Claims Clerk, Sr. jobs in Nevada

Claims Clerk, Sr. reviews insurance claim forms and supporting documents for completeness and accuracy and obtains missing information as necessary. Inputs claim information into system for processing. Being a Claims Clerk, Sr. verifies coverage eligibility. Calculates settlement amounts according to guidelines. Additionally, Claims Clerk, Sr. processes routine claim payments. Requires a high school diploma or equivalent. Typically reports to a supervisor. The Claims Clerk, Sr. works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. To be a Claims Clerk, Sr. typically requires 1-3 years of related experience. (Copyright 2024 Salary.com)

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Sr Insurance and Claims Specialist
  • Renown Health
  • Reno, NV FULL_TIME
  • Position Purpose

    The Senior Insurance and Claims Specialist is responsible for compliant billing, account follow up and system operations to ensure timely and accurate claim submission and prevention of denials per regulatory and payor requirements, as well as improved payment turnaround.

     

     

     

    Nature and Scope

    The Senior Insurance and Claim Specialist is responsible for:

     

    • Optimization of system that will ensure accurate claim submission and follow-up resulting in timely reimbursement per payor and regulatory guidelines.

    • Complete detailed appeal of denial or payment variance to payor, incorporating contract terms, clinical or regulatory justification for reconsideration or additional reimbursement.

    • Recommend system changes for clean claim submission to aid in the prevention of denials.

    • Work with the Renown Contracting Department or payor representatives to resolve billing issues due to payor or regulatory changes affecting the billing of healthcare claims.

    • Assisting with testing and troubleshooting of system for payor or regulatory changes.

    • Maintaining expertise for all payor, HIPAA and other regulatory changes affecting the billing of healthcare claims.

    • Working hand in hand with Operations Analysts and Information Technology to maintain and improve business system changes based on payor or regulatory changes.

    • Acts as a resource for staff on all areas relating to edit and denial/rejection resolution.

    • Identify trends in payor non-compliance and inform management if not able to resolve with payor.

    • Demonstrates a thorough knowledge of all department functions, processes, and procedures.

     

    This position does not provide patient care.

     

     

    Disclaimer

    The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.

     

     

     

    Minimum Qualifications
    Requirements - Required and/or Preferred

    Name

    Description

    Education:

    Must have working-level knowledge of the English language, including reading, writing and speaking English. Associates Degree Preferred.

    Experience:

    Two years healthcare billing office experience with extensive knowledge of healthcare billing, government and third party payor requirements.

    License(s):

    None

    Certification(s):

    Coding Certification Preferred for Professional Billing.

    Computer / Typing:

    Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.

     

     

  • 10 Days Ago

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NV - Reno - 1099 Property Claims Adjuster
  • Copper Claims Services, Inc.
  • Reno, NV FULL_TIME
  • 1099 Property Claims Adjuster Copper Claims Services is a quickly growing independent loss adjusting firm based out of Irvine, CA with offices in California, Arizona, Oregon, Nevada, Washington, Utah,...
  • 1 Month Ago

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NV - Las Vegas - 1099 Property Claims Adjuster
  • Copper Claims Services, Inc.
  • Las Vegas, NV FULL_TIME
  • 1099 Property Claims Adjuster Copper Claims Services is a quickly growing independent loss adjusting firm based out of Irvine, CA with offices in California, Arizona, Oregon, Nevada, Washington, Utah,...
  • 1 Month Ago

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Aerie - Sr Brand Ambassador (Sr Sales Associate) - US
  • Sr Brand Ambassador (Sr Sales Associate) - US - American Eagle Outfitters Careers
  • United States, NV FULL_TIME
  • BE PART OF SOMETHING REAL YOUR ROLE As a part-time Sr Brand Ambassador, you bring our brand to life every day! Your goal is to provide everyone who comes in the store with an amazing shopping experien...
  • 17 Days Ago

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AE - Sr Brand Ambassador (Sr Sales Associate) - US
  • Sr Brand Ambassador (Sr Sales Associate) - US - American Eagle Outfitters Careers
  • United States, NV FULL_TIME
  • BE PART OF SOMETHING REAL YOUR ROLE As a part-time Sr Brand Ambassador, you bring our brand to life every day! Your goal is to provide everyone who comes in the store with an amazing shopping experien...
  • 17 Days Ago

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2019-2020 General Resource Room Cooperative Teacher, 9-12
  • Juvenile Det. JR/SR
  • Las Vegas, NV FULL_TIME
  • 2019-2020 General Resource Room Cooperative Teacher, 9-12
  • 22 Days Ago

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Claims Administrator
  • Synkriom
  • Laguna Hills, CA
  • Job Description Job Description JOB DETAILS: Semi manual DMHO claims adjudication using our in-house claim system. MS Ex...
  • 3/28/2024 12:00:00 AM

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Claims Administrative Assistant
  • Brandon J. Broderick, Attorney At Law
  • River Edge, NJ
  • Job Description Job Description A prominent law firm based in Bergen County, NJ, is seeking an experienced Claims Admini...
  • 3/27/2024 12:00:00 AM

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Claims Handler/Estimator
  • Fusion Claims Consultants, LLC
  • Belcamp, MD
  • Job Description Job Description Company Description At Fusion Claims Consultants, we embody the spirit of unity and part...
  • 3/27/2024 12:00:00 AM

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Temporary Claims Administrator
  • Contemporary Staffing Solutions
  • King of Prussia, PA
  • Job Description Job Description Contemporary Staffing Solutions is seeking a Temporary Claims Administrator to support o...
  • 3/27/2024 12:00:00 AM

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Claims Administrative Support Specialist
  • Progressive Corp.
  • Greenville, SC
  • Job Description - Claims Administrative Support Specialist (188914) **** Claims Administrative Support Specialist **Job ...
  • 3/27/2024 12:00:00 AM

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Claims Administrator
  • Barasch & McGarry
  • New York, NY
  • Job Description Job Description Purpose Timely processing and managing of clients' Victim Compensation Fund, “VCF”, clai...
  • 3/26/2024 12:00:00 AM

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Claims Clerk
  • Canon Business Process Services, Inc.
  • Cincinnati, OH
  • Overview: The Claims Clerk will review insurance claims forms and documents for accuracy and completion and obtain missi...
  • 3/26/2024 12:00:00 AM

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Claims clerk
  • West Valley Staffing Group
  • Hayward, CA
  • Job Description Job Description About the role: 2-3 months contract – Monday to Friday (8-5) We are looking for a detail...
  • 3/26/2024 12:00:00 AM

Nevada is almost entirely within the Basin and Range Province, and is broken up by many north-south mountain ranges. Most of these ranges have endorheic valleys between them, which belies the image portrayed by the term Great Basin. Much of the northern part of the state is within the Great Basin, a mild desert that experiences hot temperatures in the summer and cold temperatures in the winter. Occasionally, moisture from the Arizona Monsoon will cause summer thunderstorms; Pacific storms may blanket the area with snow. The state's highest recorded temperature was 125 °F (52 °C) in Laughlin (e...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Clerk, Sr. jobs
$43,316 to $54,768

Claims Clerk, Sr. in Pittsburgh, PA
Please bring your information and your payment to the City Clerk.
January 10, 2020
Claims Clerk, Sr. in Alexandria, LA
Other names for this job might include Call Center Representative, Claim Processing Specialist, Claim Representative, Claim Service Representative, Claim Taker, Claim Technician, Claims Adjudicator, Claims Adjuster, Claims Associate, Claims Clerk.
January 30, 2020
Claims Clerk, Sr. in Pierre, SD
On this portion of the website, you will find the paperwork needed to initiate and respond to a small claims case within Ada County.
December 17, 2019