<h3>Job Description</h3>
Job DescriptionAbout the Role
We are seeking a detail-oriented and dependable Reimbursement Processor to join our Reimbursement Services team. In this role, you will be responsible for adjudicating and entering Flexible Spending Account (FSA) reimbursement requests and Benefits Card receipt submissions. You’ll play a key part in ensuring timely and accurate processing while maintaining the highest standards of confidentiality and compliance.
What You’ll Do
<ul>
<li>Review and adjudicate FSA claims up to $5,000</li>
<li>Process Benefits Card receipt requests</li>
<li>Accurately enter claims into participant accounts</li>
<li>Update participant demographic information as needed</li>
<li>Process third-party FSA claim files</li>
<li>Maintain strict confidentiality and security of sensitive information</li>
</ul>
What You Bring
<ul>
<li>High School Diploma or equivalent</li>
<li>At least 1 year of experience in a professional office setting</li>
<li>Strong attention to detail and commitment to accuracy</li>
<li>Proficiency in Microsoft Excel and Outlook</li>
<li>Typing speed of at least 50 WPM and 10-key speed of 9,500 KPH</li>
</ul>
Preferred Qualifications:
<ul>
<li>Prior experience in claims processing</li>
<li>Familiarity with tax-advantaged benefit plans</li>
<li>Basic proficiency in Microsoft Word</li>
</ul>
Why Join Us
<ul>
<li>Be part of a collaborative team of 5+ professionals</li>
<li>Contribute to a high-impact area during our busy renewal season</li>
<li>Gain valuable experience in the benefits and reimbursement space</li>
<li>Support meaningful work that directly impacts our customers</li>
</ul>
Apply today to join a team that values precision, integrity, and service excellence.
Pay and Benefits
The pay range for this position is $17.00 - $18.00/hr.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:
 • Medical, dental &amp; vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life &amp; AD&amp;D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)
Workplace Type
This is a hybrid position in Middleton,WI.
Application Deadline
This position is anticipated to close on Oct 15, 2025.
h4&gt;About TEKsystems: 
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. 
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
About TEKsystems and TEKsystems Global Services
We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

Healthcare Claims Reimbursement Processor

<h3>Job Description</h3>
Job Description
HEALTHCARE CLAIMS PROCESSOR JOB SUMMARY: CDS Administrators is looking for an experienced Healthcare Claims Processor to join our growing team! CDS specializes in benefit administration and prioritizes exceptional customer service. We are looking for people who want to further their career and find a place to call home. This position requires attention to detail, analytical thinking / problem solving and great organizational skills.
This is a full time, direct hire in office role. Working hours are 8:30am to 5:00pm in our Downtown office.
QUALIFICATIONS
<ul>
<li>High School Diploma Required</li>
<li>Must have at least 1-year previous experience processing claims – medical claims experience preferred</li>
<li>Must have the ability to manage their own time throughout the day while actively addressing client and team requests</li>
<li>Must have strong problem-solving skills</li>
<li>Proficiency in core MS Office applications including Word, Excel, PowerPoint, and Outlook.</li>
<li>Proficiency in role specific software / Ability to learn new software quickly</li>
<li>Previous experience with, data entry and data analytics preferred.</li>
<li>Must be willing to submit to a background investigation; any offer of employment is conditional upon the successful completion of a background investigation.</li>
</ul>
HEALTHCARE CLAIMS PROCESSOR PAY &amp; PERKS:
<ul>
<li>Hourly Rate Starting At $20.00 per hour</li>
<li>Monday to Friday schedule</li>
<li>Professional development and coaching</li>
<li>Health, Dental, and Vision insurance</li>
<li>401(k)</li>
<li>Life insurance</li>
<li>Paid time off</li>
</ul>
HEALTHCARE CLAIMS PROCESSOR DUTIES &amp; RESPONSIBILITIES:
As a Healthcare Claims Processor, you will be responsible for analyzing, reviewing, and adjudicating medical, dental, and vision claims while maintaining exceptional customer service, including providing information to providers as well as participants regarding eligibility, benefits, and claim status.
<ul>
<li>Answer/resolve incoming participant and provider calls</li>
<li>Conduct outbound calls to follow up on participant concerns</li>
<li>Process medical, dental and vision claims</li>
<li>Data entry for claims processing</li>
<li>Able to read, analyze, and understand Explanation of Benefits</li>
<li>Understand and effectively communicate covered/non-covered benefits, deductibles, maximum amounts, limitations, and exclusions</li>
<li>Able to read, analyze, and understand Plan Documents and Summary Plan Descriptions</li>
</ul>
ABOUT US: CDS Administrators, Inc. (CDS) is a locally owned and operated employee benefit services firm in the greater Pittsburgh area. We are seeking candidates interested in working in a fast-paced environment in a growing organization. We promote from within, and are invested in training and development.

Healthcare Claims Processor in Downtown, Pittsburgh

<h3>Job Description</h3>
Job Description
TTF is recruiting for an Insurance Verification Representative for a growing client in Phoenix, Arizona. This is a contract to possible hire position and the starting pay will depend on experience. &nbsp; Qualified candidates will have at least 2 years of experience in healthcare patient services; high volume insurance verification and authorizations experience is required. &nbsp; For consideration, please send resumes to Chelle at <a href="mailto:CBodnar@ttfrecruit.com" target="_blank">CBodnar@ttfrecruit.com</a>. &nbsp; TTF is a search and staffing company that partners with hospitals, physician groups, TPA's, medical management companies, pharmaceutical and pharmacy benefit plan organizations, surgery centers, DME/home health, consulting companies, and all other healthcare fields. &nbsp; TTF places candidates in the revenue cycle, health information management and healthcare administrative fields with the following specialties and titles:&nbsp; Hospital Collector, Commercial, Government, Managed Care, Billing Representative, Medical Biller, AHCCCS, Medicare, Medicaid, Medical Claims, Medical Data Entry, Follow-Up Rep, Medical Collections Representative, Medical Collector, Medical Reimbursement Specialist, Patient Account Rep, Patient Financial Representative, Reimbursement Representative, Reimbursement Specialist, Claims Processing, Credentialing Specialists, Medical Front Office, Medical Assistants, Insurance Verification, Coder, Coding, HIMS Tech, and Claims Processor. &nbsp; TTF never charges a fee to candidates and all conversations are kept confidential. We would like to be your career consultant and look forward to working with you.
Company DescriptionTTF is a recruiting firm that partners with companies nationwide to find the talent they need for success. 
<h3>Company Description</h3>
TTF is a recruiting firm that partners with companies nationwide to find the talent they need for success.

Insurance Verification Representative

<h3>Job Description</h3>
Job Description
Job Title: Business Solutions Architect
***Remote***
About Us
We are a growing Pharmacy Discount Card Claims Processor dedicated to improving patient access to affordable medications. As we continue to expand our partnerships and services, we're building a Business Integrations Team to streamline enterprise processes, strengthen client onboarding, and enable efficient data and workflow integrations across the business.
We're looking for Business Solutions Architects who are strategic thinkers, problem solvers, and hands-on collaborators ready to help shape the future of our operational excellence and client delivery.
Position Overview The Business Solutions Architect (BSA) plays a critical role in bridging business needs with technology solutions across the enterprise. This role is responsible for leading the intake, evaluation, and implementation of new business initiatives and client integrations, designing efficient workflows, and ensuring seamless data exchange across internal and external systems.
The ideal candidate combines business acumen, process improvement expertise, and technical understanding of data workflows—particularly within healthcare, pharmacy, or claims environments.
Key Responsibilities
Enterprise Portfolio &amp; Intake Management
-Support centralized project intake and portfolio management processes.
-Collaborate with business stakeholders to evaluate new requests, define scope, and assess alignment with enterprise priorities.
-Maintain and improve tracking tools for project intake, prioritization, and status reporting.
Business Workflow Process Creation &amp; Improvement
-Analyze current-state business processes and identify opportunities for optimization.
-Design future-state workflows that improve efficiency, compliance, and scalability.
-Document and communicate process designs through clear visuals, models, and standard operating procedures (SOPs).
-Partner with technology teams to ensure process automation and integration.
File Exchange &amp; Data Mapping
-Coordinate setup and validation of data file exchanges (compendia, claims, etc.).
-Work closely with IT/data teams to map inbound and outbound data files, ensuring accuracy and compliance with client requirements. -
Support issue resolution, testing, and quality assurance of data workflows.
Business Analysis for Special Projects &amp; Initiatives
-Conduct business analysis for assigned special projects or strategic initiatives to identify opportunities for improvement, integration, or innovation.
-Gather and document detailed business requirements, user stories, and process flows to support project objectives.
-Evaluate potential solutions, perform impact assessments, and develop business cases or recommendations for leadership review. -
Collaborate cross-functionally to translate business needs into actionable technical or operational solutions.
-Support pilot programs or proof-of-concept initiatives, ensuring alignment with enterprise goals and scalability.
Compliance &amp; Conduct
-Maintain compliance with company policies, including timely reporting of noncompliance.
-Adhere to Buzz Integrations Code of Conduct, ensuring ethical and regulatory compliance.
Qualifications Required
-Bachelor's degree in Business, Information Systems, Healthcare Administration, or a related field (or equivalent experience).
-5+ years of experience in business analysis, process improvement, or solution design roles.
-Strong understanding of healthcare data workflows, preferably in pharmacy benefit management (PBM), claims processing, or health technology environments.
-Experience with project intake, portfolio management, or enterprise request systems.
-Proficiency in business process modeling (Visio, Lucidchart, Miro, etc.).
-Familiarity with data mapping, file exchange formats (EDI, CSV, flat files), and integration documentation.
-Excellent communication, facilitation, and stakeholder management skills.
-Proven ability to balance strategic thinking with hands-on execution.
Preferred
-Experience in a startup or growth-stage organization within healthcare or technology.
-Familiarity with workflow automation tools, integration platforms, or project portfolio management systems (e.g., Smartsheet, Jira, Monday.com).
-Knowledge of HIPAA and PHI handling standards.
-Certification(s) in Business Analysis, Process Improvement, or Project Management (CBAP, Lean Six Sigma, PMP, etc.).
What We Offer
-Opportunity to help build a foundational function within a growing organization.
-Collaborative, flexible, and mission-driven work environment.
-Competitive salary and benefits package.
-Professional growth and cross-functional exposure across operations, IT, and client services.
Work Location:
This position can be remote for purposes of providing adequate support to internal clients; offshore teams, being available for interactions and coordination of work with other employees, colleagues, clients, or vendors; as well as for facilitation of quick and effective decisions through collaboration with stakeholders.
Working Hours:
This exempt-level position requires one to work the hours needed to get the job done. Therefore, one must have the flexibility to work beyond traditional hours and be able to work nights, weekends, or on holidays as required. This may be changed from time to time to meet the needs of the business. Typical core business hours are Monday through Friday from 8:00 am to 5:00 pm.
Travel:
This position may require domestic travel and attendance at various local conferences and meetings.
We are unable to sponsor or take over sponsorship of an employment visa at this time.
We encourage you to review our full Privacy Policy for detailed information on our privacy practices.

Business Solutions Architect

<h3>Job Description</h3>
Job DescriptionSalary: 
Job Title:Business Solutions Architect
 
***Remote***
 
About Us
We are a growing Pharmacy Discount Card Claims Processor dedicated to improving patient access to affordable medications. As we continue to expand our partnerships and services, were building a Business Integrations Team to streamline enterprise processes, strengthen client onboarding, and enable efficient data and workflow integrations across the business.
 
Were looking for Business Solutions Architects who are strategic thinkers, problem solvers, and hands-on collaborators ready to help shape the future of our operational excellence and client delivery.
 
Position OverviewThe Business Solutions Architect (BSA) plays a critical role in bridging business needs with technology solutions across the enterprise. This role is responsible for leading the intake, evaluation, and implementation of new business initiatives and client integrations, designing efficient workflows, and ensuring seamless data exchange across internal and external systems.
 
The ideal candidate combines business acumen, process improvement expertise, and technical understanding of data workflowsparticularly within healthcare, pharmacy, or claims environments.
 
Key Responsibilities
Enterprise Portfolio &amp; Intake Management
-Support centralized project intake and portfolio management processes.
-Collaborate with business stakeholders to evaluate new requests, define scope, and assess alignment with enterprise priorities.
-Maintain and improve tracking tools for project intake, prioritization, and status reporting.
 
Business Workflow Process Creation &amp; Improvement
-Analyze current-state business processes and identify opportunities for optimization.
-Design future-state workflows that improve efficiency, compliance, and scalability.
-Document and communicate process designs through clear visuals, models, and standard operating procedures (SOPs).
-Partner with technology teams to ensure process automation and integration.
 
File Exchange &amp; Data Mapping
-Coordinate setup and validation of data file exchanges (compendia, claims, etc.).
-Work closely with IT/data teams to map inbound and outbound data files, ensuring accuracy and compliance with client requirements. -
Support issue resolution, testing, and quality assurance of data workflows.
 
Business Analysis for Special Projects &amp; Initiatives
-Conduct business analysis for assigned special projects or strategic initiatives to identify opportunities for improvement, integration, or innovation.
-Gather and document detailed business requirements, user stories, and process flows to support project objectives.
-Evaluate potential solutions, perform impact assessments, and develop business cases or recommendations for leadership review. -
Collaborate cross-functionally to translate business needs into actionable technical or operational solutions.
-Support pilot programs or proof-of-concept initiatives, ensuring alignment with enterprise goals and scalability.
 
Compliance &amp; Conduct
-Maintain compliance with company policies, including timely reporting of noncompliance.
-Adhere to Buzz Integrations Code of Conduct, ensuring ethical and regulatory compliance.
 
QualificationsRequired
-Bachelors degree in Business, Information Systems, Healthcare Administration, or a related field (or equivalent experience).
-5+ years of experience in business analysis, process improvement, or solution design roles.
-Strong understanding of healthcare data workflows, preferably in pharmacy benefit management (PBM), claims processing, or health technology environments.
-Experience with project intake, portfolio management, or enterprise request systems.
-Proficiency in business process modeling (Visio, Lucidchart, Miro, etc.).
-Familiarity with data mapping, file exchange formats (EDI, CSV, flat files), and integration documentation.
-Excellent communication, facilitation, and stakeholder management skills.
-Proven ability to balance strategic thinking with hands-on execution.
 
Preferred
-Experience in a startup or growth-stage organization within healthcare or technology.
-Familiarity with workflow automation tools, integration platforms, or project portfolio management systems (e.g., Smartsheet, Jira, Monday.com).
-Knowledge of HIPAA and PHI handling standards.
-Certification(s) in Business Analysis, Process Improvement, or Project Management (CBAP, Lean Six Sigma, PMP, etc.).
 
What We Offer
-Opportunity to help build a foundational function within a growing organization.
-Collaborative, flexible, and mission-driven work environment.
-Competitive salary and benefits package.
-Professional growth and cross-functional exposure across operations, IT, and client services.
 
Work Location:
This position can be remote for purposes of providing adequate support to internal clients; offshore teams, being available for interactions and coordination of work with other employees, colleagues, clients, or vendors; as well as for facilitation of quick and effective decisions through collaboration with stakeholders.
 
Working Hours:
This exempt-level position requires one to work the hours needed to get the job done. Therefore, one must have the flexibility to work beyond traditional hours and be able to work nights, weekends, or on holidays as required. This may be changed from time to time to meet the needs of the business. Typical core business hours are Monday through Friday from 8:00 am to 5:00 pm.
 
Travel:
This position may require domestic travel and attendance at various local conferences and meetings.
 
We are unable to sponsor or take over sponsorship of an employment visa at this time.

<h3>Job Description</h3>
Job Description
The Supervisor of Revenue Cycle Management (RCM) is directly accountable for the company’s daily Billing and Collection functions. 
This individual’s principal goals are to develop and manage the billing processes in order to maintain Accounts Receivable days at a required level. The Supervisor will plan, coordinate, direct, and design all operational activities of the department, as well as provide direction and support for solutions that enhance mission-critical business operations. This individual will lead their team in the accurate and timely preparation and submission of claims to all payors. The Supervisor will monitor Fraud and Abuse regulations, to ensure that the facility is in constant compliance.
Key Responsibilities:
<ul>
<li>Responsible for managing the day-to-day billing and collection functions including preparation of summary, analytical reports, etc. </li>
<li>Responsible for maintaining Accounts Receivable days at acceptable levels. </li>
<li>Responsible for various reports needed for Medicare cost report and financial and program audits. </li>
<li>Ensures compliance with internal control policies of the organization. </li>
<li>Supervise department operational and strategic planning, including business requirements, project planning, and organizing and negotiating the</li>
<li>allocation of resources.</li>
<li>Hires, trains, supervises, directs, disciplines, and evaluates employees in assigned departments. Establishes standards of work performance.</li>
<li>and methods of operation for each department assigned.</li>
<li>Other duties as assigned.</li>
</ul>
Qualifications: 
Skill, Knowledge and Abilities:
<ul>
<li>Computer proficient and expertise in patient accounts billing and collection. </li>
<li>Proven track record in managing the billing and collection functions. </li>
<li>Familiar with CPT, HCPS and ICD-9-CM coding, government and commercial billing and reimbursement.</li>
<li>Can efficiently prepare UB-04 and CMS 1500 forms.</li>
<li>HFMA or AHIMA certification is a plus.</li>
<li>Knows when and how to choose the appropriate form.</li>
<li>Proficient operation of personal computer hardware and billing software, typewriter/ word processor, fax machines, calculator, other common office machines. </li>
<li>Excellent communication skills. </li>
<li>Overall knowledge of business office procedures and hospital general policies.</li>
</ul>
Education: Bachelor’s degree in Business, Health Care Administration, Finance or related field, or equivalent experience. 
Licensure: None required.
Experience: Two years in healthcare RCM, with 1 year in a Lead or Supervisory role.
Reports to: Chief Finance Officer (CFO).
What we offer:
<ul>
<li>Competitive Salary: $70-$85k base - depending on experience.</li>
<li>Benefits: Health/Dental/Vision, 401(k), generous PTO and training support to grow your skills.</li>
<li>Real Impact: Your work fuels patient care. This is a place where you can truly make a difference in people's lives.</li>
</ul>
About Lakeview Specialty Hospital &amp; Rehab:
Lakeview Specialty Hospital and Rehab is a Joint Commission Accredited and licensed long term acute care hospital (LTACH) and Inpatient Rehabilitation Hospital (IRF) that has delivered 30 years of innovative programs and extensive services with expertise in medically complex care, neurobehavioral health, rehabilitation, and community supportive living. With superior proficiency in brain injury, rehabilitation and complex respiratory care we are able to help our patients with difficult medical conditions reach their highest level of healing and functional independence possible. Located on more than 80 acres in a rural community outside of Milwaukee in Waterford, Wisconsin. Our peaceful grounds, coupled with tenured, talented and caring staff, lend to the healing and recovery process.

Supervisor, Revenue Cycle Management (RCM)

<h3>Job Description</h3>
Job Description
Healthcare Claims Processor I&nbsp;to be responsible for the accurate and timely processing of claims. Support the overall quality effectiveness to ensure that all claims are processed accurately and complete to ensure appropriate adjustment code usage, and payment rate. Schedule:&nbsp;Monday-Friday, 8:00 AM-5:00 PM during Training Location:&nbsp;8733 Highway 17 Bypass,&nbsp;Myrtle Beach Pay:&nbsp;Weekly pay
<ul>
<li>Research and processes claims according to business regulation, internal standards and processing guidelines.</li>
<li>Verifies the coding of procedure and diagnosis codes.</li>
<li>Resolve system edits, audits and claims errors through research and use of approved references and investigative sources.</li>
<li>Coordinates with internal departments to work edits and deferrals, updating the patient identification, other health insurance, provider identification and other files as necessary.</li>
</ul>
 Required Skills and Abilities: Strong analytical, organizational and customer service skills. Strong oral and written communication skills. Proficient spelling, punctuation and grammar skills. Good judgment skills. Basic business math skills. Required Software and Tools: Basic office equipment. Proficient in word processing and spreadsheet applications. Proficient in database software. Required Education: High School Diploma or equivalent Required Work Experience: 1 year-of experience in a healthcare or insurance environment. Preferred Skills and Abilities: Ability to use complex mathematical calculations.
Company DescriptionProfessional Management Enterprises is a minority and veteran owned business that partners with major healthcare providers to find quality employees and thrives on helping people find positions that exceeds their expectations. 
<h3>Company Description</h3>
Professional Management Enterprises is a minority and veteran owned business that partners with major healthcare providers to find quality employees and thrives on helping people find positions that exceeds their expectations.

Medical Claims Processor

<h3>Job Description</h3>
Job DescriptionSalary: $17.00 per hour DOE 
Mailroom Document Processor
 
 
Job Type: Full-time
Salary: $17.00 per hour
Work Schedule: Monday Friday 7:00 am 3:30pm
 
Work Location: Lake Forest, CA
Background Screen required
 
 
Position Summary:
Imagenet is a leading provider of healthcare technology services around the country. We pride ourselves on our diverse and dedicated workforce and know that having varied perspectives generates better ideas. We promote from within whenever possible so that everyone has the opportunity to grow with the company.
 
Due to the strong and growing demand for our services, our company is expanding its operations. We are now seeking a reliable Mailroom Prep Clerk to help support our team and contribute to our continued success.
 
 
What We Offer:
<ul>
<li>Genuine work/life balance - a predictable schedule and no night shifts</li>
<li>Paid training period</li>
<li>Medical, Dental, Life, Vision, HSA, 401K</li>
<li>PTO</li>
<li>7 Paid Holidays</li>
</ul>
 
What You'll Do:
<ul>
<li>Learn about different types of healthcare documents and how to operate mailroom equipment.</li>
<li>Open mail, identify document types, and group documents together.</li>
<li>Hand off documents to our scan team - may require standing, walking, bending, and lifting 30~ pounds (one Banker's Box).</li>
</ul>
 
What We're Looking For:
<ul>
<li>You show up to work on time every day.</li>
<li>You're always positive and professional.</li>
</ul>
<ul>
<li>You've worked in an office and have a high school diploma or equivalent.</li>
</ul>
 
The Ideal Candidate:
<ul>
<li>You can work independently or within a team.</li>
<li>You are good at time management.</li>
<li>You have a "can do" attitude.</li>
</ul>
 
 
Ready to join our growing team? Wed love to learn more about you! Click Apply Now to get started and tell us why youd be a great fit for Imagenet. 
 
 
About Imagenet, LLC 
Imagenet is a leading provider of back-office support technology and tech-enabled outsourced services to healthcare plans nationwide. Imagenet provides claims processing services, including digital transformation, claims adjudication and member and provider engagement services, acting as a mission-critical partner to these plans in enhancing engagement and satisfaction with plans members and providers.
 
The company currently serves over 70 health plans, acting as a mission-critical partner to these plans in enhancing overall care, engagement and satisfaction with plans members and providers. The company processes millions of claims and multiples of related structured and unstructured data elements within these claims annually. The company has also developed an innovative workflow technology platform, JetStreamTM, to help with traceability, governance and automation of claims operations for its clients.
 
Imagenet is headquartered in Tampa, operates 10 regional offices throughout the U.S. and has a wholly owned global delivery center in the Philippines.

Mailroom Document Processor

<h3>Job Description</h3>
Job Description
LHH is looking for Medical Claims Processor/Adjudicator who is responsible for accurately reviewing, analyzing, and processing managed healthcare claims, authorizations, and referrals in accordance with contractual agreements, regulatory guidelines, and organizational policies. This role requires a strong understanding of healthcare claims processing standards, medical billing regulations, and data integrity practices. The incumbent ensures accurate claim outcomes by verifying and updating data across multiple internal and external systems.
Essential Responsibilities
<ul>
<li>
Review, research, and adjudicate professional and hospital claims for all lines of business, ensuring timely and accurate payment or denial in compliance with policies and regulations.
</li>
<li>
Investigate claim holds and pends, tracking necessary information and documentation to facilitate resolution.
</li>
<li>
Conduct proactive and responsive outreach to providers, members, and internal stakeholders via phone, email, or other communication channels.
</li>
<li>
Collaborate with cross-functional teams to identify and resolve claim-related issues efficiently.
</li>
<li>
Provide feedback to supervisors and the training team regarding process improvements, training needs, and educational resources to enhance departmental productivity.
</li>
<li>
Assist with the preparation of documentation and materials for external audits as requested.
</li>
<li>
Identify and communicate emerging trends, issues, or discrepancies to leads and management.
</li>
<li>
Maintain up-to-date knowledge of applicable county, state, and federal healthcare regulations.
</li>
<li>
Perform additional related duties as assigned within the scope of the department.
</li>
</ul>
Job QualificationsMinimum Qualifications
Education:
<ul>
<li>
High School Diploma or General Education Development (GED) required.
</li>
</ul>
Experience:
<ul>
<li>
Minimum of three (3) years of experience in claims adjudication required.
</li>
</ul>
Additional Requirements:
<ul>
<li>
Demonstrated customer service experience.
</li>
<li>
Proficiency in basic PC operations and Microsoft Word.
</li>
<li>
Strong analytical and problem-solving skills with the ability to interpret and apply complex claims processing procedures.
</li>
<li>
Proven ability to work independently with minimal supervision.
</li>
<li>
Effective communication and collaboration skills in a team-oriented environment.
</li>
<li>
Ability to work effectively in a Labor Management Partnership setting.
</li>
</ul>
 Pay Details: $25.00 to $27.00 per hour Search managed by: Abigail Revalee Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable. Equal Opportunity Employer/Veterans/Disabled To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to <a href="https://www-uat.lhh.com/us/en/candidate-privacy" target="_blank">https://www-uat.lhh.com/us/en/candidate-privacy</a> The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable: 
<ul>
<li>The California Fair Chance Act</li>
<li>Los Angeles City Fair Chance Ordinance</li>
<li>Los Angeles County Fair Chance Ordinance for Employers</li>
<li>San Francisco Fair Chance Ordinance</li>
</ul>
 
Massachusetts Candidates Only: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

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