Insurance Placement Solutions’ Post

"Expert Claims Handler with Proficiency in Medical Underwriting | Healthcare & Insurance Specialist." With nearly 5 years of dedicated service, my journey as a Claims Handler with S3 GLOBAL SOLUTIONS LLP has been nothing short of inspiring. From meticulously analyzing claims to steering complex underwriting decisions - my career has been a testament to my passion for blending analytical prowess with high-quality customer service. What fuels my drive? ✨ A solid grounding in evaluating files, ensuring that every detail is scrutinized for accuracy and compliance. The opportunity to collaborate closely with professionals, enabling informed decision-making that ultimately protects both companies and policyholders. A continuous quest for knowledge, staying abreast of the latest industry practices and innovations to deliver beyond expectations. As I look to the horizon, I'm eager to channel my experiences into a new challenge, specifically as a Claims Handler on a personal injury team. My aim? To not just meet the benchmarks, but to set them, contributing to a culture of excellence and innovation. 📢 I'm on the lookout for opportunities where I can leverage my expertise and make a meaningful impact. Do you know a team I can contribute to? Let's connect! Your insights or a simple share can pave the way for exciting new collaborations. #JobSearch #InsuranceIndustry #ClaimsHandling #ProfessionalGrowth #LetConnect

DVA is not associated with this job posting Medical Claim Resolution Specialist - Digitech - Remote https://lnkd.in/gzk_sSMs Essential Duties and Responsibilities: Work claims that are pending, are unable to be released or have been denied or incorrectly paid by Insurance carriers. Review claims that have been put on hold, working to identify causes and address issues causing them to remain on hold. Work denials aiming to identify why claims have been denied, and handle follow-up accordingly. Provide insurance companies with additional information as necessary to process a claim correctly and/or send an appeal. Handle all correspondence via mail, email, and any necessary refunds. Performs other duties as assigned by management. #recruiting #nowhiring #hiring #jobs #jobsearch #job #recruitment #careers #recruiting #hiringnow #employment #career #jobseekers #jobopening #work #jobhunt #resume #jobopportunity #applynow #jobsearching #jobseeker #hr #staffing #jobshiring #cfbr #jobinterview #vacancy #recruiter #jobalert #business #joinourteam

Authorization and Credentialing Specialist Remote or hybrid work, FT with benefits, 40K   Experience with multiple insurances, experience with CBH, Credible, Excel Must be detail oriented, motivated, reliable, a team player.  5 years Billing/TPL/Auth experience -Call commercial insurance payersand verify each client's insurancebenefits -Confirm commercial insurance eligibility and specific coverage details for clients, communicate benefit information to the parents/guardians, and discusses financial responsibilities -Identify and document each commercial payer's policy and procedures regarding coverage, prior authorizations, andsubmission process -Complete prior authorizationrequest forms as appropriate forauthorization requests in partnership with clinical partners -Confirm that the clinicaldocumentation received is whatis required by the plan. -Ensure prior authorizations aresubmitted on time accordinglyto company and payor guidelines -Follow up with commercial insurance payers to check status of previously submitted prior authorization -Enter all documents and clientinformation or responses regardingprior authorization into companysystems -Quick to respond and communicate any changes in client's prior authorization status to care operations, clinical, andpartnerships teams. -Review and confirm all currentday copayment were collecteddaily -Process Authorization/TPL form  -Check for retro coverage on existing services, resubmit as needed -Edit billing signed services and resubmit to Payers -Credentialing of company and MD, CRNP and Psychologists with insurances.  #hiring

I am hiring for many Insurance Follow-Up Specialists- These are very long-term, W-2, 100% remote positions. FULL TIME M-F 8-4:30 est. **Epic experience is required - 3 years and must be recent** **Must have ACTUE HOSPITAL AND PROFESSIONAL BILLING EXPERIENCE*** 1. How many years of hands-on appeals experience do you have, including all the investigation required to determine if an appeal is necessary? 2. Explain your active experience in the past three years with – AR, follow up, appeals, underpayments, payor knowledge, research accounts, medical terminology. a. Does your resume reflect these skillset requirements within the last 2 years? (If not please update your resume to reflect this experience) 3. Can you provide an example of your experience with appealing denials? And resubmitting corrected claims? Underpayments? 4. Can you provide an example of a denied claim that you appealed? What steps did you take? (Please provide as much detail as possible) 5. Tell me about your experience in calling insurance companies daily checking status of past due claims? (They should know how to call BC/BS and Cigna as well as other payors to resolve claims.) 6. Tell me about your experience with using websites to check the status of multiple claims with the payors? 7. Tell me about your experience with reading an explanation of benefits? 8. Can you explain what the explanation of benefits provides? 9. Tell me about your experience with understanding medical terminology? Give examples. 10. Validate that you do not have any PTO scheduled during the first 90 days of the project. 11. Tell me about your experience in dealing with Medicare Managed Care and Medicaid Managed Care. 12. What MCO payers are you familiar with? 13. How successful have you been in collecting aged AR? 14. What is your experience with hospital /institutional claims 15. What is your backend (AR/Denials) experience working in Epic and how many years? What job functions do you do inside Epic? How were you assigned daily/weekly work to work these accounts in Epic? All resumes to [email protected] Please share- Thank you- MUST RESIDE IN USA-

I am hiring for many Insurance Follow-Up Specialists- These are very long-term, W-2, 100% remote positions. FULL TIME M-F 8-4:30 est. **Epic experience is required - 3 years and must be recent** **Must have ACTUE HOSPITAL AND PROFESSIONAL BILLING EXPERIENCE*** 1. How many years of hands-on appeals experience do you have, including all the investigation required to determine if an appeal is necessary? 2. Explain your active experience in the past three years with – AR, follow up, appeals, underpayments, payor knowledge, research accounts, medical terminology. a. Does your resume reflect these skillset requirements within the last 2 years? (If not please update your resume to reflect this experience) 3. Can you provide an example of your experience with appealing denials? And resubmitting corrected claims? Underpayments? 4. Can you provide an example of a denied claim that you appealed? What steps did you take? (Please provide as much detail as possible) 5. Tell me about your experience in calling insurance companies daily checking status of past due claims? (They should know how to call BC/BS and Cigna as well as other payors to resolve claims.) 6. Tell me about your experience with using websites to check the status of multiple claims with the payors? 7. Tell me about your experience with reading an explanation of benefits? 8. Can you explain what the explanation of benefits provides? 9. Tell me about your experience with understanding medical terminology? Give examples. 10. Validate that you do not have any PTO scheduled during the first 90 days of the project. 11. Tell me about your experience in dealing with Medicare Managed Care and Medicaid Managed Care. 12. What MCO payers are you familiar with? 13. How successful have you been in collecting aged AR? 14. What is your experience with hospital /institutional claims 15. What is your backend (AR/Denials) experience working in Epic and how many years? What job functions do you do inside Epic? How were you assigned daily/weekly work to work these accounts in Epic? All resumes to [email protected] Please share- Thank you-

When it comes to insurance claims and legal proceedings, access to accurate medical records is vital to expedited process improvement and prompt claims handling. However, traditional methods of retrieving these records have often been cumbersome, time-consuming, and prone to errors. This has led to significant backlogs, delayed settlements, and frustration for claims adjusters and legal professionals alike. Learn how Wisedocs can assist you in streamlining your claims management with automated medical record retrieval in this insightful article. #wisedocs #automatedmedicalrecordretrieval #claimsmanagement #insuranceindustry #insuranceclaims #legalindustry #freelancewriter #articlewriter #opentowork

We’re Growing & You Can Grow With Us! Hey there, LinkedIn community! Our team at PPO Negotiation Solutions is on the hunt for an organized, detail-oriented superstar to join us as a Credentialing Coordinator. What makes us excited to come to work every day? It's simple: our culture. We thrive in an environment built on respect, collaboration, trust, and open communication. Our remote work setup allows for flexibility, but it’s the support and camaraderie amongst the team that truly makes every challenge a pleasure to tackle. Now, let’s talk about the role. This 100% remote position is designed for someone who's has the keen eye of an eagle and the organizational skills of a seasoned librarian.  You'll be handling Standardized Credentialing Applications, processing terminations, supporting a team of Project Managers and navigating OPT-OUT forms with the precision of a master craftsman. You're the type who makes a verification call feel like a friendly chat, yet you're eagle-eyed enough to spot an expired document from a mile away. Your exceptional time management skills mean deadlines don’t scare you – they motivate you. If you’re nodding along, you might just be our ideal candidate. We’re looking for: Phone Enthusiast: Enjoys being on the phone with insurance companies, as 50% of the job involves phone-related tasks, completing verification calls, and coordinating energies between the Client and project manager. Problem Solver: Can manage contracts like a pro, ensuring smooth and efficient operations. Top-Notch Communicator: Articulates complex ideas with ease and clarity. Interpersonal Champ: Knows how to foster relationships and earn trust from colleagues and clients alike. Detail-Oriented: A master of detail – nothing gets past you. Independent Spirit: Can juggle multiple projects without breaking a sweat. Great Attitude: Brings positivity and enthusiasm to the team. Team-Oriented: Works well with others and contributes to a collaborative environment Does this sound like you? Do you love the idea of working with a team that values your input and treats you like the rockstar you are? If yes, we can’t wait to meet you! Let’s create some magic together and transform the PPO landscape, one credential at a time.   If you have these skills, we have a training program to get you on track very quickly with this position. Interested? Apply now and let’s chat about how you can be a part of our PPO Negotiation family! Click here to apply :  https://lnkd.in/eM3hv_ax #Hiring #RemoteJob #CredentialingCoordinator #TeamCulture #PPOFamily #WorkFromAnywhere

If you’re a Coder, Manager, Health Information professional or an Auditor this is a really important read. I can not over emphasize the importance of anyone involved in Revenue Cycle truly understanding the consequences of fraudulent activity. Health Information professionals require the integrity - regardless of payor requirements, or reimbursement, to absolutely safeguard each and every encounter by only selecting and applying diagnostic codes that are documented and supported by the physician(s). Each Coder took a sort of “oath” that requires ethical behavior at all times when receiving our credentials. I am stunned and disheartened to read the findings in this article. We must do better. We’re a team with our physicians and should work as such. Wow.

🔥 Do you know someone who’s ready for a challenge? 💼 In the world of medical coding and billing, we don't shy away from setting high standards in the interview process. We believe in being brutally honest and wildly optimistic when it comes to finding the right talent for our demanding positions. 💪 Some may call it an uphill battle, but we see it as an opportunity to make a difference. We're looking for individuals who are tenacious, highly ethical, and won't settle for anything less than collecting every. damn. penny. from those greedy #insurancecompanies. 💵 At our Spark Billing, our Revenue Manager doesn’t just talk the talk, we hold insurance companies accountable for the standards they agreed to. We know that they're counting on us to give up, but we won't back down. We're the ones who ensure that doctors are paid what they deserve, customers aren't burdened with unnecessary expenses, and insurance billing practices are followed to the letter. 📝 Join our team and become the driving force behind change. Together, we can rewrite the motto of #unitedhealthcare, #aetna, and #Bcbs from win-lose-lose-lose to win-win-win-win. 🌟 Ready to take on the challenge? Send me a message to learn more! Let's make a difference together. 👊 #medicalcoding #medicalbilling #accountability #ethicalbusiness #hiringnow #hiring

#hiring Revenue Cycle Specialist, Washington, United States, fulltime #jobs #jobseekers #careers #Washingtonjobs #DistrictofColumbiajobs Apply: https://lnkd.in/gY6KE7sY ABOUT YOUYou are a person who loves researching and evaluating claims for proper reimbursement and working with third party payers to ensure maximum collections! We need someone to thrive when reviewing chargemaster, and assisting in clinic fee schedule, and pricing analysis. In the role of Revenue Cycle Specialist, you'll be responsible for supporting clinic fee schedule, billing, and coding. If you can put your signature on this, we can't wait to hear from you!Tell us about your experience with Revenue Cycle.Are you a team player, learner, and a self-motivator?What is your experience with conducting business in a way that is a credit to a company?We are counting on you to manage multiple projects using your problem-solving skills.We're looking for someone UNCOMMON. What is uncommon about you?Are you highly committed? Are you team-oriented? Do you value professionalism, trust, honesty, and integrity? If so, we can't wait to meet you.ABOUT THE JOBThe people you will work with are exceptional. Here is what you can look forward to, and why you'll LOVE YOUR MONDAYS.Call payers and use probing questions to understand the claim status.Review denied claims on payer portals or EOBs and take necessary steps to resolve the denial that are outlined by the client or management.Clearly document multiple EHR systems to ensure clear understanding of actions taken to resolve the claim.Write, submit and follow up on appeals for denied claims.Meet quality and productivity standards set by Signature and/or our client.Review billing documents as assigned for submission to insurance plans and government entities