Job Closed

This listing is no longer active.

Enrollment and Billing Specialist

Location

United States

Posted

105 days ago

Salary

0

No structured requirement data.

Job Description

Enrollment and Billing Specialist

TML Multistate Intergovernmental Employee Benefits Pool d b a TML Health Benefits Pool

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description Performs moderately advanced benefits program administration and member assistance work. Work involves determining benefits eligibility, processing applications for benefits, and providing guidance to Benefit Coordinators with benefits eligibility inquiries. - Answers incoming inquiries (e.g. phone calls, emails, etc.) from Benefit and Billing Coordinators regarding benefit administration, eligibility, billing, and any other questions regarding employee benefits. - Contacts benefit coordinators to resolve potential issues that have been identified internally. - Clearly documents case activities, outcomes, and feedback received by members. - Proactively handles own caseload and shared work queues to ensure timely resolution of escalated issues while meeting service levels and quality standards. - Processes changes to employee and dependent TXHB offered benefits, demographics, and beneficiary information. - Builds effective working relationships with Benefit Coordinators and others at assigned groups. - Serves as a resource for Benefit Coordinators, guiding and mentoring them regarding TXHB benefit administration processes, policies, and procedures. - Conducts basic data reviews of cases and inquiries to identify recurring issues, knowledge gaps, or process breakdowns and recommends potential solutions to leadership. - Proactively identifies and reaches out to Benefit Coordinators to discuss ongoing benefits or eligibility trends related to individual group benefit administration challenges. - Collaborates with other internal teams and external vendors to resolve eligibility and billing questions or issues. - Provides direction to peers by assisting with trainings as directed by Supervisor. - Participates on cross‑functional project teams focused on implementing new clients, systems, or benefit programs by representing the advocate perspective and validating processes. - May review and provide feedback on AI-generated responses provided to group contacts. - May serve as a backup for cross‑departmental work, including supporting special projects, documenting and testing new or updated processes, assisting with trainings, and contributing to operational readiness activities during peak periods or program changes. Qualifications - 1-2 years of work experience in a related field such as Human Resources or health insurance - Graduation from an accredited four-year college or university with major coursework in business administration, insurance, or a related field is preferred. - Experience working in a service-oriented position, where customer satisfaction is a key performance indicator is preferred. Requirements - Strong knowledge of eligibility requirements including Section 125 and COBRA rules. - Strong knowledge of MS Office and billing and enrollment software. - Strong problem-solving and research skills. - Ability to effectively communicate complex benefits administration subjects both verbally and in writing. - Effective time management, organization, and prioritization skills. - Advanced knowledge of TXHB products, benefit terminology, benefits design, and eligibility rules. - Ability to work in a team environment and perform multi-task job functions. - Strong service-oriented communication skills, including the ability to empathize with others and diffuse tense situations when needed. - Ability to convey a professional manner in dealing with others and maintain constructive working relationships. - Self-motivated to fulfill tasks, resolve issues promptly, and meet deadlines. - Ability to effectively work within rapidly changing circumstances as needed. Physical Demands - Ability to speak/hear clearly to communicate by phone or in person. - Ability to frequently stand, sit and walk. - Ability to frequently lift and/or move up to 15 pounds. - Prolonged periods of sitting at a desk and working on a computer. Flexible Work Arrangements - 100% Remote (MON- FRI) Work Schedule - 8:00 AM - 5:00 PM (MON- FRI)

Job Requirements

  • 1-2 years of work experience in a related field such as Human Resources or health insurance
  • Graduation from an accredited four-year college or university with major coursework in business administration, insurance, or a related field is preferred.
  • Experience working in a service-oriented position, where customer satisfaction is a key performance indicator is preferred.
  • Strong knowledge of eligibility requirements including Section 125 and COBRA rules.
  • Strong knowledge of MS Office and billing and enrollment software.
  • Strong problem-solving and research skills.
  • Ability to effectively communicate complex benefits administration subjects both verbally and in writing.
  • Effective time management, organization, and prioritization skills.
  • Advanced knowledge of TXHB products, benefit terminology, benefits design, and eligibility rules.
  • Ability to work in a team environment and perform multi-task job functions.
  • Strong service-oriented communication skills, including the ability to empathize with others and diffuse tense situations when needed.
  • Ability to convey a professional manner in dealing with others and maintain constructive working relationships.
  • Self-motivated to fulfill tasks, resolve issues promptly, and meet deadlines.
  • Ability to effectively work within rapidly changing circumstances as needed.
  • Physical Demands
  • Ability to speak/hear clearly to communicate by phone or in person.
  • Ability to frequently stand, sit and walk.
  • Ability to frequently lift and/or move up to 15 pounds.
  • Prolonged periods of sitting at a desk and working on a computer.
  • Flexible Work Arrangements
  • 100% Remote (MON- FRI)
  • Work Schedule
  • 8:00 AM - 5:00 PM (MON- FRI)

Related Categories

Related Job Pages

More Billing Specialist Jobs

ProMedica logo

Supervisor Central Billing - Remote

ProMedica

ProMedica is a mission-driven, not-for-profit health care organization headquartered in Toledo, Ohio. It serves communities across nine states and provides a range of services, including acute and ambulatory care, a dental plan, and academic business lines. ProMedica owns and operates 10 hospitals and has an affiliated interest in one additional hospital. The organization employs over 1,300 health care providers through ProMedica Physicians and has more than 2,300 physicians and advanced practice providers with privileges. Committed to its mission of improving health and well-being, ProMedica has received national recognition for its clinical excellence and its initiatives to address social determinants of health. For more information about ProMedica, please visit promedica.org/aboutus .

Billing Specialist105 days ago
OtherRemoteTeam 10,001+Since 1986H1B Sponsor

Location: Remote - MichicanDepartment: PPG CBOWeekly Hours: 40Status: Full timeShift: Days (United States of America) Job Summary: As the Central Business Office (CBO) Ambulatory Supervisor, you oversee and ensure timely and accurate resolution to outstanding accounts receivable, while maintaining the highest level of patient, physician, and employee satisfaction. You manage daily operations of your assigned CBO department and practice management system processes and files. The above summary is intended to describe the general nature and level of work performed in this role. It should not be considered exhaustive. REQUIREMENTS - High school diploma or equivalent - 3 years of experience in a professional or physician office - 2 years of experience specific to credentialing and/or billing office leadership Salary Range - $37,440 - $81,640 We offer a competitive benefits package with coverage effective day one of employment which includes medical, dental, vision, company paid life insurance, paid time off, a 401k retirement plan, an employee assistance program and other voluntary coverage options and employee discounts. ProMedica is a mission-driven, not-for-profit health care organization headquartered in Toledo, Ohio. It serves communities across nine states and provides a range of services, including acute and ambulatory care, a dental plan, and academic business lines. ProMedica owns and operates 10 hospitals and has an affiliated interest in one additional hospital. The organization employs over 1,300 health care providers through ProMedica Physicians and has more than 2,300 physicians and advanced practice providers with privileges. Committed to its mission of improving health and well-being, ProMedica has received national recognition for its clinical excellence and its initiatives to address social determinants of health. For more information about ProMedica, please visit promedica.org/aboutus. Benefits: We provide flexible benefits that include compensation and programs to help you take care of your family, your finances and your personal well-being. It’s what makes us one of the best places to work, and helps our employees live and work to their fullest potential. Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex/gender (including pregnancy), sexual orientation, gender identity or gender expression, age, physical or mental disability, military or protected veteran status, citizenship, familial or marital status, genetics, or any other legally protected category. In compliance with the Americans with Disabilities Act Amendment Act (ADAAA), if you have a disability and would like to request an accommodation in order to apply for a job with ProMedica, please contact employment@promedica.org Equal Opportunity Employer/Drug-Free Workplace

United States
$37.4K - $81.6K / year
Job Closed
Eye Care Partners Career Opportunities logo

Provider Enrollment Specialist

Eye Care Partners Career Opportunities

EyeCare Partners is the nation’s leading provider of clinically integrated eye care. Our national network of over 300 ophthalmologists and 700 optometrists provides a lifetime of care to our patients with a mission to enhance vision, advance eye care and improve lives. Based in St. Louis, Missouri, over 650 ECP-affiliated practice locations provide care in 18 states and 80 markets, providing services that span the eye care continuum.

Billing Specialist105 days ago
OtherRemoteTeam 5,001-10,000

EyeCare Partners is the nation’s leading provider of clinically integrated eye care. Our national network of over 300 ophthalmologists and 700 optometrists provides a lifetime of care to our patients with a mission to enhance vision, advance eye care and improve lives. Based in St. Louis, Missouri, over 650 ECP-affiliated practice locations provide care in 18 states and 80 markets, providing services that span the eye care continuum. For more information, visit www.eyecare-partners.com. Job Title: Provider Enrollment Specialist MUST LIVE IN ONE OF OUR 18 States: Missouri, Florida, Kansas, Kentucky, Pennsylvania, Virginia, New Jersey, Texas, Minnesota, Michigan, Oklahoma, Alabama, North Carolina, Georgia, Illinois, Ohio, Indiana, Arizona Pay: $25.00/hr; No Negotiation Job Summary Our growing eye care organization has an immediate need for an experienced Provider Enrollment Specialist who is familiar with provider data management and credentialing. A successful individual in this role will manage multiple enrollments and priorities while providing support to the Supervisor of Provider Enrollment. Duties and Responsibilities - Enroll providers with payers by providing information to the payers as applicable. This includes Medicare, Medicaid, commercial plans, and MCOs. - Complete required documentation and applications for credentialing, recredentialing and privileging providers at assigned hospitals/ facilities. - Serve as the first point of contact for internal office and provider requests.   - Maintain a database for provider credentialing and update the applicable software/ systems as needed to ensure all provider enrollment data is up-to-date and current.  - Keep CAQH updated with accurate and current information.  - Keep NPPES updated with accurate and current information.  - Maintain constant contact with insurance payer representatives.  - Communicate effectively any enrollment updates and issues to leadership.  - Follow up with payers on outstanding enrollments on a weekly basis.  - Maintain all demographic changes for all providers. - Maintain all hospital appointments and re-appointments. - Maintain and renew provider expirables (medical license, DEAs, board certification, malpractice insurance, etc.). Education: High School Diploma or GED Required Experience Requirements - 2+ years of related experience or training, equivalent combination of education and experience will be considered Knowledge, Skills and Abilities Requirements - Professional in appearance and actions - Logical and Critical thinking skills for problem solving and analysis. - In-depth knowledge of performance metrics - Customer-focused with excellent written, listening and verbal communication skills - Ability to maintain control of a call de-escalating issues and instilling confidence that a resolution will be found - Ability to function effectively under stress of conflicting demands on time and attention, while successfully meeting deadlines - Enjoys learning new technologies and systems • Detail oriented, professional attitude, reliable - Exhibits a positive attitude and is flexible in accepting work assignments and priorities - Meets attendance and tardiness expectations, ability to work overtime, if required. - Management and organizational skills to support the leadership of this function - Ability to follow or provide verbal & written instructions with sufficient grammar and spelling skills to avoid mistakes or misinterpretations - Interpersonal skills to support customer service, functional, and teammate support need - Able to communicate effectively in English, both verbally and in writing - Ability for basic to intermediate problem solving, including mathematics - Intermediate computer operation - Proficiency with Microsoft Excel, Word, PowerPoint and Outlook - Specialty knowledge of systems relating to job function - Knowledge of state and federal regulations for this position; general understanding of HIPAA guidelines Other Skills and Ability - Proficient computer skills, particularly in Microsoft - Good understanding of insurance payers and enrollment methods.  - Ability to diagnose and resolve basic enrollment issues - Excellent organizational skills - Desire to gain industry knowledge and training - Demonstrates initiative in accomplishing goals - Ability to grow, adapt, and accept change - Consistently creating a positive work environment by being team-oriented - Excellent verbal, written, and social skills.  - Ability to work overtime if/when needed Location: Work takes place in a remote work environment. Travel to other locations may be necessary to fulfill the essential duties and responsibilities of the job. Thus, those needing to travel for work must have access to dependable transportation, and their driving record must meet company liability carrier standards. Please do not contact the office directly – only resumes submitted through this website will be considered. If you need assistance with this application, please contact (636) 227-2600 EyeCare Partners is an equal opportunity/affirmative action employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status. Job descriptions are intended to be accurate reflections of those principal job elements essential for making fair pay decisions about jobs. Nothing in this job description restricts management right to assign or reassign duties and responsibilities to this job at any time.

United States
Job Closed

Seasonal Tax Associate Needed! This Jobot Consulting Job is hosted by: Shane Bennett Are you a fit? Easy Apply now by clicking the "Apply" button and sending us your resume. Salary: $25 - $35 per hour A bit about us: We are a full-service CPA firm dedicated to providing accounting, tax, audit, and advisory services to individuals and businesses across a wide range of industries. Our team takes pride in delivering accurate, timely, and personalized solutions that help clients achieve financial clarity and long-term success. With a commitment to professionalism, integrity, and client care, we strive to be trusted advisors who add value beyond the numbers. Why join us? - Opportunity to work on diverse client engagements across multiple industries - Supportive team culture with mentorship and professional development resources - Commitment to work–life balance and employee well-being - Career growth potential within a trusted and respected CPA firm Job Details Job Details: Get ready to take your career to new heights! We are currently seeking a dynamic and experienced Seasonal Tax Associate to join our Accounting and Finance team. This role requires a professional who is passionate about tax consulting and possesses a deep knowledge of income tax, corporate tax returns, and S Corp. You will have the opportunity to work on a variety of tax projects and contribute to the success of our clients. This position is seasonal and will provide the right candidate with an opportunity to work in a challenging and fast-paced environment. Responsibilities: As a Seasonal Tax Associate, your primary responsibilities will include: 1. Preparing and reviewing federal and state income tax returns for individuals, corporations, partnerships, and trusts. 2. Providing tax consulting services to clients, including research and planning. 3. Assisting clients with tax compliance and planning, including the calculation of estimated tax payments and the preparation of tax projections. 4. Providing assistance during tax audits and responding to tax notices. 5. Keeping up to date with the latest tax laws and regulations to ensure our clients are in compliance. 6. Collaborating with team members to provide high-quality tax services. 7. Identifying opportunities to improve client tax processes and procedures. Qualifications: The successful candidate must possess the following qualifications: 1. Bachelor's degree in Accounting, Finance, or related field. 2. Minimum 5 years of experience in public accounting or tax consulting. 3. Extensive knowledge of income tax, corporate tax returns, and S Corp. 4. Certified Public Accountant (CPA) or Enrolled Agent (EA) designation is preferred. 5. Proficiency in tax software and Microsoft Office Suite. 6. Excellent analytical, problem-solving, and project management skills. 7. Strong written and verbal communication skills. 8. Ability to work independently and as part of a team. 9. High attention to detail and accuracy. 10. Ability to handle multiple tasks and meet strict deadlines. This exciting role offers an opportunity to work with a team of experienced professionals in the Accounting and Finance industry. If you are a seasoned tax professional with a passion for client service, we would love to hear from you. Apply today and take the next step in your career! Interested in hearing more? Easy Apply now by clicking the "Apply" button. Jobot is an Equal Opportunity Employer. We provide an inclusive work environment that celebrates diversity and all qualified candidates receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, age (40 and over), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. Jobot also prohibits harassment of applicants or employees based on any of these protected categories. It is Jobot’s policy to comply with all applicable federal, state and local laws respecting consideration of unemployment status in making hiring decisions. Sometimes Jobot is required to perform background checks with your authorization. Jobot will consider qualified candidates with criminal histories in a manner consistent with any applicable federal, state, or local law regarding criminal backgrounds, including but not limited to the Los Angeles Fair Chance Initiative for Hiring and the San Francisco Fair Chance Ordinance. Information collected and processed as part of your Jobot candidate profile, and any job applications, resumes, or other information you choose to submit is subject to Jobot's Privacy Policy, as well as the Jobot California Worker Privacy Notice and Jobot Notice Regarding Automated Employment Decision Tools which are available at jobot.com/legal. By applying for this job, you agree to receive calls, AI-generated calls, text messages, or emails from Jobot, and/or its agents and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy here: jobot.com/privacy-policy

United States
Job Closed
Centene Corporation logo

Authorization Specialist II

Centene Corporation

Transforming the health of the communities we serve, one person at a time.

Billing Specialist105 days ago
OtherRemoteTeam 10,001+Since 1984H1B No Sponsor

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Acts as a resource and supports the prior authorization request process to ensure that all authorization requests are addressed properly in the contractual timeline. Supports utilization management team to document authorization requests and obtain accurate and timely documentation for services related to the members healthcare eligibility and access. - Aids the utilization management team and maintains ongoing tracking and appropriate documentation on authorizations and referrals in accordance with policies and guidelines - Supports the authorization review process by researching and documenting necessary medical information such as history, diagnosis, and prognosis based on the referral to the clinical reviewer for determination - Verifies member insurance coverage and/or service/benefit eligibility via system tools and aligns authorization with the guidelines to ensure a timely adjudication for payment - Performs data entry to maintain and update various authorization requests into utilization management system - Supports and processes authorization requests for services in accordance with the insurance prior authorization list and routes to the appropriate clinical reviewer - Remains up-to-date on healthcare, authorization processes, policies and procedures - Performs other duties as assigned - Complies with all policies and standards Education/Experience: Requires a High School diploma or GED Requires 1 – 2 years of related experience Knowledge of medical terminology and insurance preferred. Pay Range: $17.84 - $28.02 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

United States
$18 - $28 / hour
Job Closed