<h3>Job Description</h3>
Job DescriptionDescription:
 
Join our team at Cobalt Benefits Group and start an exciting new career in employee benefits solutions. As a Claims Refund Specialist, you’ll play an important role in helping us offer customized, self-funded insurance options to our clients and members.
 
Reporting to the Claims Manager and Assistant Claims Manager, the Refund Specialist is responsible for various administrative tasks related to services and claims for our health plans. The ideal candidate is detail-oriented, with exceptional communication skills, and a background in healthcare/insurance processing.
 
Key Responsibilities:
<ul>
<li>Audit, review, and adjust medical, dental, and flexible spending accounts and Health Reimbursement Account claims.</li>
<li>Review, apply and create refund letters for all lines of business to members and providers.</li>
<li>Reprocess payments when necessary.</li>
<li>Communicate with members, providers, employer group contacts, and other inquirers pertaining to specific refund questions.</li>
<li>Review plan documents for various groups to research and resolve claim processing questions and issues.</li>
<li>Act with urgency to respond to inquiries regarding refund request status-including research and resolution regarding outstanding request.</li>
<li>Perform other related duties, as assigned.</li>
</ul>
Requirements:
<ul>
<li>6 months’ experience in healthcare or insurance industry with respect to operations support, including provider maintenance, billing, coding, or customer support.</li>
<li>Experience in health care billing or a background with a health insurance carrier or Third-Party Administrator strongly desired.</li>
<li>Solid time-management skills, with the ability to prioritize multiple tasks, while working with a sense of urgency.</li>
<li>Strong interpersonal skills with excellent verbal and written communication skills.</li>
<li>Basic keyboard and Windows based computer skills required.</li>
<li>Familiarity with Microsoft Excel.</li>
<li>Eager to learn the TPA industry and new concepts and processes.</li>
</ul>
Work Environment &amp; Physical Demands:
<ul>
<li>Hybrid/ remote work availability may be offered based on meeting key performance metrics.</li>
<li>Prolonged periods of sitting may be required.</li>
<li>Regular use of a computer, keyboard, and mouse is necessary; reasonable accommodations will be provided upon request.</li>
<li>Employees should ensure an ergonomically appropriate desk and chair setup.</li>
<li>Comfort with being on camera for virtual meetings (e.g., Microsoft Teams)</li>
</ul>
Benefits:
 
After successfully completing a waiting period, eligible Full-time employees have access to our comprehensive benefits package, including:
<ul>
<li>Fantastic medical, dental, and vision insurance*</li>
<li>Twice annual employer HSA contributions, covering 50% of the HDHP plan’s annual deductible!</li>
<li>Company provided Basic Life and AD&amp;D</li>
<li>Company paid Short-Term and Long-Term Disability**</li>
<li>Flexible Spending Accounts*</li>
<li>401(k) Retirement Plan with up to a 6% employer-match** WOW! (100% fully vested after 3 years)</li>
<li>10+ paid holidays</li>
<li>Generous paid vacation and sick time</li>
<li>Annual Volunteer Paid Day</li>
<li>Annual Tuition Reimbursement</li>
<li>Annual Health and Wellness Reimbursement</li>
<li>Lots of fun company events</li>
</ul>
Who We are:
 
As a trusted third-party administrator (TPA) specializing in self-funded benefit plans, Cobalt Benefits Group (CBG) is committed to helping employers find high-quality coverage at a cost they can afford. We administer self-funded insurance benefits through our three companies: EBPA, Blue Benefit Administrators of Massachusetts, and CBA Blue.
 
With over 30 years of experience and a dedicated team of more than 200 employees, we work collaboratively to build customized self-funded health plans, manage claim payments and disputes, and administer other specialized programs such as FSAs, HSAs, COBRA, and retiree billing. Join us as we match employers across our region with the right solutions for their employee benefit needs. To learn more about working at CBG, visit <a href="https://www.cobaltbenefitsgroup.com/careers/" target="_blank">https://www.cobaltbenefitsgroup.com/careers/</a>.
 
Benefit Waiting Period Notes:
 
*60 day waiting period **90 day waiting period

Claims Refund Specialist

<h3>Job Description</h3>
Job Description Description:
 
Join our team at Cobalt Benefits Group and start an exciting new career in employee benefits solutions. As a Claims Refund Specialist, you'll play an important role in helping us offer customized, self-funded insurance options to our clients and members.
 
Reporting to the Claims Manager and Assistant Claims Manager, the Claims Refund Specialist is responsible for various administrative tasks related to services and claims for our health plans. The ideal candidate is detail-oriented, with exceptional communication skills, and a background in healthcare/insurance processing.
Key Responsibilities:
<ul>
<li>Audit, review, and adjust medical, dental, and flexible spending accounts and Health Reimbursement Account claims.</li>
<li>Review, apply and create refund letters for all lines of business to members and providers.</li>
<li>Reprocess payments when necessary.</li>
<li>Communicate with members, providers, employer group contacts, and other inquirers pertaining to specific refund questions.</li>
<li>Review plan documents for various groups to research and resolve claim processing questions and issues.</li>
<li>Act with urgency to respond to inquiries regarding refund request status-including research and resolution regarding outstanding request.</li>
<li>Perform other related duties, as assigned.</li>
</ul>
Requirements:
<ul>
<li>6 months' experience in healthcare or insurance industry with respect to operations support, including provider maintenance, billing, coding, or customer support.</li>
<li>Experience in health care billing or a background with a health insurance carrier or Third-Party Administrator strongly desired.</li>
<li>Solid time-management skills, with the ability to prioritize multiple tasks, while working with a sense of urgency.</li>
<li>Strong interpersonal skills with excellent verbal and written communication skills.</li>
<li>Basic keyboard and Windows based computer skills required.</li>
<li>Familiarity with Microsoft Excel.</li>
<li>Eager to learn the TPA industry and new concepts and processes.</li>
</ul>
Work Environment &amp; Physical Demands:
<ul>
<li>Hybrid/ remote work availability may be offered based on meeting key performance metrics.</li>
<li>Prolonged periods of sitting may be required.</li>
<li>Regular use of a computer, keyboard, and mouse is necessary; reasonable accommodations will be provided upon request.</li>
<li>Employees should ensure an ergonomically appropriate desk and chair setup.</li>
<li>Comfort with being on camera for virtual meetings (e.g., Microsoft Teams)</li>
</ul>
Benefits:
 
After successfully completing a waiting period, eligible Full-time employees have access to our comprehensive benefits package, including:
<ul>
<li>Fantastic medical, dental, and vision insurance*</li>
<li>Twice annual employer HSA contributions, covering 50% of the HDHP plan's annual deductible!</li>
<li>Company provided Basic Life and AD&amp;D</li>
<li>Company paid Short-Term and Long-Term Disability**</li>
<li>Flexible Spending Accounts*</li>
<li>401(k) Retirement Plan with up to a 6% employer-match** WOW! (100% fully vested after 3 years)</li>
<li>10+ paid holidays</li>
<li>Generous paid vacation and sick time</li>
<li>Annual Volunteer Paid Day</li>
<li>Annual Tuition Reimbursement</li>
<li>Annual Health and Wellness Reimbursement</li>
<li>Lots of fun company events</li>
</ul>
Who We are:
 
As a trusted third-party administrator (TPA) specializing in self-funded benefit plans, Cobalt Benefits Group (CBG) is committed to helping employers find high-quality coverage at a cost they can afford. We administer self-funded insurance benefits through our three companies: EBPA, Blue Benefit Administrators of Massachusetts, and CBA Blue.
 
With over 30 years of experience and a dedicated team of more than 200 employees, we work collaboratively to build customized self-funded health plans, manage claim payments and disputes, and administer other specialized programs such as FSAs, HSAs, COBRA, and retiree billing. Join us as we match employers across our region with the right solutions for their employee benefit needs. To learn more about working at CBG, visit <a href="https://www.cobaltbenefitsgroup.com/careers/" target="_blank">https://www.cobaltbenefitsgroup.com/careers/</a>.
 
Benefit Waiting Period Notes:
 
*60 day waiting period **90 day waiting period
 Equal Opportunity Employer, including disability/protected veterans 
PI277175634

<h3>Job Description</h3>
Job Description
 
 Why do Payment Integrity &amp; Refund Specialists want to work here? The reason people love working for KabaFusion is because of the impact we have on our patients. Here, it doesn’t matter what your role is, you will be part of a team that works collaboratively to change lives. You will go home knowing you’ve made a difference and improved someone’s life.
About us: 
What started as a single pharmacy in 2010 has grown into KabaFusion becoming the largest privately held home infusion company in the country. We have a national network of pharmacies and nursing offices strategically placed to service 40+ states. Couple that with over 30 years of combined experience and it’s no wonder why KabaFusion is the industry leader in home infusion.
About the role:
As a Payment Integrity &amp; Refund Specialist with KabaFusion, you will review claims for accuracy. This will include familiarizing yourself with the various payors we work with; understanding their fee schedules and contract requirements, making claims adjustments when necessary. 
Essential Duties &amp; Responsibilities:
<ul>
<li>Improve the reimbursement process by identifying claims errors and making adjustments as needed prior to submittal</li>
<li>Provide feedback and process improvement recommendations to upper management</li>
<li>Maintain continuous, accurate, and complete documentation</li>
</ul>
As a Payment Integrity &amp; Refund Specialist, you bring:
<ul>
<li>Bachelor’s degree in business administration, Healthcare Administration, or other related fields (preferred)</li>
<li>1+ year of revenue cycle experience in a healthcare setting</li>
<li>1+ year of quality assurance, auditing, compliance, and/or process improvement in a healthcare setting</li>
<li>Intermediate / Advanced Excel skills</li>
<li>Good communication and interpersonal skills</li>
</ul>
Our Benefits:
<ul>
<li>Benefits start on your 1st day of employment.</li>
<li>401k w 4% match – no waiting or vesting period</li>
<li>PTO / Floating Holidays / Paid Holidays</li>
<li>Company paid life insurance and short-term disability</li>
<li>Employee Assistance programs to help with mental health / wellness</li>
<li>Learning &amp; Development Programs</li>
<li>Perks… includes discounts on travel, cell phone, clothing and more…</li>
<li>Generous employee referral program</li>
</ul>
To learn more about KabaFusion, please visit our careers page:<a href="https://www.kabafusion.com/careers/" target="_blank">https://www.kabafusion.com/careers/</a>
KabaFusion is a mission driven company with a focus on innovation and patient care so, as a Pharmacy Technician, if that sounds like something you want to be a part of, then look no further.

Payment Integrity & Refund Specialist

<h3>Job Description</h3>
Job Description
Location: On-Site in Dania, FL
This Role:
As a Refund Specialist at LogixHealth, you will work independently to provide cutting-edge solutions that will directly improve business operations. You’ll contribute to our fast-paced, collaborative environment and will bring your expertise to research, resolve, and respond to all banking and client payment issues.
The ideal candidate will have strong technical skills, excellent interpersonal communication, and a desire to learn.
Key Responsibilities:
<ul>
<li>Print all refund paperwork daily</li>
<li>Review all daily print logs and refunds for accuracy</li>
<li>Approved refunds in the reporting portal</li>
<li>Review/Match all refund checks received</li>
<li>Mail all refund checks</li>
<li>Research/resolve uncashed checks</li>
</ul>
Qualifications:
To perform this job successfully, an individual must be able to perform each Key Responsibility satisfactorily. The following requirements are representative of the knowledge, skills, and/or ability required to perform this job successfully. Reasonable accommodation may be made to enable individuals with disabilities to perform the duties. 
Required:
<ul>
<li>10 key pad oriented</li>
<li>Ability to work independently in a fast-paced environment</li>
<li>Proficiency with MS 365 including Teams, Word, Excel, and Outlook</li>
<li>Excellent written and verbal communication skills</li>
</ul>
Preferred:
<ul>
<li>One to two years related experience</li>
</ul>
Benefits at LogixHealth:
We offer a comprehensive benefits package including health, dental and vision, 401(k), PTO, paid holidays, life and disability insurance, on-site fitness center and company-wide social events.
About LogixHealth:
At LogixHealth we provide expert coding and billing services that allow physicians to focus on providing great clinical care. LogixHealth was founded in the 1990s by physicians to service their own practices and has grown to become the nation’s leading provider of unsurpassed software-enabled revenue cycle management services, offering a complete range of solutions, including coding and claims management and the latest business intelligence reporting dashboards for clients in 40 states.
Since our first day, we have had a clear vision of a better healthcare system and have continually evolved to get there. In addition to providing expert revenue cycle services, we utilize proprietary software to provide valuable financial, clinical, and other data insights that directly improve the quality and efficiency of patient care.
At LogixHealth, we’re committed to Making intelligence matter through our pillars of Physician-Inspired Knowledge, Unrivaled Technology and Impeccable Service.
To learn more about us, visit our website <a href="https://www.logixhealth.com/" target="_blank">https://www.logixhealth.com/</a>.
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qSauqOHxEt

Refund Specialist, Cash Management

<h3>Job Description</h3>
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
\n
The Denials and Refund Management Specialist will be focused on refund requests – you will be reading, interpreting, and analyzing commercial contracts. Once you are able to validate whether or not the request is valid, you will submit the appeal to contest the refund. Once the appeal is granted, you will request a refund from the commercial payors due to the claim having been declined instead of accepted. People who have a very extensive background in interpreting and analyzing commercial contracts will do well in this position.
\n
This position is full-time, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00am – 3:30pm PST. It may be necessary, given the business need, to work occasional overtime. Employees are required to work 1 day onsite and 4 days from home.
\n
We offer 2 weeks of paid training. The hours during training will be 8:00am - 4:30pm PST, Monday - Friday.
\n
If you are within commutable distance to the office at 5003 Commercial Circle, Concord, CA 94520, you will have the flexibility to work from home and the office in this hybrid role* as you take on some tough challenges.
\n\n
Primary Responsibilities:
\n
<ul>\n
<li>Collect and resolve denied payments from insurance companies by contacting assigned payers</li>
\n
<li>Execute the denial appeals process, which includes receiving, assessing, documenting, tracking, responding to, and/or resolving appeals with third-party payers in a timely manner</li>
\n
<li>Research and resolve payer rejected/denied claims and analyze accounts for insurance payment accuracy/completeness and for payer claim processing accuracy per contract. Work with clinical staff as needed to follow-up and appeal denials</li>
\n
<li>Maintain data on the types of claims denied and root causes of denials, and collaborate with team members to make recommendations for improvement and issue resolution</li>
\n
<li>Prepare, maintain, assist with, and submit reports as required</li>
\n
<li>Track and trend recovery efforts by utilizing various departmental tools. Appropriately report on-going problems specific to, health system departments, and/or contracts</li>
\n
<li>Provide feedback and process improvement ideas to management regarding facility, Patient Access, Case Management, HIM, Billing and/or payer issues identified when reviewing accounts for appeal</li>
\n
<li>Draft professional appeal letters in accordance with methodology in departmental policy and procedure including using correct grammar and spelling</li>
\n
<li>Identify contract issues related to denials and communicate those issues to Director of Revenue Integrity</li>
\n
<li>Provide on-going feedback to clinical staff about denial reasons, appeals and their outcomes, and managed care contractual requirements</li>
\n
<li>Transmit required documentation to Government and third-party payers for the purpose of resolving payments.</li>
\n
<li>Ensure all payer contact is fully documented in the appropriate software application</li>
\n
<li>Ensure claims are crossed over to secondary insurances, reporting any delay in unbilled secondary claims to the unit supervisor</li>
\n
<li>Consistently meet the current productivity standards in addressing and resolving denied accounts</li>
\n
<li>Consistently meet the current quality standards in taking appropriate actions to identify and track root causes, successfully appeal denied accounts, and trend issues</li>
\n
<li>Provide individual contribution to the overall team effort of achieving the department AR goal</li>
\n
<li>Identify opportunities for system and process improvement and submit to management</li>
\n
<li>Demonstrate proficient use of systems and execution of processes in all areas of responsibilities</li>
\n
<li>Demonstrate knowledge of John Muir Health System HIPAA privacy standards and ensure compliance with system PHI privacy practices</li>
\n
<li>Follow the Health System’s general Policy and Procedures, the Department’s Policy and Procedures, and the Emergency Preparedness Procedures</li>
\n
<li>Become cross-trained and fill in for other staff as assigned</li>
\n
<li>Follow department guidelines for lunch, breaks, requesting time off, and shift assignments</li>
\n
<li>Operate office equipment and machinery and utilizes ergonomic workstations, equipment, and supplies</li>
\n
<li>Follow JCAHO and outside regulatory agencies’ mandated rules and procedures</li>
\n
<li>Utilize assigned menus and pathways in the hospital mainframe system. Report software application problems to the appropriate supervisor</li>
\n
<li>Utilize assigned menus and pathways in foreign software applications. &nbsp;Report software application problems to the appropriate supervisor</li>
\n
<li>Utilize assigned computer hardware. &nbsp;Report hardware problems to the appropriate supervisor</li>
\n
<li>Participate in the testing for assigned software applications, including verification of field integrity</li>
\n
<li>Perform other duties and responsibilities as assigned</li>
\n
<li>Maintain confidentiality in matters relating to patient/family</li>
\n
<li>Assure patient privacy and confidentiality as appropriate or required</li>
\n
<li>Ensure minors have a parent or guardian listed as guarantor as appropriate</li>
\n
<li>Maintain professional relationships and convey relevant information to other members of the healthcare team within the facility and any applicable referral agencies</li>
\n
<li>Initiate communication with peers about changes and procedures</li>
\n
<li>Relay information appropriately over telephone, email, and other communication devices</li>
\n
<li>Interact with internal customers including HIM, Revenue Integrity, Patient Access, and the SBO in a professional manner to achieve revenue cycle department AR goals and objectives</li>
\n
<li>Assist with special projects as assigned</li>
\n
<li>Work closely with other staff, co-workers, peers, and other members of the healthcare team to ensure a positive and effective work environment</li>
\n
<li>Report to appropriate personnel regarding assignments, projects, etc.</li>
\n
<li>Initiate problem solving and conflict resolution skills to foster effective work relationships with peers</li>
\n
<li>Report to work on time and as scheduled</li>
\n
<li>Attend staff meetings, in-services, and continuing education</li>
\n
<li>Assist in the development of indicators, thresholds, study methods, and data collection as assigned</li>
\n
<li>Respond to problems/opportunities to improve care/customer service</li>
\n
<li>Support involvement in system performance improvement initiatives</li>
\n
<li>Participate in and maintain competencies required for the position and specific unit/area(s) of assignment</li>
\n</ul>
\n\n
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
\n
<ul>\n
<li>High School Diploma / GED</li>
\n
<li>Must be 18 years of age OR older</li>
\n
<li>2+ years of experience with insurance follow-up and/or payment variance review</li>
\n
<li>2+ years EPIC experience</li>
\n
<li>2+ years hospital accounts billing follow up experience – not professional billing</li>
\n
<li>2+ years of experience analyzing commercial contracts including interpreting commercial language</li>
\n
<li>Ability to perform mathematical calculations</li>
\n
<li>Keyboard by touch</li>
\n
<li>Intermediate experience and knowledge Microsoft Office including ability to open, create, save, edit, and send Excel Spreadsheets, Word Documents, and Outlook emails and calendar invites</li>
\n
<li>Must be able to work in the office at least one day a week</li>
\n
<li>Ability to work full-time, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7am – 3:30pm PST. It may be necessary, given the business need, to work occasional overtime</li>
\n</ul>
\n\n
Telecommuting Requirements:
\n
<ul>\n
<li>Reside within commutable distance to the office at 5003 Commercial Circle, Concord, CA 94520</li>
\n
<li>Ability to keep all company sensitive documents secure (if applicable)</li>
\n
<li>Required to have a dedicated work area established that is separated from other living areas and provides information privacy</li>
\n
<li>Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service</li>
\n</ul>
\n\n
Soft Skills:
\n
<ul>\n
<li>Strong organizational and project management skills</li>
\n
<li>Strong presentation skills</li>
\n
<li>Negotiation skills</li>
\n
<li>Leadership skills</li>
\n
<li>Detail-oriented, good organizational skills, and ability to be self-directed</li>
\n
<li>Ability to learn quickly and meet continuous timelines</li>
\n
<li>Strong time management skills, managing multiple priorities and a heavy workload in a high-stress atmosphere</li>
\n
<li>Flexibility to perform other tasks as needed in an active work environment with changing work needs</li>
\n
<li>High-level problem solving, analytical, and investigational skills</li>
\n
<li>Excellent internal/external customer service skills</li>
\n
<li>Excellent communication skills to include oral and written comprehension and expression</li>
\n
<li>Excellent communication skills when dealing with patients, families, public, co-workers, and professional offices</li>
\n
<li>Ability and willingness to exhibit behaviors consistent with principles of excellent service</li>
\n
<li>Ability and willingness to demonstrate and maintain competency as required for job title and the unit/area(s) of assignment</li>
\n
<li>Ability and willingness to exhibit behaviors consistent with standards of performance improvement and organizational values (e.g., efficiency &amp; financial responsibility, safety, partnership &amp; service, teamwork, compassion, integrity, and trust &amp; respect)</li>
\n</ul>
\n\n
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
\n\n
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.00 - $35.72 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
\n\n
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.
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\n

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UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
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UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
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#RPO #RED #RPOLinkedIn

Denials and Refund Management Specialist

<h3>Job Description</h3>
Business Support Specialist
Responsibilities include but are not limited to the following day-to-day general office duties:
· Assists Regional Business Operations Manager in developing, implementing, and executing the business support standardized processes that align with company policies and government compliance.
· Perform timesheet data entry in the Time Entry system. Submit manual overrides to Payroll weekly, as needed. Track vacation, sick, and floating holiday usage.
· Review Kronos Exception Report weekly and correct errors prior to feed into Time Entry.
· Maintain electronic file storage of timesheets on the Area Shared Drive.
· Setup correct prevailing wage rate for SRs and projects in the PWS system weekly.
· Send Certified Payroll Reports and Statements of Compliance to customers weekly, for service. File electronically in the designated compliance portal or with the State weekly, and as required.
· Submit PW restitution requests to designated compliance analyst for processing.
· Manage Accounts Payable invoice queue in Basware Alusta. Coordinate PO receipts, and new or adjusted POs with ICS or PC/PM for timely invoice processing in order to meet established KPIs.
· Review ACE Accrued Receipts report monthly and submit adjustments to Fire Service Manager for approval.
· Perform invoice research of monthly statements received from suppliers, as well as invoices processed against a PO when needed. Respond to invoice and payment inquiries from suppliers.
· Complete and submit manual check requests for immediate payments not processed through Basware Alusta.
· Complete and submit out of cycle payment requests via the EGPR tool.
· Assist local requesters with new supplier setups and manage the process. Perform supplier updates and changes as needed.
· Follow the established process related to refund checks from suppliers or returned/unused checks to ensure funds are returned to the appropriate department or project.
· Act as district contact with the Vendor Master Team, Field Subcontractor Team, PBC Invoice Processing Team, and PBC Payments Team.
· Maintain and replenish office supplies as needed.
· Route incoming calls and distribute incoming mail.
· Perform other duties as directed by RBAM.
Required:
· High School Diploma
· Strong attention to detail and excellent organizational skills.
· Must be proficient in MS Excel and Word.
· Must have the ability to multi-task in a fast paced and deadline driven environment.
· Excellent written and verbal communication skills.
· Ability to prioritize projects and strong problem-solving skills.
· Good research skills and attention to detail.
Preferred:
· 3-5 years experience working in the construction industry.
· 2-year degree, or equivalent combination of education and experience.
· 2+ years experience with California state prevailing wage.
HIRING HOURLY RANGE: $30-45 (Hourly rate to be determined by the education, experience, knowledge, skills, and abilities of the applicant, internal equity, and alignment with market data.) &nbsp;This position includes a competitive benefits package. For details, please visit the About Us tab on the Johnson Controls&nbsp;Careers site at <a href="https://jobs.johnsoncontrols.com/about-us" target="_blank">https://jobs.johnsoncontrols.com/about-us</a>

Fire Business Support Specialist

<h3>Job Description</h3>
Job Description
Insurance Billing Specialist, Onsite
 
We are currently looking for experiences Insurance Billing Specialist!
Must be willing to reasonably commute to Hopedale IL, this is not a remote position. 
 
 
Job Preview
Obtain accurate, ethical, and optimal reimbursement for hospital and hospital-based services, initiate follow-up of past due balances, handle all components of claims processing including management of disputed, rejected, and delayed claims.&nbsp;&nbsp;Develop a thorough understanding of third-party reimbursement requirements. Enter and electronically or hard copy submit billing data, as necessary.&nbsp;&nbsp;Know and understand all policies and procedures of Insurance Billing.&nbsp;&nbsp;Must be a problem solver, have organizational skills, attention to detail, excellent telephone technique and rapport, and computer knowledge.
 
Responsibilities:
1&nbsp;&nbsp;&nbsp;Insurance Claim Billing
<ul>
<li>Reviews patient accounts and verifies data for correct billable services and fees.&nbsp;Ensures all pertinent billing information is documented to produce a clean UB-04 claim.</li>
<li>Runs daily insurance billing reports and reviews discrepancies.&nbsp;&nbsp;Corrects accounts, as necessary.</li>
<li>Generated Medicare, Medicaid, and Commercial Insurance claims via electronic and hard copy processes.</li>
<li>Prior to submission, reviews each claim for accuracy and missing information.&nbsp;&nbsp;Transmits claims electronically to TruBridge.</li>
</ul>
2&nbsp;&nbsp;&nbsp;&nbsp;Insurance Claim Follow up
<ul>
<li>Follow up on any unpaid claim.</li>
<li>Follow-up on insurance denials and takes appropriate steps to resolve discrepancies.&nbsp;&nbsp;&nbsp;</li>
<li>Communicates discrepancies and the need for additional information to the appropriate parties.&nbsp;&nbsp;Obtain supporting documentation to appeal claim payment.</li>
<li>&nbsp;All collection and follow-up efforts will be annotated in the CPSI computer System.</li>
<li>&nbsp;Re-bill accounts as needed.</li>
</ul>
3&nbsp;&nbsp;&nbsp;Ensure accurate Insurance Payments are received
<ul>
<li>Receive daily incoming payments and prepare for posting. Review explanation of benefits and verify patient information, payer, and date of service for all transactions.</li>
<li>Audit payments against contract terms.</li>
<li>Compute contractual allowances as needed.</li>
<li>Non-collectible accounts will be forwarded to the Revenue Cycle Director as soon it is determined they are non-collectible with supporting documentation to be written off.</li>
<li>Assists patients and insurance companies with questions regarding billing procedures, charges, insurance reimbursement, copies of itemized statements, split billings, payments in office, etc.</li>
</ul>
4 Accounts Receivable Management
<ul>
<li>Monitor and maintain assigned Accounts Receivable at minimal levels.</li>
<li>All assigned accounts are regularly worked and followed up on.</li>
<li>Ensure any credit balances are resolved and generate refund requests for over payment as soon as possible.</li>
</ul>

5 Other Duties as Assigned
<ul>
<li>Keep updated on all third-party billing requirements.&nbsp;Serves as a resource person for staff inquiries regarding billing issues.</li>
<li>Assists with training of staff as necessary.</li>
<li>Other duties as assigned.</li>
</ul>
 
Knowledge/Skill/Ability Requirements:
<ul>
<li>Minimum of High School Diploma.&nbsp;&nbsp;Some college preferred.</li>
<li>Knowledge of Medicare Part A, Medicaid, and Insurance Procedures.</li>
<li>Knowledge of medical billing /collection procedures.</li>
<li>Prefer 1-2 years in medical business office including Insurance Claim follow up.</li>
<li>Demonstrated working knowledge of a computerized medical information management system.</li>
<li>Skills in Microsoft Office Suite (Word, Excel, Outlook).</li>
<li>Good verbal and written communication skills required.</li>
<li>Ability to work independently with only general supervision.</li>
<li>Great attention to detail required along with a high level of dependability.</li>
<li>Excellent telephone techniques and rapport.</li>
<li>Ability to effectively communicate and interact with colleagues, hospital staff, patients, physicians and their staff, and third-party insurance personnel.</li>
</ul>
 
Compensation details: 25-27 Hourly Wage
 
PI0eee1465566a-25405-38471877

Insurance Billing Specialist, Onsite

<h3>Job Description</h3>
Job Description
Experienced Accounts Receivable Specialist - Join a Growing Surgical Practice!
Job Title: Accounts Receivable (A/R) Representative - Surgical Practice Hiring Agency: Medix Location: White Plains / West Harrison, NY Area Schedule: Monday - Friday | 9:00 AM - 5:00 PM | 35-hour workweek Pay Rate: $28.00 - $36.00 per hour (DOE)
Job Description:
Medix is partnering with a well-established, multi-specialty private surgical practice in the White Plains/West Harrison area that is expanding and seeking a detail-oriented Accounts Receivable (A/R) Representative to join their growing Revenue Cycle team.
This is a fantastic opportunity to become part of a collaborative, forward-thinking environment. The ideal candidate will bring a strong foundation in claims follow-up, denial management, and appeals. Candidates with specialized experience in surgical billing, complex denials, and federal No Surprises Act (NSA) compliance are encouraged to apply.
Key Responsibilities:
<ul>
<li>
Perform follow-up on out-of-network surgical and E&amp;M claims
</li>
<li>
Analyze EOBs including co-pays, deductibles, coinsurance, contractual adjustments, and denials
</li>
<li>
Initiate claim status checks and follow-ups via phone or insurance portals
</li>
<li>
Draft and submit reconsiderations and appeals for denied claims
</li>
<li>
Handle patient inquiries regarding billing issues and account balances
</li>
<li>
Collaborate with internal teams and leadership on A/R strategy and issues
</li>
<li>
Ensure accurate documentation in EMR and billing systems
</li>
<li>
Conduct insurance verifications and review/respond to refund requests
</li>
<li>
Comply with HIPAA and all relevant federal and state laws
</li>
</ul>
Requirements:
<ul>
<li>
Proficiency with Microsoft Office Suite (Outlook, Word, Excel, SharePoint)
</li>
<li>
Strong written and verbal communication skills
</li>
<li>
Ability to read and interpret EOBs, denial codes, and insurance policies
</li>
<li>
Familiarity with CPT/ICD-10 codes and medical billing terminology
</li>
<li>
Knowledge of fee schedules and Usual &amp; Customary Guidelines
</li>
<li>
Strong attention to detail and organizational skills
</li>
<li>
Experience with EMR systems (ModMed preferred)
</li>
<li>
High level of professionalism and customer service skills
</li>
<li>
Must be a quick learner, self-motivated, and able to multitask in a fast-paced environment
</li>
</ul>
Preferred Qualifications (Nice to Have):
<ul>
<li>
Experience working with the Federal No Surprises Act and IDR submissions
</li>
<li>
Prior experience in surgical claims billing and complex appeals
</li>
<li>
Strong understanding of insurance recoupments and contractual obligations
</li>
</ul>
Apply today through Medix to join a supportive and mission-driven team making a difference in surgical care billing!
For California Applicants:
We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).
This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.
Company DescriptionHere at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine. Our commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us? 
<h3>Company Description</h3>
Here at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine.\r\n\r\nOur commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?

AR Representative

<h3>Job Description</h3>
Job Description Description:
Summary &amp; Objective
The Manager, Facility Fiscal Services is responsible for the overall organization and coordination of the financial services at the facility level. Integrates the policies set by the Centralized Business Office and adapts it to pricing, admissions and discharges. The position entails a broad range of reporting and support to the CBO on, the pre-billing and billing cycles, in the audit and appeal processes, in coordination with the admissions office, case management, and health information management departments. Responsible of the charitable care assistance process at the facility level.
Essential Functions
<ul>
<li>Maintains control of all cash and cash receipts, including the Resident Trust Fund, indigent fund, petty cash and determines the surety bond amount. Oversees and manages the private pay patient financial services functions, including billing, collection, cash receipts, and customer service. (If applicable)</li>
<li>Make decisions and finalize the process of making the facility become the resident's representative payee (Social Security). (If applicable)</li>
<li>Independently manages the enrollment and updated enrollment of all long term care residents in their Medicaid managed care plans. Ensure annual eligibility for all long term care residents and independently facilitate with resident and residents family that eligibility is current. ( if applicable)</li>
<li>Participates in daily, weekly and/or monthly management team meetings to discuss patients and/or resident's status, financial obligation, census changes, or patient and/or resident's complaints or concerns.</li>
<li>Prepares and/or assists in the completion of third party payer appeals process to facilitate payment for clinical denials in collaboration with the Director, Executive / Administrator and Corporate Business Office.</li>
<li>Ensure proper coding of all receipts to the appropriate accounts</li>
<li>Implement controls to ensure appropriate submission, billing and payment cycles by coordinating information flow (receipt of charges, invoices, checks, etc.) between CHS and facility via use of courier service, email, scanning, faxing, etc.</li>
<li>Prepare and delivery bank deposits, ensuring that all receipts are deposited to the appropriate bank account as necessary</li>
<li>Balance out cash received against receipts and submit control totals to CBO/ controller for reconciliation purposes.</li>
<li>Responsible for the financial updates and changes reported on UR weekly meeting as well as in the interdisciplinary team conferences.</li>
<li>Resolve internal and external customer financial issues in a timely manner using common sense and judgment</li>
<li>Responsible for collection activity for all in-house private pay accounts.</li>
<li>Process and verify designated ancillary charges on a monthly basis if applicable.</li>
<li>Facilitates the billing process by assisting CBO with pertinent detailed information</li>
<li>Verifies insurance coverage on a monthly basis to determine whether patient insurance is currently active.</li>
<li>Keep abreast of the Patient Trust Fund and Social Security/Pension Income if applicable</li>
<li>Review and control the cash collected directly from patients and/or residents. In addition, submit all refund requests to CBO for processing.</li>
<li>Liaison between the facility and charitable fundraisers with CBO</li>
<li>Oversee accounts payable submission to CHS if applicable.</li>
<li>Coordinate with CHS on distribution of accounts payable checks if applicable.</li>
<li>Plans, organizes, implements, directs, evaluates and controls the overall operation of the Business Office.</li>
<li>Meets with Administrator to discuss escalated matters, obtain direction and set time frames for planned activities.</li>
</ul>
*Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position.
Other Duties
<ul>
<li>Prepares and reviews financial assistance application to deem eligibility with Director, Executive / Administrator for submission to CBO.</li>
<li>Reviews and distributes mail received to facility in collaboration with Administration if applicable.</li>
<li>Maintain/scan patient and/or resident financial documents/recording into storage software and paper filing systems if applicable.</li>
<li>Maintain Medicaid resident files and update billing software as necessary.</li>
<li>Implement and control pre-billing audit in billing software.</li>
<li>Review month end closing to ensure census accuracy and submit to CBO.</li>
<li>Hold and document valuables in facility safe.</li>
<li>Coordinate with Social Service and Medicaid Specialist on all Medicaid pending cases.</li>
<li>Communicates with patient and/or responsible party on patient responsibility in event of appeal loss.</li>
<li>Promotes positive employee engagement, teamwork, and mutual respect and safety work practices.</li>
<li>Maintain mandatory skill updates</li>
<li>Comply with all policies, local, state and federal laws and regulations.</li>
<li>Perform other duties as assigned</li>
</ul>
Supervisory Responsibility
<ul>
<li>May serve as an interim department leader depending on need</li>
</ul>
Physical Requirements
<ul>
<li>Must be able to lift and/or move up to 50 pounds and push/pull up to 250+ pounds, walk, climb stair or ladders, stand on feet for extended periods of time, etc.</li>
</ul>
Disclaimer
The job description is not designed to cover or contain a comprehensive listing of activities duties or responsibilities that are required of the employee. Other duties, responsibilities and activities may change or be assigned at any time.
EEOC Statement
CHS provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
 
PM19
Requirements:
Knowledge &amp; Experience Requirements
<ul>
<li>Bachelor's Degree (B.A.) and /or 3-5 years related experience and training in bookkeeping or accounting practices.</li>
<li>2-3 years of experience in a Health Care Facility preferred</li>
<li>Must have knowledge of computer office/billing software</li>
<li>Must be able to read, write and understand the English language</li>
</ul>
 
PI6b63e6488fa6-25405-38549630

206 refund-specialist Jobs