Description Medical Billing Specialist Remote About KeyBridge KeyBridge Medical Revenue Care is an 18-time Best Places to Work award winner known for its culture of compassion, integrity, and excellence. The company’s mission is to bridge the gap between healthcare providers and patients by delivering empathetic financial care and exceptional service in a call center setting. Rather than simply processing medical bills, KeyBridge focuses on turning confusion into clarity, denials into dollars, and data into done—helping clients and patients navigate the complex world of healthcare billing. Medical Billing Specialist As a Medical Billing Specialist, you’ll serve as a critical link between patients, providers, and payors. The role combines investigative problem-solving with customer service and data accuracy to ensure insurance claims are processed, paid, and documented correctly. What You’ll Do: - Be a Billing Detective: Analyze denials, investigate claim issues, and resolve discrepancies to secure payments. - Collaborate Like a Champ: Work closely with clients, teammates, and insurance representatives to maintain smooth project workflows. - Build Relationships: Represent KeyBridge with professionalism and empathy—maintaining positive, trust-based relationships with clients and colleagues. Requirements Essential Job Functions Interpersonal Responsibilities - Maintain professionalism, accuracy, and timeliness in all tasks. - Demonstrate strong communication, organization, and computer skills (Microsoft Office proficiency required). - Uphold KeyBridge’s reputation through positive, ethical interactions. Operational Responsibilities - Utilize billing systems and payor platforms (e.g., Availity, Navinet, MITS, Quadax). - Research and resolve insurance denials and credits. - Submit and track claims, follow up on rejections or appeals, and document all actions in internal systems. - Collaborate with clients and internal teams to achieve productivity and quality goals. - Contribute to the company’s mission and embody its Core Values daily. In Short: This role is perfect for someone who’s detail-oriented, analytical, and people-focused—someone who enjoys both problem-solving and teamwork, and who wants to make a meaningful impact in the healthcare revenue cycle field.

Job Description​ Saint Luke’s in Kansas City is seeking a Patient Accounts Representative to join our team. You will perform a variety of functions related to managing accounts, customer service, and troubleshooting while following established processes and policies for billing and reimbursement. This position is a call center environment, working remotely in the Kansas City area. Shift Details: Monday- Friday 9:00am-5:30pm Responsibilities: - Responsible for answering inbound patient calls - Answer patient emails in Electronic Medical Record system - Making outbound collection calls to patients to obtain information needed to collect payment - Provide price estimates for patients - Process credit card payments - Establish payment plans with patients and complete referral to extended payment plan vendor when applicable - Identify patients needing financial assistance, explain financial assistance process and additional documents needed - Research and troubleshoot issues related to patient balances - Serve as liaison between patient and other departments as needed - Process incoming mail and faxes - Process accounts within a work queue in the Electronic Medical Record system and take action as appropriate - In SBO will also: - Perform straightforward coding (i.e. Review patient charts for billing implications or referrals) - Meet department productivity and quality metric - Identify opportunities and report trends to improve patient satisfaction and workflow efficiencies by identifying reasons for patient calls that could have been prevented by education up stream in the process or practice management programming solutions. Examples of this would be educating patients on financial policies, financial expectations of services rendered, correct coding, explanation of coverage, collecting payments when scheduling, system enhancements to identify the correct insurance at registration, correct payment posting, medical necessity warnings. We are looking for someone with excellent customer service skills. The ideal candidate has strong computer and critical thinking skills and can multitask. Comfortable working in a call center environment. Why Saint Luke’s? We believe in creating a collaborative environment, while looking for innovative ways to improve. We offer competitive salaries and benefits packages to all eligible employees: - Medical health plans - Tuition reimbursement - Paid time off - Retirement contributions - Employee Assistance Program Job Requirements Applicable Experience: 1 year Diploma Job Details Full Time Day (United States of America) The best place to get care. The best place to give care. Saint Luke’s 12,000 employees strive toward that vision every day. Our employees are proud to work for the only faith-based, nonprofit, locally owned health system in Kansas City. Joining Saint Luke’s means joining a team of exceptional professionals who strive for excellence in patient care. Do the best work of your career within a highly diverse and inclusive workspace where all voices matter. Join the Kansas City region's premiere provider of health services. Equal Opportunity Employer.

Description ABOUT VISANTE We are relentless in solving the most complex challenges in health system pharmacy—designing pharmacy footprints that meet our clients where they are today and position them to win tomorrow. Our work delivers measurable financial gains, operational excellence, and an elevated patient experience. We set ambitious goals, move with urgency, and create extraordinary value. Obsessed with client impact, we thrive in a collaborative, innovative culture where deep expertise turns insight into action. We’re proud of the results we deliver and the trust we earn—fueling sustained growth and exceptional client satisfaction. Our mission is to transform healthcare through pharmacy, and our vision is to reimagine pharmacy to improve lives. ABOUT THE POSITION (Remote) The Medication Access Specialist plays a vital role in Visante’s managed services team, working under the leadership team to streamline insurance processes, enhance medication access, and reduce financial burdens for patients. Acting as a liaison among pharmacies, clinic staff, and insurance providers, the specialist optimizes treatment initiation and improves patient satisfaction by handling medication authorizations, conducting benefits investigations, and identifying assistance programs. They gather prior authorization details, support coverage denial appeals, and communicate medication options and financial resources to patients while monitoring insurance status and reporting access issues to the treatment team. Emphasizing collaboration and efficiency, this position contributes to Visante’s mission of ensuring patients receive the medications they need. Principal Duties and Responsibilities - Review and process medication authorizations submitted by the client. - Conduct benefits investigations to determine patient coverage, out-of-pocket costs, and available financial assistance. - Identify and recommend patient assistance programs, copay cards, grants, or funds to reduce financial burdens. - Gather and review necessary documentation for prior authorization submissions, assisting clinics with appeals for coverage denials. - Communicate directly with clinics to obtain additional details and guidance on authorization processes. - Inform patients about medication coverage and financial assistance options, providing pharmacy recommendations. - Ensure accurate documentation in client EMR systems and Visante tracking tools for workflow efficiency. - Assist with onboarding and training of client-employed medication access specialists and contribute to process improvements. - Collaborate with Visante team members and leadership to enhance operational effectiveness and implement recommended improvements. - Support efforts to refine clinical and pharmacy workflows, strengthening communication between staff and patients. Requirements Education Required: High school diploma or equivalent Experience Required: 3 years of experience working within healthcare or with pharmacy providers on medication access Preferred: Previous consulting and/or client-facing experience; Experience with electronic medical record documentation and prior authorization workflows; Experience with performing retail pharmacy PBM adjudication; Experience in utilizing CoverMyMeds® to submit prior authorizations; Two (2) years of experience in healthcare revenue cycle that includes medication authorizations; Knowledge of CPT and ICD coding is highly desired; Knowledge of Medicare and third-party payer regulations and guidelines is highly desired; Two (2) years of experience in preadmission/precertification Licensure Required: State Board of Pharmacy Technician registration obtained within 6 months of hire Preferred: Active CPhT certification through either PTCB or NHA Skills and Abilities - Demonstrate strong judgment and decision-making, effectively managing competing demands while prioritizing tasks and meeting deadlines with urgency. - Cultivates strong client relationships, exhibiting excellent interpersonal and team collaboration skills while communicating professionally and concisely in both verbal and written forms. - Possesses extensive expertise in medication reimbursement, prior authorization, and healthcare coding, utilizing analytical and creative problem-solving abilities to diagnose and resolve issues. - Maintains confidentiality and ensures accuracy, leveraging proficiency in Office Suite (Word, Excel, PowerPoint) to analyze and disseminate critical information effectively. Compensation and Benefits: We offer competitive salary and benefits for this full-time salaried role. Equal Opportunity Statement: Visante is an equal opportunity employer. Visante’s people are its greatest asset and provide the resources that have made the company what it is today. Visante is, therefore, committed to maintaining an environment free of discrimination, harassment, and violence. This means there can be no deference because of age, religion or creed, gender, gender identity or expression, race, color, sexual orientation, national origin, disability, veteran status, or any other characteristic protected by applicable laws and regulations

Job Description The incumbent will use clinical and coding expertise to analyze medical records and charts in relation to provider coding. The Coding Analyst identifies physician practices with complex coding patterns and reports relevant data to the Centers for Medicare and Medicaid Services (CMS). What You'll Do - Analyzes necessary documentation, including medical records/charts, and applies clinical coding expertise to evaluate appropriateness of provider coding and reports relevant data to the Centers for Medicare and Medicaid Services (CMS). - Uses all resources to ensure compliance and understanding of the CMS Hierarchical Condition Category (HCC) payment methodology. - Develops and maintains professional working relationships with Medical Providers and their staff necessary to facilitate onsite review of medical records. - Maintains documents for tracking audit results, status of reviews etc. What You'll Bring - High school diploma or GED - 3+ years of experience in related field - Certified Professional Coder or Certified Risk Coder Bonus Points - Minimum of one year of risk adjustment experience - Familiarity with Outlook, Excel and Coding Systems What You’ll Get - The opportunity to work at the cutting edge of health care delivery with a team that’s deeply invested in the community  - Work-life balance, flexibility, and the autonomy to do great work   - Medical, dental, and vision coverage along with numerous health and wellness programs   - Parental leave and support plus adoption and surrogacy assistance   - Career development programs and tuition reimbursement for continued education   - 401k match including an annual company contribution   - Learn more   Salary Range At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs. *Based on annual corporate goal achievement and individual performance. $45,761.00 - $73,217.00 Skills _____________________________________________________________________ JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Blue Cross and Blue Shield of North Carolina in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All our career opportunities are published on https://bcbsnc.wd5.myworkdayjobs.com/en-US/BCBSNC. If you have already provided your personal information that you suspect is fraudulent activity, please report it to your local authorities. Any fraudulent activity should be reported to: HR.Staffing@BCBSNC.com.