apply
Customer Service Representative - State Farm Agent Team Member
Jeff Berthney - State Farm Agent —Monroeville, PA
- $30,000 - $40,000 a year
- Full-time
- High school
- Office
- Communication skills
- Paid holidays
- Paid time off
Quick Apply
New Business Service Representative 94433
New York Life —Pittsburgh, PA
- $43,000 - $47,500 a year
- Overtime
- Hybrid work
- Office
- Administrative experience
- Fingerprint clearance
- Loan repayment program
- Health insurance
Customer Service Representative
Graybar Electric Company, Inc. —Pittsburgh, PA
- From $21.63 an hour
- Full-time
- Associate's degree
- 2 years
- Communication skills
- Profit sharing
- Paid holidays
Quick Apply
Customer Service Representative - State Farm Agent Team Member
Hanna Drane - State Farm Agent —Evans City, PA
- $45,000 - $65,000 a year
- Full-time
- Office
- Leadership
- Communication skills
- Paid time off
- Opportunities for advancement
Quick Apply
Associate Specialist, Patient Access - PRN
Ensemble RCM LLC —Butler, PA
- $17.00 - $18.15 an hour
- Part-time
- Hospital
- Customer service
- Inpatient
- Tuition reimbursement

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Billing Assistant/EVV Coordinator

Ideal Home Health Agency
Pittsburgh, PA

Apply Now

Job Details

Full-time
9 days ago

Qualifications

HIPAA
High school diploma or GED
Healthcare privacy protection
Health information regulatory compliance

Full Job Description

IDEAL HOME HEALTH CARE, LLC

JOB DESCRIPTION

JOB TITLE: Billing Assistant / EVV Coordinator
REPORTS TO: Administrator

A. BASIC PURPOSE

The Billing Assistant / EVV Coordinator is responsible for ensuring the accuracy, compliance, and timely completion of Electronic Visit Verification (EVV), scheduling oversight, insurance eligibility verification, and billing functions. This position supports agency operations by monitoring visit documentation, maintaining payor compliance requirements, processing billing submissions, and assisting with administrative functions necessary to ensure uninterrupted patient services and revenue cycle management.

B. PRIMARY RESPONSIBILITIES

Billing Management

Scheduling Oversight

Monitor patient schedules to ensure services align with authorized hours and approved Plans of Care.
Verify that all scheduled visits are completed, documented, and appropriately billed.
Identify scheduling discrepancies and coordinate corrective actions with appropriate departments.

EVV Compliance & Dashboard Monitoring

Monitor the EVV call dashboard throughout the workday and address visit exceptions promptly.
Review EVV records daily for missed clock-ins, clock-outs, documentation issues, and visit discrepancies.
Communicate with caregivers, patients, and supervisors to resolve EVV exceptions.
Maintain a minimum quarterly EVV compliance rate of 90% or greater, or as required by payer contracts and agency standards.

Prebilling & Billing Submission

Review and clear all prebilling items within established deadlines.
Complete prebilling review and prepare billing for services rendered from the 1st through the 15th by the first business day following the 15th of each month.
Complete prebilling review and prepare billing for services rendered from the 16th through the end of the month by the first business day of the following month.
Submit accurate and timely claims through HHAeXchange, Availity, and other payer-required billing platforms.
Ensure all billing submissions comply with payer guidelines and agency requirements.

Billing Tracking & Reconciliation

Maintain billing logs and tracking reports by payer source.
Reconcile claims, remittance advice, and Explanation of Benefits (EOBs).
Research claim denials, payment discrepancies, and billing errors and initiate corrective actions or rebilling as necessary.
Assist with reporting and revenue tracking activities.

Funds Allocation

Allocate incoming payments to appropriate agency bank accounts based on remittance documentation and internal procedures.
Missed Shift Reporting

Prepare and submit all required missed shift reports accurately and within payer deadlines.
Submit UPMC and Highmark missed shift reports monthly by the 10th day of the following month.
Submit AmeriHealth and Health Partners Plan missed shift reports weekly every Tuesday.
Maintain documentation supporting all reported missed visits.
Insurance Eligibility Verification

Conduct insurance eligibility verification for all active patients every Monday or Tuesday when Monday falls on a holiday.
Perform monthly eligibility verification on the first business day of each month.
Notify appropriate staff, patients, and family members of any eligibility changes, coverage issues, or payer updates.
Maintain documentation of eligibility verification activities.
Employee System Maintenance

Enter newly hired employees into HHAeXchange, Alora, and other agency systems as assigned.
Maintain employee demographic and status information in agency software systems.
Assist with system updates and data maintenance as needed.
Administrative Support

Provide support to Billing, Scheduling, Intake, Human Resources, Nursing, and Administrative departments as assigned.
Complete special projects and additional duties within required deadlines.
Participate in process improvement initiatives to improve efficiency and compliance.

The primary responsibility statements are intended to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

HUMAN RELATIONS

Must maintain a professional attitude and demeanor and communicate effectively and courteously with patients, caregivers, referral partners, supervisors, and co-workers.
Must work collaboratively with all departments to ensure timely billing, accurate documentation, and regulatory compliance.
Must demonstrate attention to detail, accountability, and commitment to quality service.

C. QUALIFICATIONS

High school diploma or equivalent required.
Associate degree in Healthcare Administration, Business Administration, Accounting, or related field preferred.
Minimum one (1) year of experience in healthcare billing, EVV coordination, scheduling, administrative support, or related healthcare operations preferred.
Working knowledge of Medicaid, Managed Care Organizations (MCOs), EVV requirements, and healthcare billing processes preferred.
Strong organizational, analytical, and problem-solving skills.
Proficiency in Microsoft Office applications, including Excel, Outlook, and Word.
Ability to manage multiple priorities and meet strict deadlines.

D. PREFERRED SKILLS

Experience with HHAeXchange, Alora Plus, Availity, NaviNet, or similar healthcare systems.
Familiarity with Pennsylvania Medicaid home care billing requirements.
Experience working with managed care organizations including UPMC, AmeriHealth, Highmark Wholecare, and Health Partners Plans.
Ability to analyze billing discrepancies and resolve claim issues independently.
Bilingual in Nepali and/or Spanish preferred.

E. OTHER REQUIREMENTS

a. Satisfactory professional references.
b. Satisfactory criminal background check and applicable clearances.
c. Ability to maintain confidentiality and comply with HIPAA requirements.
d. Ability to sit for extended periods while performing computer-based work.
e. Ability to occasionally lift office materials weighing up to 20 pounds.

Apply Now

Refine Your Search

claims representative jobs in westmoreland county pa

Billing Assistant/EVV Coordinator

Storm Restoration Roof Inspector | Become A Public Adjuster

Customer Service Representative- Health Care Concierge - Must be located in Pittsburgh, or Surrounding Area

Work from Home - Pharmacy Tech Support/Call Center Rep (8a-5p ET) - National

Claims Processing Specialist - Tarentum, PA

Workers Compensation Claims Specialist, Sr

Customer Service Representative

Field Claims Representative (Field Liability Claims Adjuster) - Pittsburgh

Casualty Claims Representative

Claim Rep Outside Liability

Temporary Customer Service Representative (Onsite)

Liability Specialist

Workers Comp Senior Claims Rep Remote-NJ PA MA

Patient Access Coordinator II / ED - Full Time - Rotational - West Penn

Customer Service Representative - State Farm Agent Team Member

Customer Service Representative - State Farm Agent Team Member

New Business Service Representative 94433

Customer Service Representative

Customer Service Representative - State Farm Agent Team Member

Associate Specialist, Patient Access - PRN

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