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US CA Modesto |
Insurance Representative |
American Medical Response | $11.50 - $14.46/Hour | 7/30 |
| Details: POSITION SUMMARY BRIEF: The A/R Follow-up Representative – Level 1 (Non-Government Claims) is responsible for the follow-up on all private pay and commercial insurance claims. The incumbent will resolve unpaid accounts in a timely and efficient manner for one or more geographical areas, while maintaining quality and productivity standards set for the Level 1 A/R Follow-up Representative.   DUTIES:  ManagerialManage own time and work assignments effectively.Seek advice/feedback in terms of priorities or issues when necessary.TechnicalReview, modify as necessary, and re-bill rejected/denied claims in “queue" by assigning appropriate insurance carrier, utilizing the billing address and/or payor prefix.Process “queues" within appropriate timeframes, (e.g. claims status checks, appeals of denied claims).Recode private pay, commercial insurance and HMO claims, assigning proper condition codes/ICD-9 codes/procedure codes into the Accounts Receivable Billing System and re-file claims as necessary.Update appropriate modifiers, based on origin and destination of trip and change insurance claims as necessary.Create narrative in the Accounts Receivable Billing System to document status of trip for use in claim appeal process.Ensure that charges are billable to a particular commercial payor, based on the payor’s criteria, as needed.Resolve payment issues with carriers, (e.g. denials, partial payments, etc).Appeal claims as necessary.Process daily claims reports, (e.g. “Collection Plan Audit", “Unpaid Claims", “CSR Queues").Process incoming correspondence, including signature letters, denials and additional information necessary to release the claim.Forward all credit card payments to Cash Posting when identified in Patient Care Report (PCR), correspondence and/or Computer Aided Dispatch (CAD) notes.Determine the Level of Service to be billed, based on supporting documentation on the PCR and/or in the CAD notes, including but not limited to, designating Advanced Life Support (ALS), Basic Life Support (BLS), Wheelchair, or Specialty Care Transport (SCT)/Critical Care Transport (CCT).Review clearinghouse transmission listings and in-house error logs, make appropriate corrections.Resolve incoming calls from carriers, providers and patients.Adjust Patient Accounts based on court instructions, due to bankruptcy proceedings, as required.File claims for deceased patients, against estates, as required.Process “Very Important Person" (VIP) transports by verifying information with Human Resources and adjusting the account accordingly as required.Perform other duties as required.InterpersonalWork in a spirit of teamwork and cooperation.Convey a sense of competence and commitment.Use initiative to learn new skills, enhance personal knowledge and improve communications.Demonstrate an ability to work well with team members.Communicate a willingness to help others succeed.Share workspace and resources as necessary.KnowledgeMedical transportation processes.Terminology on a PCR, Hospital Face Sheet, and/or a CAD Sheet.Process of signature and paperwork compliance.Payor-specific requirements for one or more geographical areas.Distinctions between ALS/BLS/SCT/Gurney/Wheelchair/CCT levels of service.ICD-9 coding/condition codes and procedure codes.Insurance carrier coverage guidelines, filing limits and necessary prior authorizations.Medical terminology and insurance terminology.Appeal process.HIPAA requirements.Skills Proficient in the Accounts Receivable Billing System and Internet tools, (e.g. Internet mapping programs, eligibility websites, address search engines). Basic understanding of Microsoft Word and Excel.Communicate effectively, (both orally and in writing) in English.AbilitiesPass new-hire and department-specific testing, (e.g. data entry test and department-specific aptitude testing).Flexible with shifting daily priorities.Meet deadlines working within tight time constraints.Handle a large volume of work and/or phone calls.Recognize improper fee schedules.Identify non-payment issues by carrier and claim and to escalate to Management as necessary.Recognize overpayments and request refunds as necessary.Prioritize workflow. Process clean claims for one or more geographical areas.Meet or exceed and sustain all established standards for productivity and quality. | ||||
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US CA Modesto |
Sales - Insurance Agent |
Physicians Mutual Insurance Company | 7/28 | |
| Details: Looking for a job that offers you personal freedom, financial rewards and professional growth? Then take a closer look at becoming a Physicians Mutual® career agent. We pride ourselves on being a family-oriented Company and contract with those agents who share our values of commitment and dedication to customers. Our customer-focused products include*: Health Insurance Dental Insurance Life Insurance Medicare Supplement Insurance Long-Term Care Insurance Cancer Insurance Annuities  We think you’ll find the compensation, extensive training and the lead support very rewarding. Join our family … and open new doors to success. | ||||
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US CA Dallas |
RN Clinical Care Coordinator II - Medicaid Insurance |
Molina Healthcare Inc. | 7/22 | |
| Details: About Molina Healthcare, Inc.Molina Healthcare Inc., is among the most experienced managed healthcare companies serving patients who have traditionally faced barriers to quality healthcare-including individuals covered under Medicaid, the Healthy Families Program, the State Children's Health Insurance Program (SCHIP) and other government-sponsored health insurance programs. Molina has health plans in California, Michigan, New Mexico, Missouri, Utah, Ohio, Texas and Washington as well as 19 primary care clinics located in Northern and Southern California. The company's corporate headquarters are in Long Beach, California. RN Clinical Care Coordinator II – Medicaid Insurance-Dallas  Identifies, assesses and manages catastrophic and SSI appropriate cases as per established criteria. Coordinates care coordination activities with the primary care provider, UM staff, disease management staff, medical case managers, social workers, mental health professionals, chemical dependency treatment providers, public agencies, and other providers as required. Documents all findings, contracts and interventions per protocol. Channels services to network providers including transfer of out-of-network facilities. Coordinates necessary services with participating ancillary service providers and public agencies as appropriate. Maintains regular communication with state agencies, healthcare individuals and support systems to promote efficient and well –coordinated quality care. Develops case management recommendations consistent with the preferences of member and family and incorporating care goals based on identified needs and required services. Determines appropriate frequency and type of contacts to meet care plan goals. Includes assessment of health needs, individualized care plans, implementation, monitoring and evaluation of outcomes. Arranges for health care services within the scope of available benefits. Documents all findings, contracts and interventions per protocol. Completes State required assessments according to Contractual requirements. Meets face to face with member in home to conduct assessments; available by phone to receive member calls and provide service coordination. | ||||
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US CA Modesto |
Sales - Insurance Agent [Entry Level & Experienced Sales] |
Bankers Life and Casualty Company | 7/22 | |
| Details: Bankers Life and Casualty Company has offered challenging and rewarding insurance sales opportunities since 1879. With branch offices nationwide, Bankers specializes in serving the growing senior market, offering solid insurance protection and top quality service that makes Bankers an insurance industry leader. Bankers is growing and recruiting intelligent, dedicated, outgoing professionals who are interested in a rewarding career in insurance sales. To help our insurance sales representatives reach their full earnings potential, we offer: Competitive commissions and compensation packages Quarterly bonus and incentives Formal training via our nationally recognized programs Management growth opportunities Access to lead generation and prospecting programs Independence and freedom to set your own work schedule Solid technology support | ||||
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US CA Modesto |
INSURANCE WINTON IRE |
7/21 | ||
| Details: INSURANCE Winton-Ireland, Strom & Green, A growing regional ins. agency is seeking an insurance producer that is fluent in Spanish. Ins. lic & exp req'd. Please Send resume to: 1100 14th St Ste C Modesto, CA 95354. Source - The Modesto Bee | ||||
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US CA Merced |
(New) Farmers Insurance Agency Manager / Owner |
Farmers Insurance Group® | 7/7 | |
| Details: Due to Growth, Farmers Insurance Group has opened a new agent training facility in your local area. Develop your sales skills, build your marketing pipelines and participate in ongoing training while you lay the foundation of your own small business. Small business ownership can be overwhelming, which is why Farmers has developed this innovative new agent training program. This program allows you to establish a strong foundation for the future without all the expenses other small businesses incur. Additionally, Farmers offers financial assistance for the first two years of the Career Program, group medical benefits for you and your family and the training and support of a business partner with over 82 years of experience.  Find out why this program is often referred to the "Best Small Business Opportunity in America." We have a brand new, state of the art training facility with agency opportunities for qualified candidates. If you have always wanted the freedom of being in business for yourself but not by yourself, Farmers could be your trusted partner to ensure long term business success. | ||||
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US CA Stockton |
Medical Insurance Billing & Coding Instructor - Adjunct |
Heald College | 7/3 | |
| Details: Job Title Medical Insurance Billing & Coding Instructor - Adjunct Job Code STC-MIBC Location Stockton, CA Description Do you like the stability of a company that has been around for 145 years but the excitement and energy of a new company poised for growth? Do you enjoy your profession but really desire to make a difference in your community? Heald College may be the right place for you. Heald College is a career college founded in 1863 that prepares students for academic, personal, and professional success through quality career- focused programs that develop skills to last a lifetime. Heald College has an opening for a Medical Insurance Billing and Coding Adjunct Instructor for our Stockton campus. This position oversees and instructs the overall operation of a campus’s Medical Insurance Billing and Coding program. A primary focus of this position must be on instruction, organization, planning, development, and general effectiveness of the program. Instructors, as a part of their professional responsibilities, are required to: Provide quality instruction; Meet course objectives, requirements, and student learning outcomes; Manage the classroom environment using a variety of teaching strategies; Provide formative and summative assessment of student learning; Facilitate a safe, positive and supportive learning environment; Support students in their efforts to succeed; Maintain accurate records and submit records and data by the due dates, compliance with FERPA, and other regulations; Participate in professional growth opportunities and support campus events; Model and employ professional and positive interpersonal relationships with colleagues and students; Work collaboratively with all members of the Heald-wide community; Serve on committees; Advise students; Participate in reviewing curriculum and course related conference calls; Provide feedback on textbooks for course adoptions; Respond to course/program surveys; and Adapt to changes in the work environmentProgram Responsibilities: Continually review the program and implement modifications needed that are specific to conducting the program efficiently on the campus. Review program and curriculum regularly. Make recommendations to appropriate parties for updates/changes as needed to maintain currency of the program. Review procedures for maintaining accurate records related to the Medical Insurance Billing and Coding. program. Make recommendations for guidelines and procedures to appropriate parties as needed. Review equipment needs for the program on an annual basis. Provide input regarding equipment needs as part of Academic Affairs Department budgeting process. Order necessary classroom supplies on an ongoing basis. Advise students as necessary regarding their experiences in the Medical Insurance Billing and Coding program. The minimum qualifications to successfully fulfill this function: RHIA or RHIT or CCS or CCS-P preferred CSA or CMA preferred 2 Years field experience Teaching experience preferred Bachelors degree desirable MIBC/Phlebotomy Certified Please include STC-MIBC in the subject of your response Heald College is an Equal Opportunity Employer. (cb) | ||||
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