21 claims supervisor jobs found

PURPOSE OF THIS POSITION This position is responsible for all medical claims including pre-billing and follow up activities for delayed claims by ensuring, through various activities, that claims are clean and should be paid promptly by insurers without requiring further intervention. This staff member performs all pre-claim submission activities, including verifying existing information is accurate, determining when additional data is needed, and collecting necessary details to ensure claims are complete. Additionally, this individual follows departmental productivity and quality control measures that support the organization’s operational goals. This position promotes revenue integrity and accurate reimbursement for the organization by ensuring timely and accurate billing, timely payer follow-up activities and collection of accounts. JOB DUTIES/RESPONSIBILITIES Duty 1: Maintains a thorough understanding and education of federal and state regulations and payer specific policies...

"Our mission, vision, and values are inspired directly from Scripture and guide our work at every level of Catholic Charities." If you are a compassionate and dedicated person looking for an opportunity to make a difference in society, we encourage you to apply. Catholic Charities isn't just an organization that provides help to those in need in our communities-it's a place where employees are encouraged to live purpose driven lives, professionally and personally. Join our team as we provide help and create hope for those in need. At Catholic Charities, we serve everyone, regardless of belief or background, and we employ qualified individuals who commit to our mission with the goal of transforming lives for the better. One need not be Catholic to join our workforce nor to access our services. Billing Specialist- Temporary Catholic Charities is seeking a dynamic individual to assist our Billing team! This assignment will be temporary through the end of 2024. This individual...

Job Description: Title: Medical Billing Specialist Job Code: 64305OH Division: Senior Living Corporate Status: Non-Exempt Reports to: Lead Medical Billing Specialist Revision date: April 2019 Supervises: n/a PURPOSE According to prescribed policies and procedures of the organization including all applicable state, federal and accreditation regulations and under the general supervision of the Lead Medical Billing Specialist assumes responsibility for performing all general accounting, billings, and bookkeeping functions for the Senior Living Division's Facilities. ESSENTIAL FUNCTIONS Manage accounts receivable for medical billing for the Senior Living Division including, but not limited to: Part A and B Medicare, Medicaid, Home Health, Hospice, Part B, Outpatient, Managed Care, Insurance, and Co-Insurance Billing. Communicates with different insurance carriers for timely payment of our services. Prepares and files insurance claims. Performs...

PFS Facility Medical Billing Specialist - 40 hrs/wk, 1st shift Join to apply for the PFS Facility Medical Billing Specialist - 40 hrs/wk, 1st shift role at Blanchard Valley Health System . PURPOSE OF THIS POSITION This position is responsible for all medical claims including pre‑billing and follow‑up activities for delayed claims by ensuring, through various activities, that claims are clean and should be paid promptly by insurers without requiring further intervention. This staff member performs all pre‑claim submission activities, including verifying existing information is accurate, determining when additional data is needed, and collecting necessary details to ensure claims are complete. Additionally, this individual follows departmental productivity and quality control measures that support the organization’s operational goals. This position promotes revenue integrity and accurate reimbursement for the organization by ensuring timely and accurate billing, timely payer...

What Customer Service Operations contributes to Cardinal Health Customer Service is responsible for establishing, maintaining and enhancing customer business through contract administration, customer orders, and problem resolution. Customer Service Management is responsible for strategic oversight and leadership direction within the Customer Service function. Job Summary The Supervisor, HCP Medical Documentation oversees the Clinical Notes Team responsible for reviewing and qualifying medical documentation to ensure compliance with insurance requirements, primarily for Continuous Glucose Monitoring (CGM) products. This role manages a team of associates who interpret clinical notes from healthcare providers, validate documentation against Medicare and insurance policies, and support the submission of claims. The Supervisor ensures timely turnaround of documentation, allocates work across multiple systems, and drives team performance through coaching, development, and...

Job Description Job Description Description: JOB TITLE: Medical Certified Professional Biller DEPARTMENT: Administration – Finance – Revenue Cycle Management REPORTS TO: Director of Revenue Cycle Management STATUS: Non-exempt SUMMARY: Responsible for entering and coding patient services into computer system and ensuring encounters transfer properly for submission to insurance payers. Sorts and files paperwork, handles insurance claims, and performs collections/refund duties. ESSENTIAL DUTIES AND RESPONSIBILITIES: Collect, post, and manage patient account payments. Submit claims to insurance payers. Review delinquent accounts and call for collection purposes. Collect unpaid claims and clear up discrepancies Process refund requests to patients and insurance payers. Maintain strict patient confidentiality and information security. Sort and file paperwork. Ensure healthcare facilities are reimbursed for all procedures. Handle information about patient...

Pharmacy Compliance Auditor 340B Program Join our team as a Pharmacy Compliance Auditor 340B Program and play a vital role in ensuring access to affordable medications for underserved communities. In this position, you will help safeguard the integrity of the 340B Drug Pricing Programa federal initiative that enables healthcare organizations to stretch resources and provide comprehensive care to more patients. As a Pharmacy Compliance Auditor, you'll work closely with pharmacy leadership to conduct audits, monitor compliance, and identify opportunities for improvement. This role offers the chance to develop specialized expertise in 340B operations, gain advanced certifications, and make a meaningful impact on patient care and organizational success. If you are detail-oriented, passionate about compliance, and eager to grow in a critical area of pharmacy operations, we'd love to hear from you! Minimum Job Requirements: High School Diploma or GED (required) Minimum of 23...

ENT Surgery Pro Fee CoderThe ENT Surgery Pro Fee Coder must be proficient in surgical coding for high complexity ENT surgery cases.The coder will review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10 Diagnosis codes, along with CPT / HCPCS codes as defined for the service type, for coding, billing, internal and external reporting, research as required, and regulatory compliance.Under the direction of the coding managerthe coder should accurately code conditions and procedures as documented and in accordance with ICD-10-CM Official Guidelines for Coding and Reporting, CMS / MAC rules and the CPT rules established by the AMA, and any other official coding guidelines established for use with mandated standard code sets.The coder scope may involve reviewing coding related denials from payers and recommending the appropriate action to resolve the claim based on payer guidelines.This position is full time and 100% remote.Maintain...

Job Description Job Overview: The level II Medical Biller's general responsibilities include assisting the lead medical biller and fellow billing staff in submitting accurate clean claims, ensuring timely follow up. Collaboration with other teams will be needed to ensure denied claims are appealed as needed. Medical Biller II should be cross trained to work with different payers to help assist other billing staff. Reviews, investigates, and resolves credit balances. Medical Biller II will ensure the proper documentation in the facility's billing system. Responsible also for providing excellent customer service skills by answering patient and third party questions and/or addressing billing concerns in a timely and professional manner. Job Requirements: High School Diploma or GED or GED (Required) 3 - 4 years' experience in related field (Required) Billing knowledge that includes ICD-9, ICD-10, and CPT terminology Epic and Clearing House experience Working...

At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence. Primary Function/General Purpose of Position The Speech Language Pathologist works to prevent, assess, diagnose, and treat speech, language, social communication, cognitive-communication, and swallowing disorders in children and adults. They perform patient evaluations, and re-evaluations, regarding the application of a wide variety of therapeutic techniques with special attention to receptive and expressive language skills, speech fluency, vocal and oral motor competence, articulation, and auditory skills. The Speech Language Pathologist establishes patient treatment plans based upon the referral from the physician/referral source. Essential Job Functions ? Reviews physician referral, patient's condition, and medical history to determine speech...

Description The Billing Assistant Manager & Certified Coder supports the Valley View Health Centers revenue cycle by assisting with supervision of billing operations and providing certified coding support as needed. This role helps maximize cash flow, ensures compliance with payer and regulatory requirements, and strengthens internal controls across the billing and coding functions. Serving as back-up to the Billing Manager and Certified Coder, this position plays a key role in maintaining efficient, accurate, and compliant revenue cycle operations. Essential Functions Functional Area: Leadership and Management of the Billing Department Estimated Effort: 65% Responsibilities, Deliverables, Outcomes and Expectations: Ensure billing staff are adequately trained and competent in assigned duties Assist in supervising daily billing operations to ensure productivity and efficient revenue cycle flow Contribute to performance evaluations of billing personnel...

University of Toledo Physicians' mission is to improve the human condition through excellence in patient care and medical discovery. Representing more than 200 physicians, UT Physicians are leaders in clinical care, research and education of the future physicians, providing care in a wide range of medical specialties from the most complex diagnoses and treatments to primary care for the entire family. The primary site of inpatient care services is at the University of Toledo Medical Center, but many of our physicians' practice at hospitals and medical offices throughout the region. University of Toledo Physicians offers competitive pay and benefits including: 403B, Pension, health and tuition waiver at UT. POSITION SUMMARY The Certified Coder is responsible for coding ICD diagnosis and CPT facility and professional codes. Assignment may include outpatient clinic visits, diagnostic procedures, outpatient surgeries, observation and inpatient encounters, and emergency room...

General Summary: Responsible for ensuring proper codes are used in order to maximize returns. Works under the supervision of the office manager Principal Duties & Responsibilities: Example of Essential Duties: Responsible for Coordinating Laboratory and Pathology coding/billing by receiving patient treatment codes to use in reimbursement claims Responsible for creating reimbursement claims and transfer to Medicare/third party payers Responsible for Coordinating reimbursement activities including pending with errors and denials with insurance companies using e-Clinical Works. Responsible for communicating with Physician and their office billing/coding issues. Responsible for submission for paperwork to insurance when required. Responsible for e Clinical works billing processes and workflows. Assist patients and PARs with patient billing issues Responsible for communicating coding/billing issues with Laboratory Management. Other Essential Duties...

Job Description Join our team as a Pharmacy Compliance Auditor - 340B Program and play a vital role in ensuring access to affordable medications for underserved communities. In this position, you will help safeguard the integrity of the 340B Drug Pricing Program-a federal initiative that enables healthcare organizations to stretch resources and provide comprehensive care to more patients. As a Pharmacy Compliance Auditor, you'll work closely with pharmacy leadership to conduct audits, monitor compliance, and identify opportunities for improvement. This role offers the chance to develop specialized expertise in 340B operations, gain advanced certifications, and make a meaningful impact on patient care and organizational success. If you are detail-oriented, passionate about compliance, and eager to grow in a critical area of pharmacy operations, we'd love to hear from you! Minimum Job requirements: High School Diploma or GED (required) Minimum of 2-3 years of...

h1Job Type/h1pFull-time/ph2Description/h2pstrongWhy youll want to work at nimble!/strong/ppInterested in becoming a part of a dynamic Coding team? This is a great opportunity to join a well-established and market-leading brand serving a high-growth end market while gaining valuable experience working closely with Executive leadership. As an organization, we are in high-growth mode through acquisition with a laser focus on positive culture building!/ppstrongWho we are:/strong/ppnimble solutions is a leading provider of revenue cycle management solutions for ambulatory surgery centers (ASCs), surgical clinics, surgical hospitals, and anesthesia groups. Our tech-enabled solutions allow surgical organizations to streamline their revenue cycle processes, reduce administrative burden, and improve financial outcomes. Join more than 1,100 surgical organizations that trust nimble solutions and its advisors to bring deep insights and actionable intelligence to maximize their revenue...

Pharmacy Compliance Auditor – 340B Program Join to apply for the Pharmacy Compliance Auditor – 340B Program role at TriHealth . Job Description Play a vital role in ensuring access to affordable medications for underserved communities. Protect the integrity of the 340B Drug Pricing Program—a federal initiative that enables healthcare organizations to stretch resources and provide comprehensive care. As a Pharmacy Compliance Auditor, you’ll work closely with pharmacy leadership to conduct audits, monitor compliance, and identify opportunities for improvement. This role offers the chance to develop specialized expertise in 340B operations, gain advanced certifications, and make a meaningful impact on patient care and organizational success. Minimum Job Requirements Minimum of High School Degree or GED is required Must successfully complete Apexus 340B University within the first 6 months in the position. Advanced 340B Operations Certificate within the first 12 months....

Join to apply for the Medical Billing Supervisor, Prebilling role at Quadax, Inc. 1 week ago Be among the first 25 applicants Join to apply for the Medical Billing Supervisor, Prebilling role at Quadax, Inc. Coordinate and supervise department work assignments and staffing levels. Monitor work lists to verify work is being completed within required TAT (Turn Around Time). Move staff as needed to ensure the work is covered. Conduct scheduled staff meetings and other activities. This would include both onshore and offshore team members. Participate in client meetings, as needed, for discussion on process flows and billing issues. Conduct monthly quality audits on domestic and offshore staff to ensure all team members are following the client SOPs and meeting quality targets. Measure productivity for every staff member against established targets. Supervise staff in company policies and processes by coaching, counseling, disciplining employees, and appraising job contributions....

Position Summary Meridian HealthCare is seeking a detail-oriented and reliable Medical Billing Specialist to join our billing team. The ideal candidate will have a strong understanding of medical billing procedures, insurance verification, and payment posting. This role plays a key part in ensuring accurate billing, timely payments, and effective communication with patients, payers, and internal departments. The Medical Billing Specialist works closely with the Billing Manager to maintain compliance, accuracy, and efficiency across all billing operations. Responsibilities Accurately enter patient information and billing data into the system. Verify accuracy of billing data and make necessary corrections. Review and check the status of insurance claims as needed. Monitor aging reports and take steps to ensure timely payment of claims. Post payments from all payers and patients (both automated and manual). Maintain and resolve clearinghouse rejections. Identify and resolve...

Overview Looking to join our dynamic team at Ohio State University Physicians where excellence meets compassion? Who we are With over 100 cutting-edge outpatient center locations, dedicated to providing exceptional patient care while fostering a collaborative work environment, our buckeye team includes more than 1,800 nurses, medical assistants, physicians, advanced practice providers, administrative support staff, IT specialists, financial specialists and leaders that all play an important part.As an employee of Ohio State University Physicians (OSUP), you'll be an integral part of a team committed to advancing healthcare, education, and professional growth. Our culture At OSUP, we foster a culture grounded in the values of inclusion, empathy, sincerity, and determination. We meet our teams where they are, coming together to serve each other and our community. Our benefits We know that having options and robust benefit plans are important to you. OSUP prioritizes the...

Middleburg Heights 1 7500 Old Oak Blvd Middleburg Heights, OH 44130, USA Responsibilities Coordinate and supervise department work assignments and staffing levels. Monitor work lists to verify work is being completed within required TAT (Turn Around Time). Move staff as needed to ensure the work is covered. Conduct scheduled staff meetings and other activities. This would include both onshore and offshore team members. Participate in client meetings, as needed, for discussion on process flows and billing issues. Conduct monthly quality audits on domestic and offshore staff to ensure all team members are following the client SOPs and meeting quality targets. Measure productivity for every staff member against established targets. Supervise staff in company policies and processes by coaching, counseling, disciplining employees, and appraising job contributions. Review employee timesheets and monitor overtime. Contact insurance companies to resolve unusual or difficult claim...

Pharmacy Compliance Auditor – 340B Program Join our team as a Pharmacy Compliance Auditor – 340B Program and play a vital role in ensuring access to affordable medications for underserved communities. In this position, you will help safeguard the integrity of the 340B Drug Pricing Program—a federal initiative that enables healthcare organizations to stretch resources and provide comprehensive care to more patients. As a Pharmacy Compliance Auditor, you’ll work closely with pharmacy leadership to conduct audits, monitor compliance, and identify opportunities for improvement. This role offers the chance to develop specialized expertise in 340B operations, gain advanced certifications, and make a meaningful impact on patient care and organizational success. If you are detail-oriented, passionate about compliance, and eager to grow in a critical area of pharmacy operations, we’d love to hear from you! Minimum Job Requirements Minimum of High School Degree or GED is required Must...