Medical Claims Specialist
2 weeks ago
Overview
St. John's Riverside Hospital is a leading healthcare provider dedicated to delivering exceptional patient care and advancing medical technology.
Career Opportunity
We are seeking an experienced Medical Claims Specialist to join our team in Yonkers, Westchester County. As a key member of our Business Office, you will play a vital role in ensuring seamless patient financial experiences.
Job Responsibilities:
Assist patients with navigating third-party benefits and insurance coverage.
Represent patients and families in applying for government programs, such as Medicaid and State Health Plans.
Conduct daily reviews of self-pay admissions for potential financial coverage.
Verify patient demographic and insurance information for accuracy.
Screen inpatients for insurance coverage and facilitate applications for Medicaid, QHP, and Health Solution programs.
Complete and process Medicaid applications in accordance with Department of Social Services guidelines.
Maintain communication with the Department of Social Services on pending Medicaid applications.
Perform clerical duties and other tasks assigned by management.
Requirements:
High school diploma or GED required; Associate degree in business preferred.
Excellent customer service and communication skills.
Proficiency in Word and Excel.
Proven analytical and problem-solving abilities.
Minimum 1 year experience in processing Medicaid applications.
Certified Application Counselor Certification required upon hire or within 90 days.
Bilingual English and Spanish preferred.
Compensation Package:
Our competitive salary range is $55,000 - $65,000 per annum, commensurate with experience.
-
Medical Claims Specialist
2 weeks ago
Johannesburg, Gauteng, South Africa Palesa Mbali Group Full timeA Medical Claims Specialist is required to support the management team in the client's Management department and attend to escalated queries. The role involves ensuring the prompt resolution of member queries regarding all medical aid claims, telephonically and in writing.Key ResponsibilitiesMaintain defined legal, statutory, and regulatory compliance at...
-
Medical Billing Specialist
1 month ago
Johannesburg, Gauteng, South Africa Ultra Personnel Full timeJob SummaryWe are seeking a skilled Medical Billing Specialist to join our team at Ultra Personnel.The ideal candidate will have a strong background in medical billing and a keen eye for detail. They will be responsible for ensuring accurate and timely processing of medical claims, as well as maintaining compliance with industry regulations.Key...
-
Claims Specialist
1 month ago
Johannesburg, Gauteng, South Africa Rad Resources Full timeJob Title: Claims SpecialistAt Rad Resources, we're seeking a skilled Claims Specialist to join our team. As a key member of our claims administration team, you'll be responsible for managing claims portfolios and ensuring timely and efficient resolution of claims.Key Responsibilities:Administer claims portfolios, including motor and non-motor claimsManage...
-
Medical Billings Operations Specialist
3 weeks ago
Johannesburg, Gauteng, South Africa Ultra Pharmaceutical and Medical Placements Full timeAbout Ultra Pharmaceutical and Medical PlacementsWe are a well-established private hospital group seeking an experienced Medical Billings Operations Specialist to join our team.
-
Claims Expert: Death Claims Specialist
1 week ago
Johannesburg, Gauteng, South Africa Liberty Group South Africa Full timeJob Overview:We are seeking a skilled Claims Expert to join our team in Johannesburg, South Africa.As a Claims Expert: Death Claims Specialist, you will be responsible for providing specialist advice and support in the area of death claims assessment.Key Responsibilities:Consult with internal stakeholders to provide specialist input into the development and...
-
Claims Specialist
3 weeks ago
Johannesburg, Gauteng, South Africa CFS Recruitment Full timeWe are seeking a skilled Claims Specialist to join CFS Recruitment. This role is ideal for individuals with experience in Non-Motor Claims and a passion for delivering exceptional customer service.About the RoleThis is an exciting opportunity to work in the insurance industry, where you will be responsible for handling claims, providing customer support, and...
-
Claims Resolution Specialist
3 weeks ago
Johannesburg, Gauteng, South Africa ATripleA Recruitment and Temps Full timeJob Title: Claims Resolution SpecialistWe are seeking a skilled Claims Resolution Specialist to join our team at A Triple A Recruitment and Temps. As a key member of our operations team, you will play a critical role in resolving insurance claims efficiently and effectively.Company Overview:A JSE listed Insurance company is looking for a highly motivated and...
-
Commercial Claims Specialist
1 month ago
Johannesburg, Gauteng, South Africa CFS Recruitment Full timeJob Title: Commercial Claims SpecialistCFS Recruitment is seeking a skilled Commercial Claims Specialist to handle all aspects of commercial claims in the insurance sector.Key Responsibilities:Assessing claims to determine validity and liabilityInvestigating claims to gather necessary informationNegotiating settlements with clients and third...
-
Claims Handler Specialist
1 month ago
Johannesburg, Gauteng, South Africa Energy at Work Projects Full timeJob Title: Claims Handler SpecialistDescription:We are seeking a talented Claims Handler Specialist to join our team at Energy at Work Projects. In this role, you will be responsible for handling and resolving claims in a timely and efficient manner.Key Responsibilities:Capture and process new claims in accordance with company policies and procedures.Serve...
-
Reinsurance Claims Specialist
1 month ago
Johannesburg, Gauteng, South Africa Planned Talent Full timeAt Planned Talent, we are seeking a seasoned professional to fill the role of Reinsurance Claims Specialist. This position plays a vital part in our commitment to delivering comprehensive risk solutions to our clients.Key Responsibilities:Oversee the management of reinsurance claims, ensuring accuracy and efficiency in claim processes.Apply strong expertise...
-
Senior Claims Specialist
4 days ago
Johannesburg, Gauteng, South Africa Momentum Metropolitan Holdings Limited Full timeJob Title: Senior Claims SpecialistAbout the Role:We are seeking a highly skilled and experienced Senior Claims Specialist to join our team at Momentum Metropolitan Holdings Limited.Responsibilities:Handle and settle motor and non-motor own damage claims in accordance with applicable policies and standard operating procedures.Ensure timely resolution of...
-
Specialist Claims Handler
1 month ago
Johannesburg, Gauteng, South Africa Old Mutual Full timeAbout the RoleWe are seeking a highly skilled Specialist Claims Handler to join our team at Old Mutual.Key ResponsibilitiesProvide a quality Specialist claims service, ensuring containment of claims spend and delivering excellent service in setting a culture of best practice within mandated responsibility.Execute end-to-end claim processing, including...
-
Claims Resolution Specialist
1 month ago
Johannesburg, Gauteng, South Africa MotoRite Administrators (Pty) Ltd Full timeJob SummaryThe Claims Resolution Specialist role is designed to support the administration of claims on service plans, maintenance plans, and warranties. The successful candidate will be responsible for processing claims, interacting with customers, and adhering to predefined standards and procedures.Key ResponsibilitiesProcess claims in a timely and...
-
Medical Billing Specialist
1 month ago
Johannesburg, Gauteng, South Africa Ultra Personnel Full timeJob Summary:Job Title: Medical Billing SpecialistCompany: Ultra PersonnelLocation: Not SpecifiedJob Type: Full-timeSalary: Not SpecifiedResponsibilities:Perform Billings Auditing duties in accordance with the standard and procedureAdhere to the principles and standards of patient careReview and analyse reports as a management tool, in order to identify...
-
Medical Claims Coordinator
3 weeks ago
Johannesburg, Gauteng, South Africa Exclusively Remote Full timeAt Exclusively Remote, we are seeking a dedicated Medical Claims Coordinator to provide essential services that assist elderly clients in qualifying for Medicare and social medicine services. Our company works with referrals from doctors, lawyers, nursing homes, and other professionals to help manage estates and ensure our clients receive the care they...
-
Senior Claims Specialist
3 weeks ago
Johannesburg, Gauteng, South Africa Energy at Work Projects Full timeCompany OverviewAt Energy at Work Projects, we are committed to delivering exceptional services that meet the evolving needs of our clients. As a leading provider of innovative solutions, we strive to foster a culture of excellence and teamwork.Salary and BenefitsWe offer a competitive salary range of $80,000 - $110,000 per annum, commensurate with...
-
Claims Resolution Specialist
1 month ago
Johannesburg, Gauteng, South Africa CFS Recruitment Full timeKey Requirements:Qualifications: Matric, RE 5, FETC in Short-Term Insurance, TIAL, Ms. OfficeWork Experience: 2 years of working experience in Non-Motor Claims, Customer Service, Broker experience, Worked for a licensed insurance companyAbout the Role: We are seeking a skilled Claims Resolution Specialist to join our team at CFS Recruitment. In this role,...
-
Insurance Claims Specialist
3 weeks ago
Johannesburg, Gauteng, South Africa EMPIRE RECRUITMENT Full timeJob SummaryWe are seeking a highly skilled Insurance Claims Specialist to join our team at Empire Recruitment.About the RoleThe successful candidate will be responsible for ensuring the accurate capturing, processing, and finalisation of all Commercial Claims.Key Responsibilities:Capture, process, and finalise Commercial Claims efficiently and...
-
Senior Claims Management Specialist
1 week ago
Johannesburg, Gauteng, South Africa ATripleA Recruitment and Temps Full timeWe are looking for a highly skilled and detail-oriented Senior Claims Management Specialist to join our team at ATripleA Recruitment and Temps.As a Senior Claims Management Specialist, you will be responsible for the day-to-day management of claims, including administering claims and opening files, managing repudiations, and ensuring fair and diplomatic...
-
Senior Claims Specialist: Policy Expert
1 week ago
Johannesburg, Gauteng, South Africa Liberty Group South Africa Full timeJob TitleSenior Claims Specialist: Policy ExpertAbout the RoleWe are seeking a skilled Senior Claims Specialist to join our team in Gauteng, Johannesburg. The successful candidate will be responsible for providing specialist advice and support in area of specialisation enabling the provision of sound claims assessment expertise.Key ResponsibilitiesConsult in...