Billing Specialist Remote Jobs in Texas (US)
This page tracks remote billing specialist openings that are location-eligible for Texas.
This page tracks remote billing specialist openings that are location-eligible for Texas.
Open jobs
3,057
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$27 - $86,800
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3057 Jobs
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Role Description The Medium Voltage Specialist is primarily responsible for handling Medium Voltage escalations for SMA's customers and suppliers. The Medium Voltage Specialist partners closely with the Medium Voltage engineering team in SMA AG to work through solutions for SMA's U.S. customers and suppliers. This position is also responsible for performing warranty repairs, technical support, and extensive testing of the internal workings of SMA Medium Voltage products. We currently have 2 openings for this role in the Western region. Primary Duties / Responsibilities - Responsible for testing, including Medium Voltage Transformer core testing, troubleshoots, repairs, and analyzing SMA Large Scale MV systems in the field, operations and maintenance, and site visits. - Applies expert knowledge and training from high voltage test equipment to identify root causes for SMA's internal quality 8D reports. - Develops detailed knowledge to aid in the creation of processes and procedures for SMA's Medium Voltage products, associated SMA and/or third-party accessories sold by SMA. - Uses expert knowledge to determine correct courses of action after conducting DGA sampling and obtaining results from DGA reports. - Maintains accurate inventory count of spare parts provided by SMA. - Uses expert knowledge to repair external leaks and cold-weld patches on Medium Voltage Transformers. - Regularly works with high voltage DC, three phase power, high AC voltage, and related software/firmware of SMA products. - Maintains a high level of customer satisfaction while striving to lower the costs of field service expenditure. - Collaborates cross functionally with the Global Service Organization, Quality, and Suppliers to provide customers with Root Cause Analysis of failures, and is responsible for keeping customers informed of the RCA status. - Performs and maintains maintenance activities in accordance with the SMA product maintenance manual on assigned sites with SMA customer contractual obligations. - Other duties may be assigned or required. Qualifications - Certifications in the following are required through the AVO Training Institute or another accredited institution/trade school (either already obtained or trained upon hiring): Medium Voltage Transformer Levels I and II; Switch Gear and Circuit Breaker Maintenance with grounding and bonding; Electrical Safety for Utilities; Substation Maintenance I and II. - Must be familiar with High Voltage test equipment and understand the results from such equipment. - A bachelor's degree in a technical field is strongly preferred, or relevant years of qualified experience. - At least 5 years of experience in electrical, electronic, and/or network communications. - At least 5 years of experience with Medium Voltage equipment. - Prior experience with cold weld patch repairs and field transformer repairs. - Experience with pad mounted transformers, Medium Voltage Terminations, and operation of switchgears is preferred. Requirements - Ability to work nonstandard business hours occasionally to support service customer contracts. - Required weekend and/or night work is possible depending on customer requirements at the site. - Knowledge of solar and/or alternative energy markets is preferred. - Knowledge of the National Electric Code is preferred. - Advanced knowledge of power plant measurement devices and techniques is strongly preferred. - Ability to analyze and solve problems effectively is necessary. - Proficiency with Microsoft Office Suite (Word, PowerPoint, and Excel) is required. - Have direct interface with German counterparts for technical assistance and guidance on MV systems, and attend meetings with them on a daily or weekly basis. - This position requires significant domestic and international travel. Physical Requirements - While performing the duties of this job, the employee is required to travel, while at site; stand, walk, talk, hear, and observe surroundings. - The employee is occasionally required to sit, reach above the shoulder, stoop, bend, squat, and kneel, and must routinely lift up to 50 pounds. - The work environment is constrained to a field service environment, with occasional functions in a corporate office. - While performing the duties of this position, the employee is occasionally exposed to electrical hazards, and exposure to weather of extreme temperatures. - The noise level in the work environment is usually moderate. Benefits - Compensation: $38.00 to $43.00 per hour, dependent on experience and qualifications. - Comprehensive benefits including health, dental, and vision coverage, including $0 premium options. - Work Model: Remote. - 401(k) plan with company match. - Opportunities for professional development and training. - Inclusive, collaborative, and innovative work environment.
Located in Houston, Texas, Rice University is a private, independent, comprehensive research institution that cultivates diversity and an intellectual environme
Role Description The Engineering Research Administration (ERA) Team in the School of Engineering and Computing is seeking a Pre-Award Specialist to support all phases of research proposal development and submission. This position will serve as a key administrator for pre-award activities, working closely with faculty, departmental staff, and institutional partners to ensure timely and compliant submissions of grant proposals. Success in this role requires: - An independent, analytical mindset - Strong organizational and time management skills - The ability to thrive in a fast-paced, deadline-driven environment - A solid understanding of federal, state, and sponsor-specific regulations, policies, and procedures related to research administration Qualifications - Experienced research administrator - Strong communication, organizational, and problem-solving skills - Adept at managing complex proposals and interpreting sponsor guidelines - Familiarity with research systems such as Cayuse - Working knowledge of budgeting and compliance requirements Requirements - Bachelor's Degree - Two or more (2+) years of related experience in proposal development, project management, and/or accounting - In lieu of education or experience requirement, additional related experience may be substituted on an equivalent year-for-year basis Benefits - Starting annual salary of $65,000 - Exempt (salaried) positions under FLSA are not eligible for overtime - Full-time, fully remote position with potential occasional travel Essential Functions - Organizes, facilitates, and tracks proposal development efforts and proposal preparation timelines - Understands, explains, and clarifies various sponsors' proposal requirements and review processes - Researches and writes non-technical sections of proposals - Provides comments, suggestions, and questions on the narrative section - Ensures compliance with sponsor requirements - Assists in the facilitation of faculty teams and colleagues in preparing large, complex, collaborative, multi-disciplinary, multi-institutional proposals - Identifies limited submission funding opportunities and assists in coordinating limited submission competitions - Assists with training and development sessions on proposal development for faculty, staff, postdocs, graduate students, and/or undergraduate students - Assists in preparing ad hoc administrative projects, such as website materials and proposal archives - Supports the Principal Investigator (PI) on administrative requirements in proposal preparation - In collaboration with the PI, develops and reviews the budget and assists with attaining cost-share commitments - Coordinates the request and review of subcontract documents - Performs data entry into the sponsor portal and Cayuse SP record - Performs all other duties as assigned
Role Description The Court Services Specialist is an integral member of the litigation docket team, primarily responsible for managing the filing and docketing of court-related documents. This position supports the firm's attorneys and professional staff by ensuring that all legal documents are handled with the utmost precision and adherence to court deadlines. The Specialist works closely with docket staff and legal teams to review court filings, monitor rules and procedures, and update the docket database with relevant information. The Specialist also provides comprehensive administrative and filing support, assists in departmental initiatives, special projects, and handles a variety of docketing and calendaring tasks. Job Responsibilities - Assist docket department and case teams with service and filing of court documents in Federal, State and Appellate Courts. - Handle the filing of legal documents with various courts and agencies, including pleadings, motions, and other court submissions. Ensure compliance with all court rules and procedures for document submission. - Coordinate with the docket team to maintain and update the firm's docket system to keep track of court deadlines, hearing dates, and filing schedules. Ensure all deadlines are met by coordinating with the legal team. - Act as a point of contact with court clerks/administrative offices to confirm rules and procedures and facilitate the efficient processing and retrieval of documents. - Review documents to ensure compliance with local rules. - Organize and maintain electronic and physical files in accordance with the firm's document management procedures and confidentiality standards. - Provide assistance to attorneys and case teams with gathering information related to case filings and courtroom procedures as needed. - Assist with general office duties including data entry, managing correspondence, and providing information to case teams about case status and court procedures. - Research and/or monitor cases with the use of various online resources and provide court filing and service information. - Respond promptly and professionally to information requests from attorneys and professional staff regarding docketed dates, agency and court rules and procedures. - Generate calendar reports and queries for case teams based upon standard procedures and generate custom docket reports and queries as requested and directed. - Assist with other projects as assigned or requested. Qualifications - Previous experience in a law firm or legal department, particularly in a role involving court filings and/or docket management, is strongly preferred. - Strong familiarity with litigation filing procedures. - General working knowledge of state and federal court procedure, and ability to navigate jurisdictional bodies of rules and procedures as needed. - Proficiency in utilizing docketing software (i.e., CompuLaw, CourtAlert) for calendaring and reporting is preferred. - Knowledge of various court websites, docket searching and document retrieval databases (PACER, Lexis/Nexis, Westlaw, File & Serve Express etc.). - Strong knowledge of federal and state e-filing procedures and technologies. - Proficient with Microsoft Office suite applications. - Strong attention to detail and ability to prioritize tasks in a high-pressure environment. - Excellent communication, time management and organizational skills. - Strong collaborative skills and flexibility to adapt to changing department procedures when necessary. - Strong communication, problem-solving and service skills. - Available to work overtime and/or do limited business travel. Education - An undergraduate degree is required. Equivalent training and legal experience may substitute for education. - Paralegal certification is preferred. Experience - The position requires a minimum of two (2) years of professional experience during which knowledge, skills and abilities relevant to the position were attained. Pay Range - $63,000 - $87,000 Most US office locations - $69,000 - $95,000 NY & SF Benefits - Healthcare - Vision - Dental - Retirement - All-purpose leave - Progressive options such as backup childcare, wellness programs, cultural events and social activities.
Willis Towers Watson, founded in 1828, is one of the leading professional services, risk management, and insurance brokerage companies in the world. Focusing on
Title: Senior Pension Calculation Specialist Location: US Job Description: - 202604167 - Detroit, Michigan, United States - Minneapolis, Minnesota, United States - United States - Full time Description In this challenging role as a Senior Pension Calculation Specialist, you will contribute as part of a team to the entire range of retirement administration activities, primarily focused on complex pension calculations and other related activities. If you’re looking for an exciting role, with one of the leaders in the defined benefit outsourcing business and the opportunity to grow and develop your career, apply now! In this role you will serve as a technical leader and subject matter expert to the internal team and our clients, trouble shoot issues, create client deliverables, contribute to client management and participate in the creation of new intellectual capital. This role can be held remotely from any location in the United States. The Role - Enhance your knowledge of all aspects of retirement plan administration - Enjoy a well-defined career path with opportunities for growth and advancement - Leverage the most cutting-edge tools and resources and some of the world’s experts in retirement plan design, management and pension administration - Deliver superior, consistent client management and deliverables in support of a Director for assigned clients: - Serve as primary, daily contact to clients on delivery of calculation related issues services and raise appropriate issues to Directors - Interface with colleagues from other practices and regions on assignments that reflect the client’s broader business issues - Develop a trusted advisor relationship with client contacts through effective communication and efficient, quality execution of projects - Manage a diverse set of pension administration services individually and through team initiatives - Review complex pension benefit calculations in accordance with plan provisions, Internal Revenue Code, ERISA, and other legal regulations (e.g. transfers, QDRO’s) - Review pension benefit commencement packages - Ensure that work of self and team is delivered in accordance with professional and work excellence standards - Deliver formal and informal process training to both team members and client contacts Note that visa employment-based non-immigrant visa sponsorship and/or assistance is not offered for this specific job opportunity. Qualifications The Requirements - Bachelor’s degree or prior benefits administration experience required. - 5 or more years’ of calculation experience in administration of defined benefit plans, preferably gained in a benefits consulting environment; experience in implementation of pension outsourcing processes a plus - Must have experience collaborating with other colleagues in different countries - Excellent written and verbal communication skills - Proven experience successfully managing multiple team projects simultaneously and producing quality deliverables on time and within budget - Experience mentoring and developing junior staff - Demonstrated success in managing client issues and relationships with some experience in growing relationships with current clients - Strong interpersonal and team skills - Flexibility and proven ability to diagnose and resolve issues; strong client service orientation - Proficient in Microsoft Office Excel - Ability to work independently and on client teams in a fast-paced environment - Sense of accountability; owning one’s work and taking pride in it - Self-motivated - Ability to travel and work extended hours as needed Compensation and Benefits Base salary range and benefits information for this position are being included in accordance with requirements of various state/local pay transparency legislation. Please note that salaries may vary for different individuals in the same role based on several factors, including but not limited to location of the role, individual competencies, education/professional certifications, qualifications/experience, performance in the role and potential for revenue generation (Producer roles only). Compensation The base salary compensation range being offered for this role is $75,000 to $100,000 USD per year. The role is also eligible for an annual short-term incentive bonus. Company Benefits WTW provides a competitive benefit package which includes the following (eligibility requirements apply): - Health and Welfare Benefits: Medical (including prescription coverage), Dental, Vision, Health Savings Account, Commuter Account, Health Care and Dependent Care Flexible Spending Accounts, Group Accident, Group Critical Illness, Life Insurance, AD&D, Group Legal, Identify Theft Protection, Wellbeing Program and Work/Life Resources (including Employee Assistance Program) - Leave Benefits: Paid Holidays, Annual Paid Time Off (includes paid state/local paid leave where required), Short-Term Disability, Long-Term Disability, Other Leaves (e.g., Bereavement, FMLA, ADA, Jury Duty, Military Leave, and Parental and Adoption Leave), Paid Time Off - Retirement Benefits: Contributory Pension Plan and Savings Plan (401k). Certain senior level roles may also be eligible for non-qualified Deferred Compensation and Deferred Savings Plans. Pursuant to the San Francisco Fair Chance Ordinance and Los Angeles County Fair Chance Ordinance for Employers, we will consider for employment qualified applicants with arrest and conviction records. EOE, including disability/vets This position will remain posted for a minimum of three business days from the date posted or until sufficient/appropriate candidate slate has been identified.
RTX Corporation is a defense, aerospace system, and homeland security company that specializes in providing state-of-the-art electronics, mission systems integr
Title: Principal Specialist, Contracts (Remote) Location: United States Job Description: Position Role Type: Remote U.S. Citizen, U.S. Person, or Immigration Status Requirements: Active and transferable U.S. government issued security clearance is required prior to start date. U.S. citizenship is required, as only U.S. citizens are eligible for a security clearance Security Clearance Type: DoD Clearance: Secret Security Clearance Status: Active and existing security clearance required on day 1 Principal Specialist, Contracts (Remote) At RTX, the world's largest aerospace and defense company, 185,000 great minds are united by purpose and inspired to make a difference solving the world’s most complex problems. With our three market leading businesses, world-class operations and investments in research and development, we offer capabilities and opportunity no one else can. Together, we push the boundaries of known science and find new ways to connect and protect our world. Collins Aerospace is a leader in technologically advanced, intelligent solutions that help redefine the aerospace and defense industry. With a comprehensive portfolio and deep technical expertise, we help customers meet the demands of the global market. Join us and help shape the future of aerospace and defense. What You Will Do: - Lead contract management across the acquisition lifecycle, including drafting, interpreting, negotiating, and administering Prime Contracts, Subcontracts, Non‑Disclosure Agreements (NDAs)/Proprietary Information Agreements (PIAs), and related agreements. - Provide contractual guidance, risk mitigation, and interpretation of rights, obligations, regulations, and policies to internal stakeholders while ensuring compliance with International Traffic in Arms Regulations (ITAR), Export Administration Regulations (EAR), Controlled Unclassified Information (CUI), and corporate procedures. - Support proposal development by reviewing Requests for Proposal (RFPs), conducting front‑end assessments, managing cost volumes, coordinating with pricing/estimating, and preparing submission documents under tight deadlines. - Collaborate with Program Management, Engineering, Finance, Supply Chain, Legal, and other cross‑functional partners to ensure aligned contract execution and business objectives. - Manage customer communications, contract changes, issue resolution, and flowdown of requirements, while professionally representing the company in negotiations and external interactions. - Analyze and negotiate terms and conditions, identify and manage contractual and business risks, and ensure compliant execution of contract scope across multiple contract types including Cost‑Plus‑Fixed‑Fee (CPFF), Cost‑Plus‑Incentive‑Fee (CPIF), Cost-Plus-Award-Fee (CPAF), Firm‑Fixed‑Price (FFP), and Level of Effort (CPFF-LOE & FFP‑LOE). - Multi-task routine and complex contract activities, respond to urgent requirements, and work independently while supporting members as needed. - Engage with the Defense Contract Management Agency (DCMA) and Defense Contract Audit Agency (DCAA), support accounts receivable activities, and maintain strong coordination with both internal and external customer teams. Qualifications You Must Have: - Typically requires a University Degree and minimum 5 years prior relevant experience or an Advanced Degree in a related field and minimum 3 years of experience - Active and transferable U.S. government issued security clearance is required prior to start date - Experience in contracts management or related fields such as subcontracts, procurement, estimating/pricing, finance, or business/program management, including administering U.S. Government contracts under the Federal Acquisition Regulation (FAR) and Defense Federal Acquisition Regulation Supplement (DFARS). - Experience preparing and negotiating proposals and contract actions of medium to high complexity, including sole‑source proposals subject to the Truthful Cost or Pricing Data Act (formerly TINA), and direct engagement with customers. Qualifications We Prefer: - Active or prior Top Secret (TS) or TS/Sensitive Compartmented Information (TS/SCI) security clearance and experience working in closed or secure environments. - Experience negotiating, administering, and executing complex U.S. Government and commercial contracts, including sole‑source proposals subject to the Truthful Cost or Pricing Data Act (formerly TINA), Performance‑Based Payments and Progress Payments, and a variety of agreement types such as Other Transaction Agreements (OTAs), Non‑Disclosure Agreements (NDAs), Proprietary Information Agreements (PIAs), Memorandums of Understanding/Agreement (MOUs/MOAs) and other industry-standard agreements. - Familiarity with Intellectual Property, International Traffic in Arms Regulations (ITAR), Export Administration Regulations (EAR), handling Controlled Unclassified Information (CUI), compliance with the Federal Acquisition Regulation (FAR) and Defense Federal Acquisition Regulation Supplement (DFARS). - Strong communication, interpersonal, business judgment, and problem‑solving skills, with proven ability to build and maintain high‑performance internal and external customer relationships. - Strong organizational and time‑management capabilities, with proficiency in Microsoft Office (Word, PowerPoint, Excel) and PDF editing software. - Advanced degree such as a Master of Business Administration (MBA), Master’s Degree, Juris Doctor (J.D.), or relevant industry certifications such as National Contract Management Association (NCMA), International Association for Contract and Commercial Management (IACCM), or Defense Acquisition Workforce Improvement Act (DAWIA) certification. Do you want to be a part of something bigger? A team whose impact stretches across the world, and even beyond? At Collins Aerospace, our Mission Systems team helps civilian, military and government customers complete their most complex missions — whatever and wherever they may be. Our customers depend on us for intelligent and secure communications, missionized systems for specialized aircraft and spacecraft and collaborative space solutions. By joining our team, you’ll have your own critical part to play in ensuring our customer succeeds today while anticipating their needs for tomorrow. Are you up for the challenge? Join our mission today. What We Offer: Some of our competitive benefits package includes: - Medical, dental, and vision insurance - Three weeks of vacation for newly hired employees - Generous 401(k) plan that includes employer matching funds and separate employer retirement contribution, including a Lifetime Income Strategy option - Tuition reimbursement program - Student Loan Repayment Program - Life insurance and disability coverage - Optional coverages you can buy pet insurance, home and auto insurance, additional life and accident insurance, critical illness insurance, group legal, ID theft protection - Birth, adoption, parental leave benefits - Ovia Health, fertility, and family planning - Adoption Assistance - Autism Benefit - Employee Assistance Plan, including up to 10 free counseling sessions - Healthy You Incentives, wellness rewards program - Doctor on Demand, virtual doctor visits - Bright Horizons, child and elder care services - Teladoc Medical Experts, second opinion program - Eligible for relocation assistance - And more! Learn More & Apply Now! *Please ensure the role type (defined below) is appropriate for your needs before applying to this role. Remote: Employees who are working in Remote roles will work primarily offsite (from home). An employee may be expected to travel to the site location as needed. At Collins, the paths we pave together lead to limitless possibility. And the bonds we form – with our customers and with each other -- propel us all higher, again and again. As part of our commitment to maintaining a secure hiring process, candidates may be asked to attend select steps of the interview process in-person at one of our office locations, regardless of whether the role is designated as on-site, hybrid or remote. The salary range for this role is 86,800 USD - 165,200 USD. The salary range provided is a good faith estimate representative of all experience levels. RTX considers several factors when extending an offer, including but not limited to, the role, function and associated responsibilities, a candidate’s work experience, location, education/training, and key skills. Hired applicants may be eligible for benefits, including but not limited to, medical, dental, vision, life insurance, short-term disability, long-term disability, 401(k) match, flexible spending accounts, flexible work schedules, employee assistance program, Employee Scholar Program, parental leave, paid time off, and holidays. Specific benefits are dependent upon the specific business unit as well as whether or not the position is covered by a collective-bargaining agreement. Hired applicants may be eligible for annual short-term and/or long-term incentive compensation programs depending on the level of the position and whether or not it is covered by a collective-bargaining agreement. Payments under these annual programs are not guaranteed and are dependent upon a variety of factors including, but not limited to, individual performance, business unit performance, and/or the company’s performance. This role is a U.S.-based role. If the successful candidate resides in a U.S. territory, the appropriate pay structure and benefits will apply. RTX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or veteran status, or any other applicable state or federal protected class. RTX provides affirmative action in employment for qualified Individuals with a Disability and Protected Veterans in compliance with Section 503 of the Rehabilitation Act and the Vietnam Era Veterans’ Readjustment Assistance Act.
Firstsource is self-described as a leading provider of transformational solutions and services designed to help organizations across industries reinvent operati
Title: Sr. Revenue Cycle Billing Specialist Location: United States Job Description: Role Description The Revenue Cycle Denials Representative is responsible for managing and resolving denied Professional Billing (PB/CMS-1500) and/or Hospital Billing (HB/UB-04) claims. This role identifies root causes of denials, executes appeals and corrective actions, and collaborates with internal teams to prevent future denials. The ideal candidate has hands-on experience with CARC/RARC denial codes, Epic denial work queues, and payer-specific appeal requirements across Medicare, Medicaid, and commercial payers. Roles & Responsibilities Denial Review & Resolution - PB & HB - Review and analyze denied PB (CMS-1500 / 837P) and HB (UB-04 / 837I) claims to determine root causes and appropriate resolution strategies. - Analyze account history and all previous actions in Epic prior to taking the next action step to resolve the claim. - Work claims across all top denial categories including, but not limited to: No Authorization, Timely Filing, Coordination of Benefits (COB), Medical Necessity, Additional Documentation Requests (ADR), Bundling (NCCI edits), and Duplicate Claims. - Interpret CARC and RARC codes on 835 ERA / EOB remittance data for both PB and HB claims to determine the correct resolution path. - Understand when claim corrections, rebilling (837P or 837I), or void-and-replace actions are appropriate. - Escalate claims with payers for resolution when processing is inaccurate or delayed. Appeals & Reconsiderations - Prepare and submit appeals and reconsideration requests in compliance with payer-specific guidelines and deadlines for both PB and HB denied claims. - Attach appropriate clinical documentation, medical records, authorization references, and justification letters to support appeal submissions. - Meet appeal deadlines for Medicare, Medicaid, and commercial payers in accordance with payer-specific requirements. Trend Identification & Prevention - Identify denial trends across PB and HB claim types and collaborate with coding, clinical, and billing teams to implement corrective actions. - Monitor payer policy and regulatory changes (Medicare LCDs/NCDs, Arkansas Medicaid updates) to proactively prevent denials. - Assist in developing best practices and training materials for PB and HB denial management and prevention. Payer & System Knowledge - Navigate Epic denial and underpayment work queues for both HB and PB modules; document all denial actions and resolutions. - Utilize payer portals (Availity, Arkansas DHS, Medicare.gov, and commercial payer sites) to research denial reasons and submit appeals. - Utilize resources provided by the client to promote accuracy and resolve claims in accordance with client expectations. Compliance & Documentation - Maintain thorough documentation of denial reasons, appeal actions, and resolutions in Epic. - Ensure compliance with federal, state, and payer regulations as well as hospital and physician practice policies. - Communicate effectively with insurance representatives and internal leaders to expedite resolution and improve processes. - Always maintain confidentiality of patient and account information (HIPAA). - Adhere to prescribed policies and procedures outlined in the Employee Handbook and Code of Conduct. - Maintain awareness of and actively participate in the Corporate Compliance Program. - Maintain a confidential and orderly remote work area. - Meet specified goals and objectives assigned by management and/or the Client. - Assist with other projects as assigned by management. Expected / Key Results - Deliver high levels of client and patient satisfaction (CSAT) - Achieve quality scores per defined process standards - Deliver defined process-specific metrics (e.g., denial resolution rate, overturn rate, appeal success rate) - Adherence to regulatory compliance requirements - Schedule adherence Preferred Educational Qualifications - High school diploma or equivalent required - Associate's or Bachelor's degree in Health Information Management, Business, or related field preferred - CPC, CPMA, CRCR, or CHFP certification a plus Preferred Work Experience - 2+ years of experience in healthcare revenue cycle, denial management, or claims resolution - Demonstrated experience working PB (CMS-1500 / 837P) and/or HB (UB-04 / 837I) denials - Prior experience with Epic denial work queues strongly preferred - Familiarity with Medicaid, Medicare, and commercial payers preferred - Experience interpreting CARC/RARC codes and 835 ERA / EOB remittance data - Knowledge of NCCI edits, LCD/NCD policies, and authorization/pre-certification workflows Competencies & Skills - Strong knowledge of PB and HB denial workflows, appeal processes, and payer-specific requirements - Proficiency with Epic (HB and/or PB modules, denial work queues, claim correction, void-and-replace, and rebilling) - Solid understanding of CARC/RARC denial reason codes and how to act on them for PB and HB claims - Ability to read and interpret 835 ERA / EOB remittance advice for both PB and HB claims - Knowledge of payer portals including Availity, Arkansas DHS, and commercial payer sites - Competent in working and communicating effectively with payers, patients, colleagues, and management - both in-person and via remote virtual platforms - Consistently maintains a courteous and professional demeanor - Self-motivated with the ability to stay focused and productive with minimal supervision - Proactive initiative and creative problem-solving in carrying out job responsibilities - Ability to prioritize multiple tasks through effective time management and organizational skills - Proficiency in PC operations; ability to type at a rate of 30-40 words per minute Benefits including but not limited to: Medical, Vision, Dental, 401K, Paid Time Off. We are an Equal Opportunity Employer. All qualified applicants are considered for employment without regard to race, color, age, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other characteristic protected by federal, state or local law.
Firstsource is self-described as a leading provider of transformational solutions and services designed to help organizations across industries reinvent operati
Title: Sr. Revenue Cycle Billing Specialist Location: United States Job Description: Role Description The Revenue Cycle Denials Representative is responsible for managing and resolving denied Professional Billing (PB/CMS-1500) and/or Hospital Billing (HB/UB-04) claims. This role identifies root causes of denials, executes appeals and corrective actions, and collaborates with internal teams to prevent future denials. The ideal candidate has hands-on experience with CARC/RARC denial codes, Epic denial work queues, and payer-specific appeal requirements across Medicare, Medicaid, and commercial payers. Roles & Responsibilities Denial Review & Resolution - PB & HB - Review and analyze denied PB (CMS-1500 / 837P) and HB (UB-04 / 837I) claims to determine root causes and appropriate resolution strategies. - Analyze account history and all previous actions in Epic prior to taking the next action step to resolve the claim. - Work claims across all top denial categories including, but not limited to: No Authorization, Timely Filing, Coordination of Benefits (COB), Medical Necessity, Additional Documentation Requests (ADR), Bundling (NCCI edits), and Duplicate Claims. - Interpret CARC and RARC codes on 835 ERA / EOB remittance data for both PB and HB claims to determine the correct resolution path. - Understand when claim corrections, rebilling (837P or 837I), or void-and-replace actions are appropriate. - Escalate claims with payers for resolution when processing is inaccurate or delayed. Appeals & Reconsiderations - Prepare and submit appeals and reconsideration requests in compliance with payer-specific guidelines and deadlines for both PB and HB denied claims. - Attach appropriate clinical documentation, medical records, authorization references, and justification letters to support appeal submissions. - Meet appeal deadlines for Medicare, Medicaid, and commercial payers in accordance with payer-specific requirements. Trend Identification & Prevention - Identify denial trends across PB and HB claim types and collaborate with coding, clinical, and billing teams to implement corrective actions. - Monitor payer policy and regulatory changes (Medicare LCDs/NCDs, Arkansas Medicaid updates) to proactively prevent denials. - Assist in developing best practices and training materials for PB and HB denial management and prevention. Payer & System Knowledge - Navigate Epic denial and underpayment work queues for both HB and PB modules; document all denial actions and resolutions. - Utilize payer portals (Availity, Arkansas DHS, Medicare.gov, and commercial payer sites) to research denial reasons and submit appeals. - Utilize resources provided by the client to promote accuracy and resolve claims in accordance with client expectations. Compliance & Documentation - Maintain thorough documentation of denial reasons, appeal actions, and resolutions in Epic. - Ensure compliance with federal, state, and payer regulations as well as hospital and physician practice policies. - Communicate effectively with insurance representatives and internal leaders to expedite resolution and improve processes. - Always maintain confidentiality of patient and account information (HIPAA). - Adhere to prescribed policies and procedures outlined in the Employee Handbook and Code of Conduct. - Maintain awareness of and actively participate in the Corporate Compliance Program. - Maintain a confidential and orderly remote work area. - Meet specified goals and objectives assigned by management and/or the Client. - Assist with other projects as assigned by management. Expected / Key Results - Deliver high levels of client and patient satisfaction (CSAT) - Achieve quality scores per defined process standards - Deliver defined process-specific metrics (e.g., denial resolution rate, overturn rate, appeal success rate) - Adherence to regulatory compliance requirements - Schedule adherence Preferred Educational Qualifications - High school diploma or equivalent required - Associate's or Bachelor's degree in Health Information Management, Business, or related field preferred - CPC, CPMA, CRCR, or CHFP certification a plus Preferred Work Experience - 2+ years of experience in healthcare revenue cycle, denial management, or claims resolution - Demonstrated experience working PB (CMS-1500 / 837P) and/or HB (UB-04 / 837I) denials - Prior experience with Epic denial work queues strongly preferred - Familiarity with Medicaid, Medicare, and commercial payers preferred - Experience interpreting CARC/RARC codes and 835 ERA / EOB remittance data - Knowledge of NCCI edits, LCD/NCD policies, and authorization/pre-certification workflows Competencies & Skills - Strong knowledge of PB and HB denial workflows, appeal processes, and payer-specific requirements - Proficiency with Epic (HB and/or PB modules, denial work queues, claim correction, void-and-replace, and rebilling) - Solid understanding of CARC/RARC denial reason codes and how to act on them for PB and HB claims - Ability to read and interpret 835 ERA / EOB remittance advice for both PB and HB claims - Knowledge of payer portals including Availity, Arkansas DHS, and commercial payer sites - Competent in working and communicating effectively with payers, patients, colleagues, and management - both in-person and via remote virtual platforms - Consistently maintains a courteous and professional demeanor - Self-motivated with the ability to stay focused and productive with minimal supervision - Proactive initiative and creative problem-solving in carrying out job responsibilities - Ability to prioritize multiple tasks through effective time management and organizational skills - Proficiency in PC operations; ability to type at a rate of 30-40 words per minute Benefits including but not limited to: Medical, Vision, Dental, 401K, Paid Time Off. We are an Equal Opportunity Employer. All qualified applicants are considered for employment without regard to race, color, age, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other characteristic protected by federal, state or local law. Not Accepting Referrals
• Lead and oversee the billing operations within the revenue cycle management process • Ensure accurate and timely billing for services rendered • Develop and implement strategies to optimize billing efficiency and revenue capture • Monitor and analyze billing performance metrics and indicators • Provide training, coaching, and mentorship to billing staff • Other duties as assigned
We are Oregon's only public academic health center. In addition to caring for patients, we lead groundbreaking research. We also train the next generation of health care professionals. As Portland's largest employer, we give you opportunities to learn and advance in a system of hospitals and clinics across Oregon and Southwest Washington. All are welcome. OHSU welcomes people of all ages, ethnicities, genders, national origins, religions and sexual orientations. We are striving to build an anti-racist, multicultural institution and encourage people with diverse backgrounds to apply. To request reasonable accommodation, contact askhr@ohsu.edu.
Role Description The function of the PAS Resource Specialist - Scheduling position within Diagnostic Imaging Services is to provide essential customer service support and guidance to clinics and patients in the areas of financial screening, patient eligibility for services, managed care, and complex patient referrals. The PAS Resource Specialist completes multifaceted, radiology specific, scheduling tasks, with the purpose of assisting, scheduling, and coordinating patient diagnostic imaging appointments in EPIC and RIS. The employee in this position promotes OHSU’s mission statement by delivering high quality, cost effective, family-oriented service excellence. This position helps to create a collaborative environment by integrating education, research, and clinical leadership. Qualifications - One year of experience in a medical office setting, including high-volume direct patient contact, scheduling of appointments and may require experience obtaining managed care authorizations. - OR one and a half years of work experience in a high-volume direct public contact position and 6 months experience in a medical office setting. - Thorough knowledge of PAS policies and procedures. - Demonstrated advanced PAS user skills. - Extensive knowledge of integrated care at OHSU. Requirements - Basic computer skills including word processing. - Windows applications, on-line scheduling, and a preference for database skills. - Excellent verbal and written communications skills. - Strong customer service orientation. - Demonstrated effectiveness in confrontational customer interactions. Preferred Qualifications - Associates degree. - 2+ years in a medical office setting. - Experience in a radiology office setting strongly preferred. - Database skills. - RIS, EPIC systems. - Radiology specific medical terminology. Benefits - Must be able to work independently from home or in the office. - Ability to concentrate in a busy, fast paced, noisy office. - This is a full-time position, and eligible for benefits. Company Description We are Oregon's only public academic health center. In addition to caring for patients, we lead groundbreaking research. We also train the next generation of health care professionals. As Portland's largest employer, we give you opportunities to learn and advance in a system of hospitals and clinics across Oregon and Southwest Washington. All are welcome. OHSU welcomes people of all ages, ethnicities, genders, national origins, religions and sexual orientations. We are striving to build an anti-racist, multicultural institution and encourage people with diverse backgrounds to apply. To request reasonable accommodation, contact askhr@ohsu.edu.
Capital One is an award-winning provider of financial services and products for commercial customers, small businesses, and consumers nationwide. In support of
Role Description We are looking for someone passionate about the hospitality industry with strong existing knowledge of what it takes to be the most high-value-add concierge. The ideal candidate will be an energetic, ambitious and determined person who wants to take their career in the customer service and concierge space to the next level. We are looking for someone passionate about the restaurant industry with extremely strong existing knowledge and relationships with some of the best restaurants in the major US markets. The ideal candidate will be an energetic relationship builder and have great knowledge and connections in the restaurant scene. General Responsibilities: - Communicating with clients, restaurants, and team members to deliver primetime reservations at the best restaurants in major US markets - Sourcing ideas for content to submit to our content team on a weekly basis - Develop new relationships with restaurants and nightlife venues in major US markets Qualifications - Experience working with high net worth clients - Strong knowledge of the major US markets dining industry - Strong existing relationships with top-tier restaurants - Experience building relationships and partnerships with dining and nightlife venues - Entrepreneurial, problem-solving attitude - Excellent, clear, and effective verbal and written communication skills - Experience working in a collaborative and transparent environment - Ability to work in high-pressure environment with tight deadlines - Flexible working hours - available to work on evenings and weekends Requirements - High School Diploma, GED, or Equivalent - Certification - At least 3 years of Luxury Hospitality experience - At least 2 years of fine-dining experience Preferred Qualifications - Bachelor’s degree - 4+ years of luxury hospitality experience Benefits - Comprehensive, competitive, and inclusive set of health, financial and other benefits that support your total well-being - Performance based incentive compensation, which may include cash bonus(es) and/or long term incentives (LTI)
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