Top 32 Claims representative Jobs in Youngstown, Oh

Billing Specialist - Behavioral Health
Open Water Counseling and Recovery, LLC —Warren, OH
- $20 - $24 an hour
- Full-time
- HIPAA
- Research
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Associate Specialist, Patient Access
Ensemble RCM LLC —Youngstown, OH
- $17.00 - $18.15 an hour
- Full-time
- Hospital
- Customer service
- High school diploma or GED
- Tuition reimbursement
2d
Multi-Line Representative - State Farm Agent Team Member
John G Clark - State Farm Agent —Boardman, OH
- $55,000 - $80,000 a year
- Full-time
- Office
- Children
- Conflict management
- Paid time off
- Opportunities for advancement
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Medical Insurance Verification/Authorization Specialist
Action Physical Therapy & Rehabilitation, Inc. —Hubbard, OH
- Part-time
- Microsoft Excel
- Medical office experience
- Physical & Rehabilitation Medicine
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Customer Service Coordinator
Essilor and Subsidiaries —Youngstown, OH
- Full-time
- Mid-level
- High school diploma or GED
- 2 years
- Health insurance
- Paid time off
1d
Customer Service Representative - State Farm Agent Team Member
John G Clark - State Farm Agent —Boardman, OH
- $40,000 - $50,000 a year
- Full-time
- Office
- Children
- Conflict management
- Paid time off
- Opportunities for advancement
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Customer Service Representative - State Farm Agent Team Member
Alyssa Tutino Harcar - State Farm Agent —New Castle, PA
- Part-time
- Communication skills
- Entry level
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Account Associate - State Farm Agent Team Member
Alyssa Tutino Harcar - State Farm Agent —New Castle, PA
- Full-time
- Office
- Communication skills
- Entry level
- Paid time off
- Opportunities for advancement
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Customer Service Representative - Call Center (Veteran Care Liaison)
Xterra Health —Salem, OH
- $17 - $19 an hour
- Email
- Hybrid work
- Military
- Communication skills
- Entry level
- Health insurance
- Dental insurance
Quick Apply
Patient Access Specialist - PRN
Ensemble RCM LLC —Youngstown, OH
- $17.00 - $18.15 an hour
- Part-time
- Acute care
- Hospital
- Customer service
- Tuition reimbursement
Patient Access Specialist - PART TIME
Ensemble RCM LLC —Warren, OH
- $17.00 - $18.15 an hour
- Part-time
- Hospital
- Customer service
- High school diploma or GED
- Tuition reimbursement

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Billing Specialist - Behavioral Health

Open Water Counseling and Recovery, LLC -
Warren, OH

Quick Apply

Job Details

Full-time
$20 - $24 an hour

Benefits

Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance
401(k) matching
Life insurance
Retirement plan

Qualifications

Health insurance authorizations
Appeals
Medicare
Medical coding
Practice management software
HIPAA
Patient management software
High school diploma or GED
Attention to detail
Medical insurance appeals management
Medical explanation of benefits reviews
Medical claims submission
Filing patient billing claims
Insurance claims appeal handling

Full Job Description

Department

Revenue Cycle

Reports To

Revenue Cycle Manager

Location

Warren, OH (on-site)

FLSA Status

Full-Time, Non-Exempt

Compensation

$20–$24 per hour, commensurate with experience

Position Summary

The Accounts Receivable Specialist owns the follow-up and resolution of outstanding insurance and client balances across all payers and service lines. This is a production role with measurable output expectations: working assigned claim queues daily, resolving denials and underpayments, pursuing aged balances before timely-filing deadlines, and documenting every account touch in the EHR. The Specialist works within a co-sourced revenue cycle model alongside our external billing partner and is accountable for the accounts assigned to them from first follow-up through final resolution.

Essential Duties & Responsibilities

Claim follow-up. Work assigned A/R follow-up queues daily in the EHR (CareLogic/Qualifacts), prioritizing by balance, age, and timely-filing risk.
Denial resolution. Research and resolve denied, rejected, and underpaid claims; identify root cause (eligibility, authorization, coding, COB, duplicate submission, payer routing) and take corrective action through resubmission, reconsideration, or appeal.
COB management. Identify and resolve coordination-of-benefits issues, including obtaining updated primary/secondary payer information and rebilling in correct order before filing deadlines lapse.
Timely filing. Track payer-specific timely-filing and appeal deadlines for Ohio Medicaid, Medicaid managed care/MyCare plans, Medicare, and commercial payers; escalate at-risk balances to the Revenue Cycle Manager before deadlines pass, not after.
Payer contact. Contact payers by portal and phone to verify claim status, eligibility, and authorization; document reference numbers, representative names, and next actions on every call.
Documentation. Document every account touch in the EHR with a clear note stating what was found, what was done, and the follow-up date. Undocumented work is treated as work not performed.
Payment reconciliation. Review remittances and EOBs to reconcile payments against expected reimbursement; flag underpayments, incorrect capitation routing, and recoupments for escalation.
Billing partner coordination. Coordinate with the external billing partner on claim corrections, resubmissions, and escalations; respond to partner requests within one business day.
Aging management. Generate and work aging reports; contribute to monthly A/R review with accurate status on assigned accounts, including collectability assessment and recommended write-offs with supporting documentation.
Client balances. Handle client balance follow-up professionally and in compliance with company policy, including statements, payment plans, and account questions.
Compliance. Maintain full compliance with HIPAA and 42 CFR Part 2 in all account activity and communications.

Performance Standards

Performance in this role is measured, reviewed monthly, and tied to continued employment and advancement:

Minimum daily account touches as set by the Revenue Cycle Manager, with 100% of touches documented in the EHR.
Zero preventable timely-filing losses on assigned accounts. Balances lost to filing deadlines without a documented escalation are a performance failure, not a payer problem.
Measurable month-over-month reduction in assigned A/R over 90 days.
Denials on assigned accounts worked within 5 business days of receipt.
Accurate, on-time inputs to the monthly A/R aging review.

Qualifications

Required

2+ years of medical accounts receivable, insurance follow-up, or medical billing experience.
Working knowledge of the full claim lifecycle: eligibility, authorization, submission, adjudication, denial, appeal, and payment posting.
Experience reading and interpreting EOBs/ERAs, remittance advice, and denial codes (CARC/RARC).
Proficiency with practice management/EHR systems and payer portals; strong Excel fundamentals.
High school diploma or equivalent.

Preferred

Behavioral health billing experience, including Ohio Medicaid, Medicaid managed care/MyCare, and behavioral health service codes (H-codes, PHP/IOP).
CareLogic/Qualifacts experience.
Experience working in a co-sourced or outsourced billing model.
Certified Revenue Cycle Representative (CRCR) or similar credential.

Competencies

Ownership: treats assigned A/R as their responsibility to resolve, not a list to monitor. Closes loops without being chased.
Persistence: follows accounts through multiple payer contacts and appeal levels until resolved.
Attention to detail: catches COB order errors, routing issues, and underpayments others miss.
Time management: consistently hits daily production volume while prioritizing dollar and deadline risk correctly.
Communication: writes clear account notes and escalates problems early with the facts needed to act.

Work Environment & Physical Requirements

Standard office environment. Prolonged periods sitting at a desk and working on a computer. Occasional lifting up to 15 pounds. Regular, predictable, on-site attendance is an essential function of this position.

Acknowledgment

This job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities required of the employee. Duties, responsibilities, and activities may change at any time with or without notice. Open Water Counseling & Recovery is an Equal Opportunity Employer.

Pay: $20.00 - $24.00 per hour

Benefits:

401(k)
401(k) matching
Dental insurance
Health insurance
Life insurance
Paid time off
Retirement plan
Vision insurance

Work Location: In person

Quick Apply

Refine Your Search

claims representative jobs in youngstown, oh

Billing Specialist - Behavioral Health

Associate Specialist, Patient Access

Multi-Line Representative - State Farm Agent Team Member

Medical Insurance Verification/Authorization Specialist

Customer Service Coordinator

Customer Service Representative - State Farm Agent Team Member

Customer Service Representative - State Farm Agent Team Member

Account Associate - State Farm Agent Team Member

Customer Service Representative - Call Center (Veteran Care Liaison)

Patient Access Specialist - PRN

Patient Access Specialist - PART TIME

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