Claims Clerk jobs in Mishawaka, IN

Claims Clerk 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 verifies coverage eligibility. Calculates settlement amounts according to guidelines. Additionally, Claims Clerk processes routine claim payments. Requires a high school diploma or equivalent. Typically reports to a supervisor. The Claims Clerk works under the close direction of senior personnel in the functional area. Possesses a moderate understanding of general aspects of the job. May require 0-1 year of general work experience. (Copyright 2024 Salary.com)

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Medical Claims Specialist - Hybrid
  • AC3, Inc.
  • South Bend, IN FULL_TIME
  • WHO WE ARE:

    AC3 was founded by practicing oncologists along with data and practice analytics experts to support the business side of medicine. Our mission is to modernize and digitize the delivery of healthcare and improve countless lives along the way.

    We combine the power of big data technology and people to enable easier frontline decisions about complex problems. AC3 offers its employees an exciting, fast-paced, and challenging work environment. To learn more about AC3, visit us at www.ac3health.com.

    COMPANY MISSION: To simplify healthcare and reduce the cost of care, empowering care givers to focus on what matters most – fighting cancer.

    POSITION SUMMARY

    This is a hybrid position; meaning, there are occasional onsite requirements. The ideal candidate will reside within a 2 - 3 hour radius of the office in South Bend, IN. This position is responsible for gathering and processing the information required to complete the medical insurance claims process. They will be responsible for documenting and entering required information in our systems. The team member is also responsible for ensuring the collection of outstanding accounts from insurance carriers, monitoring claims submission, writing letters of appeal, reviewing, and obtaining necessary documentation to submit claims. He/she will notify the Team Leader and Revenue Cycle Manger of any claim submission errors or specific payer issues to ensure the department.

    ESSENTIAL FUNCTIONS AND JOB RESPONSIBILITIES

    Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

    • Monitors delinquent accounts and assists in resolving issues to obtain payment.
    • Compiles letters of appeal complete with LCD/NCD/ payer requirement citations.
    • Knowledge of HCPCS codes and track payer policy changes to communicate with team.
    • Interprets and utilizes medical policies and procedures.
    • Maintains login credentials and access to all assigned payer portals.
    • Monitors and works assigned tasks in PM system to maintain productivity metrics.
    • Responds to all correspondence to clients and RCM team timely.
    • Disputes and works all necessary zero pays, underpayments, and denials.
    • Prevents all possible “timely follow-up” denials on claims or appeals.
    • Determines covered medical insurance losses and overpayments.
    • Documents all medical claims actions and resolutions as specified in SOP.
    • Analyzes insurance claims to prevent fraud.
    • Maintains the practices and principles set forth by AC3 leadership with a strong commitment to service, excellence, and quality.
    • Maintains professional behavior, confidentiality, and discretion at all times, along with the ability to work with all levels of staff with a confident and professional demeanor.
    • Follows HIPPA rules and regulations.

    POSITION REQUIREMENTS

    • High school diploma or equivalent (GED).
    • Medical office experience/medical terminology preferred.
    • Accurately maintains and adheres to all safety rules and regulations.
    • Must be detail oriented and have problem solving abilities.
    • Proficient in Microsoft Office preferred.
    • Working knowledge/experience in electronic medical records and/ or other medical software if applicable.
    • Must possess the ability to work with patients and family members in a confident, respectful, and socially professional manner.
    • Must rely on experience and judgment to plan and accomplish goals.
    • Excellent communication and organizational skills with the ability to work in a fast paced environment; prioritize tasks and workloads.
    • Performs other duties as assigned.
    • This is a remote position with the expectation of travel to meet the needs of the position. Work is completed in a general office environment, sedentary in nature but may require standing and walking for up to 10% of the time. The work environment is favorable with adequate lighting and temperature, and no hazardous or unpleasant conditions caused by noise, dust, etc. Must be able to operate standard office equipment and keyboards.

    Why Work at AC3?

    When you become an AC3 Team member, you can expect ongoing training, support, and a work culture like no other. We offer our Full-Time Team Members medical, dental and vision health and wellness benefits, along with employer paid life insurance, long and short-term disability policies. Because our team’s health and wellness are our priority, we start new hires off with an above average paid time out plan and offer a comprehensive wellness program, including onsite biometrics and ongoing mental and physical wellness support. We also provide all Team Members with access to company sponsored financial wellness counselors, employee assistance services and the opportunity to enroll in our company-matched, 401k plan.

    Come join our Winning Team!

  • 1 Month Ago

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Independent Insurance Claims Adjuster in Mishawaka, Indiana
  • MileHigh Adjusters Houston Inc
  • Mishawaka, IN FULL_TIME
  • Exciting Opportunity for Aspiring Claims Adjusters! INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW!Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjus...
  • Just Posted

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Independent Insurance Claims Adjuster in South Bend, Indiana
  • MileHigh Adjusters Houston Inc
  • South Bend, IN FULL_TIME
  • Exciting Opportunity for Aspiring Claims Adjusters! INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW!Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjus...
  • Just Posted

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Independent Insurance Claims Adjuster in Granger, Indiana
  • MileHigh Adjusters Houston Inc
  • Granger, IN FULL_TIME
  • Exciting Opportunity for Aspiring Claims Adjusters! INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW!Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjus...
  • 1 Day Ago

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Independent Insurance Claims Adjuster in La Porte, Indiana
  • MileHigh Adjusters Houston Inc
  • La Porte, IN FULL_TIME
  • ADJUSTERS NEEDED NOW FOR ALL STORM RELATED SEASONS!Independent Insurance Claims Adjusters Needed Now! This is a HUGE opportunity for you, since there is currently a HIGH DEMAND forNEW ADJUSTERS AND NE...
  • 11 Days Ago

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Insurance Claims Analyst, 1st Source Insurance, Mishawaka, IN
  • 1st Source Insurance Inc
  • Mishawaka, IN FULL_TIME
  • POSITION SUMMARY This position is responsible for accurate reporting and filing of claims to the respective Carrier, in addition to handling complex claims scenarios along with resolution of claims di...
  • 27 Days Ago

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0 Claims Clerk jobs found in Mishawaka, IN area

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Retail Administrative Assistant (PT/FT)
  • Dick's Sporting Goods
  • South Bend, IN
  • Ready to take your passion for sports to the next level? As a Retail Administrative Assistant you will: Assist managers ...
  • 4/28/2024 12:00:00 AM

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Retail Administrative Assistant (PT/FT)
  • Dick's Sporting Goods
  • Granger, IN
  • Ready to take your passion for sports to the next level? As a Retail Administrative Assistant you will: Assist managers ...
  • 4/28/2024 12:00:00 AM

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Retail Administrative Assistant (PT/FT)
  • Dick's Sporting Goods
  • Goshen, IN
  • Ready to take your passion for sports to the next level? As a Retail Administrative Assistant you will: Assist managers ...
  • 4/28/2024 12:00:00 AM

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Human Resources Manager
  • Ernest Health
  • Mishawaka, IN
  • Overview: We are seeking a Human Resources Manager to join our team of passionate patient caregivers! As a participating...
  • 4/27/2024 12:00:00 AM

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Mental Health Therapist (Contractor)
  • Spring Health
  • South Bend, IN
  • Our mission: We're on a mission to help individuals and organizations thrive by eliminating every barrier to mental heal...
  • 4/27/2024 12:00:00 AM

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Mental Health Therapist (Contractor)
  • Spring Health
  • South Bend, IN
  • Our mission: We're on a mission to help individuals and organizations thrive by eliminating every barrier to mental heal...
  • 4/26/2024 12:00:00 AM

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Operations Manager
  • Dayton Freight
  • Elkhart, IN
  • Overview: Stable and growing organization Competitive weekly pay Quick advancement Professional, positive and people-cen...
  • 4/26/2024 12:00:00 AM

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Retail Administrative Assistant (PT/FT)
  • Dick's Sporting Goods
  • Elkhart, IN
  • Ready to take your passion for sports to the next level? As a Retail Administrative Assistant you will: Assist managers ...
  • 4/24/2024 12:00:00 AM

Mishawaka /ˌmɪʃəˈwɑːkə/ is a city on the St. Joseph River, in Penn Township, St. Joseph County, in the U.S. state of Indiana. The population was 48,252 as of the 2010 census. Its nickname is "the Princess City." Mishawaka is a principal city of the South Bend–Mishawaka, IN-MI, Metropolitan Statistical Area. According to the 2010 census, Mishawaka has a total area of 17.348 square miles (44.93 km2), of which 17 square miles (44.03 km2) (or 97.99%) is land and 0.348 square miles (0.90 km2) (or 2.01%) is water....
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Clerk jobs
$34,390 to $43,511
Mishawaka, Indiana area prices
were up 1.3% from a year ago