<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 Title: Cash/Claims Processor
Start Date: As soon as possible
Length of Assignment: 12/31/2025
Location Address: Mason, OH 45040
Pay range: $19.50 - $21.42 based on experience and interview performance
Schedule:
<ul>
<li>Work hours: 8:00–5:00 with 1-hour lunch, or 8:00–4:30 with 30-minute lunch</li>
<li>Onsite: 1st week will be 100% onsite. Hybrid opportunity with 3 days in office and 2 days remote.</li>
</ul>
 
GENERAL FUNCTION
The Cash Coordinator is responsible for managing the flow of cash batches and research needed to apply the cash appropriately. They must be able to communicate strongly, both internally and externally, to ensure all cash is applied in a timely manner on open receivables. This position requires significant team interaction as well as the ability to work independently. Critical thinking and problem solving skills are needed.
 
MAJOR DUTIES AND RESPONSIBILITIES
<ul>
<li>Manage the flow of processes completed by Cash Processors to ensure all cash is applied in a timely manner to outstanding invoices and provide Cash Supervisor for daily updates.</li>
<li>Document and track stats of all processes within Cash and report results to Cash Supervisor.</li>
<li>Train associates on how to process transactions, which include researching and applying cash for both Payers and Members, identifying and documenting partial payments and denials, and scanning completed batches into our systems.</li>
<li>Complete and submit applications and documentation necessary for setting up EFT's (report any issues to Cash Supervisor).</li>
<li>Provide a point of contact for any questions/issues regarding Cash for other areas of Assignment.</li>
<li>Provide a point of contact for any questions/issues regarding our systems</li>
<li>Attend meetings and/or conference calls at the request of Cash Supervisor to provide insight on Cash processes for internal or external customers.</li>
<li>Schedule and coordinate monthly team meetings.</li>
<li>Support relationships with designated Payers, including frequent updates to Management team.</li>
<li>Work pre-bill queries weekly to ensure claims are sent accurately to minimize denials.</li>
<li>Analyze open receivable trends, including payment frequency and root cause analysis.</li>
<li>Research and resolve insurance denials for proper submission of claims within a given time frame.</li>
<li>Resolve/escalate any Provider, plan set-up, store and/or system issues accurately and in a timely manner.</li>
<li>Run and work various AS400 queries for research each week to analyze in Microsoft Excel.</li>
<li>Quickly summarize outstanding AR issues and provide recommendations/solutions.</li>
<li>Analyze collections data quarterly and develop projects based on P&amp;L risk by Payer, forecasting expected payments and providing line of sight to resolution.</li>
<li>Support the collection of receivables for Canada, including write-offs (adjustments), monthly ATB analysis and resolution of issues.</li>
<li>Assist Supervisor as needed with special projects and training.</li>
</ul>
 
KNOWLEDGE AND SKILLS
<ul>
<li>Knowledge of vision and/or insurance benefits</li>
<li>Knowledge or experience in claims processing</li>
<li>Proficient in Microsoft Excel application</li>
<li>Understand and honor high level of confidentiality</li>
<li>Promote integrity and a strong work ethic</li>
<li>Able to quickly grasp and retain information and concepts</li>
<li>Able to multi-task and prioritize handling of issues</li>
<li>Team and performance oriented</li>
<li>Strong communication skills, both oral and written</li>
<li>Knowledgeable in continuous improvement and problem solving</li>
<li>Strong analytical skills</li>
<li>Strong customer service</li>
</ul>
 
ADDITIONAL JOB DETAILS
<ul>
<li>Interviews will be onsite at the Mason location.</li>
<li>Experience in healthcare, insurance or corporate related field a plus.</li>
</ul>
 
Pride Global offers eligible employee's comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life &amp; disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance and employee discounts with preferred vendors.

Claims Processor

<h3>Job Description</h3>
Job Description
Let’s do great things, together!
About Moda Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be better together.
 Position Summary Provides supervision, coaching and support to Claims Processors. Organizes staff, sets goals, establishes procedures, and continues to ensure claims are processed promptly and accurately. Measures and evaluates performance and results. Coaches and trains as required to achieve goals of quality and efficiency. This is a FT WFH role. Pay Range $58,747.10 - $73,433.88 annually, DOE. *This role may be classified as hourly (non-exempt) depending on the applicant's location. Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range.
 Please fill out an application on our company page, linked below, to be considered for this position. <a href="https://j.brt.mv/jb.do?reqGK=27761701&amp;refresh=true" target="_blank">https://j.brt.mv/jb.do?reqGK=27761701&amp;refresh=true</a> Benefits:
<ul>
<li>Medical, Dental, Vision, Pharmacy, Life, &amp; Disability</li>
<li>401K- Matching</li>
<li>FSA</li>
<li>Employee Assistance Program</li>
<li>PTO and Company Paid Holidays</li>
</ul>
 Required Skills, Experience &amp; Education:
<ol>
<li>College degree or equivalent work experience.</li>
<li>2 – 4 years medical claims processing experience, including 1 year as Senior/Lead processor.</li>
<li>Computer proficiency in company’s systems and Word and Excel.</li>
<li>Strong verbal, written and interpersonal communication skills.</li>
<li>Strong analytical, problem solving and decision-making skills.</li>
<li>Ability to work well under pressure with frequent interruptions and shifting priorities.</li>
<li>Ability to come in to work on time and daily.</li>
<li>Maintain confidentiality and project a professional business image.</li>
</ol>
 Primary Functions:
<ol>
<li>Supervises staff giving daily work direction, vacation scheduling, monitoring attendance, conducting performance reviews, and hiring and training new employees.</li>
<li>Facilitates problem solving for employees and Manager by answering claims related questions dealing with contract interpretation of benefits, procedures and claims systems.</li>
<li>Controls workflow and quality by checking date and amount of work in processors queues, assigns work to ensure time service goals, tracks processors production and quality.</li>
<li>Assists with planning by analyzing amount of work and type of work, assigns and sets priorities and decides on retraining needs.</li>
<li>Motivates and coaches the processors by reviewing results with them, conveys to them what is expected of them, asks for suggestions, and fulfills the needs of training.</li>
<li>Use and manipulate excel files. </li>
<li>Other duties as assigned</li>
</ol>
 Working Conditions &amp; Contact with Others:
<ol>
<li>Office environment with extensive close PC and keyboard work, constant sitting, and phone work. Must be able to navigate multiple screens. Work in excess of 40 hours per week, including evenings and occasional weekends, to meet business need.</li>
<li>Internally with staff, Underwriting, Professional Relation, Claims Support, Accounting, and IT. Externally with providers, policyholders, insureds, and brokers.</li>
</ol>
 Together, we can be more. We can be better. Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training. For more information regarding accommodations, please direct your questions to Kristy Nehler &amp; Danielle Baker via our <a href="mailto:humanresources@modahealth.com" target="_blank">humanresources@modahealth.com</a> email.

Supervisor Medical Claims

<h3>Job Description</h3>
Job DescriptionTTF is recruiting for a for a large client ONSITE in Prescott, AZ. This is a contract to possible hire position, and the starting pay will depend on experience. Qualified candidates will have at least 2 years of experience in healthcare patient services; high volume insurance verification and authorizations experience is required. Previous experience in financial counseling in a hospital setting is preferred. Please send your resume to Chelle at <a href="mailto:CBodnar@ttfrecruit.com" target="_blank">CBodnar@ttfrecruit.com</a> for consideration. 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. TTF places candidates in the revenue cycle, health information management and healthcare administrative fields with the following specialties and titles: 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. 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. #IND1

Patient Financial Counselor

<h3>Job Description</h3>
Job DescriptionRobert Half Finance &amp; Accounting Contract Talent is currently seeking a highly skilled Healthcare Claims Processor to join our client's team. Opportunity Overview: We are in search of a detail-oriented Healthcare Claims Processor with a strong background in healthcare AR follow-up, insurance claim collection, and claims processing. This role is critical in understanding the complexities of claim denials, drafting appeal letters, and ensuring the reimbursement process operates smoothly. The position demands a commitment of 40 hours per week. Key ResponsibIlities: Conduct thorough healthcare AR follow-up, focusing on prompt reimbursement. Skillfully handle the collection of insurance claims, ensuring accuracy and completeness. Execute comprehensive claims processing, proactively addressing potential denial factors. Demonstrate expertise in identifying and resolving issues leading to claim denials. Draft persuasive appeal letters to challenge and rectify denied claims. Stay informed about industry changes and insurance regulations affecting claims processing. Qualifications: Proven experience in healthcare claims processing, with a deep understanding of industry best practices. Proficient knowledge of insurance claim collection procedures. Familiarity with the intricacies of claim denial factors and effective resolution strategies. Exceptional skills in drafting compelling appeal letters. Available to commence work in March with a commitment of 40 hours per week. Additional Details: Familiarity with relevant healthcare coding systems is preferred. Ability to navigate and utilize healthcare information systems effectively. Understanding of healthcare compliance regulations and privacy laws. Strong analytical skills to identify patterns and trends in claim denials. Collaborative approach to work, ensuring seamless coordination with other healthcare professionals. To express your interest in this role or to obtain further information, please reach out to us directly at (314) 262-4344. We are eager to discuss this exciting opportunity with you.• Proven experience in medical insurance claims processing. • Strong knowledge of insurance claim collection procedures. • Expertise in identifying and resolving claim denial factors. • Exceptional ability to draft persuasive appeal letters. • Familiarity with healthcare coding systems and information systems. • Understanding of healthcare compliance regulations and privacy laws. • Excellent analytical skills for identifying patterns in claims data. • Availability to work consistent hours starting in March.

Medical Insurance Claims Specialist

<h3>Job Description</h3>
Job Description
TTF is recruiting for a for a large client ONSITE in Prescott, AZ. 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; Previous experience in financial counseling in a hospital setting is preferred. &nbsp; Please send your resume to Chelle at <a href="mailto:CBodnar@ttfrecruit.com" target="_blank">CBodnar@ttfrecruit.com</a> for consideration. &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.

<h3>Job Description</h3>
Job Description
TTF is recruiting for Hospital Insurance Biller / Collectors for a well-respected hospital system located in Arizona. These positions are 100% REMOTE.&nbsp; &nbsp; These positions will be responsible for billing/collections of patient accounts. Ensures UB04 claims are billed in a timely, complete, and accurate manner in accordance with appropriate guidelines. Follows up with all Insurance payors and Resolves problems and demonstrates complete understanding of payor and/or patient requirements to ensure timely and accurate payment.&nbsp;&nbsp;&nbsp; &nbsp; Qualified candidates will have 4+ years of experience in healthcare revenue cycle and a track record of success. &nbsp; For consideration, please send your resume to Chelle at <a href="mailto:cbodnar@ttfrecruit.com" target="_blank">cbodnar@ttfrecruit.com</a>. &nbsp; We place candidates in the PFS field with the following specialties and titles: Hospital Collector, Commercial, Government, Managed Care, Billing Representative, Medical Biller, AHCCCS, Medicare, Medicaid, Medical Claims, Follow-Up Rep, Medical Collections Representative, Medical Collector, Medical Reimbursement Specialist, Patient Account Rep, Patient Financial Representative, Rev Cycle Management, Reimbursement Representative, Reimbursement Specialist, Claims Processing, Payment Poster, 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.

Remote Medical Billing and Collections - Hospital Insurance Collector

<h3>Job Description</h3>
Job DescriptionTTF is recruiting for Hospital Insurance Biller / Collectors for a well-respected hospital system located in Arizona. These positions are 100% REMOTE. These positions will be responsible for billing/collections of patient accounts. Ensures UB04 claims are billed in a timely, complete, and accurate manner in accordance with appropriate guidelines. Follows up with all Insurance payors and Resolves problems and demonstrates complete understanding of payor and/or patient requirements to ensure timely and accurate payment. Qualified candidates will have 4+ years of experience in healthcare revenue cycle and a track record of success. For consideration, please send your resume to Chelle at <a href="mailto:cbodnar@ttfrecruit.com" target="_blank">cbodnar@ttfrecruit.com</a>. We place candidates in the PFS field with the following specialties and titles: Hospital Collector, Commercial, Government, Managed Care, Billing Representative, Medical Biller, AHCCCS, Medicare, Medicaid, Medical Claims, Follow-Up Rep, Medical Collections Representative, Medical Collector, Medical Reimbursement Specialist, Patient Account Rep, Patient Financial Representative, Rev Cycle Management, Reimbursement Representative, Reimbursement Specialist, Claims Processing, Payment Poster, and Claims Processor. 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. #IND1

Hospital Insurance Collector

<h3>Job Description</h3>
Job Description
Job Summary:
The Asbestos Claims Processor is responsible for the intake, review, documentation, and processing of asbestos-related claims. This role requires high attention to detail, strong organizational skills, and the ability to interpret medical and legal documents. The Asbestos Claims Processor ensures timely and accurate handling of claims/deficiencies in accordance with company policy, trust guidelines, and applicable regulations.
Key Responsibilities:
<ul>
<li>Receive, review, and process asbestos-related personal injury claims.</li>
<li>Ensure claims meet eligibility requirements under relevant asbestos bankruptcy trusts or legal frameworks.</li>
<li>Collect and verify supporting documentation, such as medical records, exposure evidence, and employment history.</li>
<li>Enter and maintain accurate data in claims management systems.</li>
<li>Communicate with claimants, attorneys, and trust administrators regarding claim status, required documentation, and next steps.</li>
<li>Track and monitor claim progress to ensure timely resolution.</li>
<li>Assist with audits and respond to inquiries or requests for information.</li>
<li>Maintain confidentiality of sensitive information and comply with HIPAA and other regulatory standards.</li>
<li>Stay up to date on trust criteria, legal rulings, and industry changes related to asbestos litigation and compensation.</li>
</ul>

Qualifications:
Required:
<ul>
<li>High school diploma or GED; Associate or Bachelor’s degree preferred.</li>
<li>1–3 years of experience in claims processing, legal support, or a similar administrative role.</li>
<li>Familiarity with asbestos litigation, personal injury claims, or bankruptcy trusts is a plus.</li>
<li>Strong computer skills, including Microsoft Office and claims management software.</li>
<li>Excellent communication, documentation, and organizational skills.</li>
<li>Ability to analyze complex documentation and ensure compliance with policies.</li>
</ul>
Preferred:
<ul>
<li>Experience working in legal or healthcare settings.</li>
<li>Knowledge of asbestos-related diseases and compensation processes.</li>
</ul>

37 healthcare-claims-processor Jobs