1,794 Healthcare Claims jobs in the United States
Business Analyst- Healthcare Claims
Posted 1 day ago
Job Viewed
Job Description
This Business Analyst position is specifically focused on claims operations , including claims processing, benefit reviews, and system configuration. The role is responsible for gathering and documenting internal and client-facing workflows tied to claims administration and benefit delivery. The analyst will review system configuration for alignment with contract and program requirements-including claims setup, pricing, benefits, and UAT outcomes-and will work closely with subject matter experts and leadership to translate operational concepts into clear documentation, process maps, and support materials. Additional responsibilities include reviewing benefit policies and procedures for accuracy and documenting necessary updates.
- 100% Remote
- Open to Direct Hire or Contract (1099)
- This role is not eligible for visa sponsorship (e.g., H-1B, TN, etc.)
- Meet with clients to gather operational and functional requirements, document processes, dependencies, and decision points in real time.
- Review system configuration to ensure they are meeting contract or program requirements. This may include claims, pricing, system configuration, UAT results and benefits.
- Review benefit policy and procedure documents for accuracy and incorporate updates into requirements documentation
- Collaborate with proposal teams to develop storyboards and solution frameworks aligned to government RFPs and program requirements.
- Participate in internal kickoff meetings, brainstorming sessions, and review cycles to refine solution narratives and ensure alignment with client objectives.
- Contribute to the development of SOPs, internal playbooks, staffing models, and other pre- and post-award materials.
- Serve as the central point of contact for assigned projects-facilitating communication between clients, internal teams, and vendors.
- Assist with the development of SOPs, internal playbooks, and proposal content as needed to support contract growth or onboarding.
- Support general administration and compliance oversight, including reporting, and quality control.
- FACETS Experience preferred.
- Previous experience in claims audit, processing, or system configurations.
- Previous healthcare experience; Government healthcare or TRICARE highly preferred.
- Comfortable interacting with internal and external stakeholders and translating client requests into business-friendly documentation.
- Experience facilitating meetings, taking detailed notes, and capturing follow-up tasks and dependencies.
- Strong time management, task tracking, and organizational skills.
Salary Range Disclosure:
The expected salary range for this position is $95,000 to $135,000 per year. Actual compensation will be determined based on experience, skills, and location.
Government Market Strategies is an Equal Opportunity Employer. We are committed to fostering a diverse and inclusive workplace and consider all qualified applicants for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected characteristic under applicable law.
We also participate in the E-Verify program and will provide the Social Security Administration (SSA) and, if necessary, the Department of Homeland Security (DHS), with information from each new employee's Form I-9 to confirm work authorization.
If you require a reasonable accommodation to apply for a position or to participate in the application process, please contact HR-governmentmarketstrategies.com
Medical Biller - Healthcare Claims
Posted 2 days ago
Job Viewed
Job Description
PFS Billing
Travel Required: None
Clearance Required: None
What You Will Do: The Medical Biller is expected to perform all areas of initial billing, secondary billing, and payer audit follow-up for government and non-government claims. Must work with other departments to facilitate the meeting of both departmental and facility goals and objectives. Demonstrates an ability to find solutions to problems and keeps management informed of patterns regarding billing edits, compliance issues, payments and or other issues with specific payers.
Has an extensive knowledge of billing requirements mandated by payers and/or governmental regulations. This position will perform any and all related job duties as assigned.
Essential Job Functions:
- Hospital Billing Emphasis
- Correcting and billing electronic and hardcopy claims
- Submits Adjusted claims
- Provides Follow-up Billing
- Prepares Billing Reconciliation
Duties and Responsibilities:
- Performs daily download and reconciliation of claims from patient accounting system to electronic billing system.
- Transmits or releases claims at a minimum daily.
- Works all assigned claims daily by resolving edits, validating claim, or placing on departmental hold by reason.
- Follows-up on all assigned held claims or unreleased claims.
- Bills claims via electronic billing system.
- Reviews same day and 72 hour admission report to determine if accounts needed to be combined.
- Ensures all address changes and or plan changes are forwarded to the appropriate people so the integrity of the insurance master is maintained.
- Files adjusted billings based on audits and or changes in diagnosis or DRG.
- Updates patient accounts with corrected demographic or insurance information.
- Works all rejection and payer audit reports within 48 hours of receipt taking whatever action may be required to obtain account resolution.
- Monitors all denials for trends and issues and reports finding to supervisor.
- Bills or re-bills as necessary.
- Ensures hospital is in compliance with all state and federal rules and regulations both billing and HIPAA.
- Assigned special projects will be completed within the time frames given.
- Appropriately documents electronic billing system and/or patient accounting system.
- Attends training sessions and seminars offered by the Hospital and Third Party Payers.
- Handles all customer calls both internal and external in a professional and courteous manner.
- Returns calls and emails as soon as possible, but must be returned within 24 hours.
- Follows the mission statement and values established by the facility.
What You Will Need:
- High School Diploma / GED or 3 years of relevant equivalent experience in lieu of diploma / GED.
- 1-3+ years working within the following sectors: healthcare, insurance, business, finance or customer service.
- Working knowledge can be of the following: insurance claims, billing, coding, follow-up, finance, accounting or customer service related responsibilities.
What Would Be Nice To Have:
- Previous billing background.
- Emphasis in Hospital Billing
- Excellent communication and interpersonal skills.
- Experience with Excel and Word.
The annual salary range for this position is $42,000.00-$70,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.
What We Offer:
- Medical, Rx, Dental & Vision Insurance
- Personal and Family Sick Time & Company Paid Holidays
- Position may be eligible for a discretionary variable incentive bonus
- Parental Leave
- 401(k) Retirement Plan
- Basic Life & Supplemental Life
- Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
- Short-Term & Long-Term Disability
- Tuition Reimbursement, Personal Development & Learning Opportunities
- Skills Development & Certifications
- Employee Referral Program
- Corporate Sponsored Events & Community Outreach
- Emergency Back-Up Childcare Program
About Guidehouse:
Guidehouse is an Equal Opportunity EmployerProtected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.
Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.
If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at or via email at All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.
All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.
If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse's Ethics Hotline. If you want to check the validity of correspondence you have received, please contact Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant's dealings with unauthorized third parties.
Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.
Medical Biller Healthcare Claims
Posted 7 days ago
Job Viewed
Job Description
The Medical Biller is expected to perform all areas of initial billing, secondary billing, and payer audit follow-up for government and non-government claims. Must work with other departments to facilitate the meeting of both departmental and facility goals and objectives. Demonstrates an ability to find solutions to problems and keeps management informed of patterns regarding billing edits, compliance issues, payments and or other issues with specific payers. Has an extensive knowledge of billing requirements mandated by payers and / or governmental regulations. This position will perform any and all related job duties as assigned. The medical biller will be working a Hybrid schedule of two days at either the San Marcos, CA or El Segundo, CA offices and three days from home.
Essential Job Functions
- Hospital Billing Emphasis
- Correcting and billing electronic and hardcopy claims
- Submits Adjusted claims
- Provides Follow-up Billing
- Prepares Billing Reconciliation
Duties and Responsibilities
- Performs daily download and reconciliation of claims from patient accounting system to electronic billing system.
- Transmits or releases claims at a minimum daily.
- Works all assigned claims daily by resolving edits, validating claim, or placing on departmental hold by reason.
- Follows-up on all assigned held claims or unreleased claims.
- Bills claims via electronic billing system.
- Reviews same day and 72 hour admission report to determine if accounts needed to be combined.
- Ensures all address changes and or plan changes are forwarded to the appropriate people so the integrity of the insurance master is maintained.
- Files adjusted billings based on audits and or changes in diagnosis or DRG.
- Updates patient accounts with corrected demographic or insurance information.
- Works all rejection and payer audit reports within 48 hours of receipt taking whatever action may be required to obtain account resolution.
- Monitors all denials for trends and issues and reports finding to supervisor.
- Bills or re-bills as necessary.
- Ensures hospital is in compliance with all state and federal rules and regulations both billing and HIPAA.
- Assigned special projects will be completed within the time frames given.
- Apropriately documents electronic billing system and/or patient accounting system.
- Attends training sessions and seminars offered by the Hospital and Third Party Payers.
- Handles all customer calls both internal and external in a professional and courteous manner.
- Returns calls and emails as soon as possible, but must be returned within 24 hours.
- Follows the mission statement and values established by the facility.
What You Will Need
- High School Diploma / GED or 3 years of relevant equivalent experience in lieu of diploma / GED.
- 0-2 years working within the following sectors: healthcare, insurance, business, finance or customer service.
- Working knowledge can be of the following: insurance claims, billing, coding, follow-up, finance, accounting or customer service related responsibilities.
What Would Be Nice To Have
- Previous billing background.
- Emphasis in Hospital Billing
- Excellent communication and interpersonal skills.
- Experience with Excel and Word.
What We Offer
- Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.
- Benefits include: Medical, Rx, Dental & Vision Insurance
- Personal and Family Sick Time & Company Paid Holidays
- Position may be eligible for a discretionary variable incentive bonus
- Parental Leave
- 401(k) Retirement Plan
- Basic Life & Supplemental Life
- Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
- Short-Term & Long-Term Disability
- Tuition Reimbursement, Personal Development & Learning Opportunities
- Skills Development & Certifications
- Employee Referral Program
- Corporate Sponsored Events & Community Outreach
- Emergency Back-Up Childcare Program
About Guidehouse
Guidehouse is an Equal Opportunity EmployerProtected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.
Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.
If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at or via email at . All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.
All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or . Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouses Ethics Hotline. If you want to check the validity of correspondence you have received, please contact . Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicants dealings with unauthorized third parties.Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.
Dovel Technologies
#J-18808-LjbffrMedical Biller - Healthcare Claims
Posted 9 days ago
Job Viewed
Job Description
The Medical Biller is expected to perform all areas of initial billing, secondary billing, and payer audit follow-up for government and non-government claims. Must work with other departments to facilitate the meeting of both departmental and facility goals and objectives. Demonstrates an ability to find solutions to problems and keeps management informed of patterns regarding billing edits, compliance issues, payments and or other issues with specific payers.
Has an extensive knowledge of billing requirements mandated by payers and/or governmental regulations. This position will perform any and all related job duties as assigned.
The medical biller will be working a hybrid schedule based either at the San Marcos, CA or El Segundo, CA offices and from home.
Essential Job Functions:
- Hospital Billing Emphasis
- Correcting and billing electronic and hardcopy claims
- Submits adjusted claims
- Provides follow-up billing
- Prepares billing reconciliation
Duties and Responsibilities:
- Performs daily download and reconciliation of claims from patient accounting system to electronic billing system.
- Transmits or releases claims at a minimum daily.
- Works all assigned claims daily by resolving edits, validating claim, or placing on departmental hold by reason.
- Follows-up on all assigned held claims or unreleased claims.
- Bills claims via electronic billing system.
- Reviews same day and 72 hour admission report to determine if accounts needed to be combined.
- Ensures all address changes and or plan changes are forwarded to the appropriate people so the integrity of the insurance master is maintained.
- Files adjusted billings based on audits and or changes in diagnosis or DRG.
- Updates patient accounts with corrected demographic or insurance information.
- Works all rejection and payer audit reports within 48 hours of receipt taking whatever action may be required to obtain account resolution.
- Monitors all denials for trends and issues and reports finding to supervisor.
- Bills or re-bills as necessary.
- Ensures hospital is in compliance with all state and federal rules and regulations both billing and HIPAA.
- Assigned special projects will be completed within the time frames given.
- Appropriately documents electronic billing system and/or patient accounting system.
- Attends training sessions and seminars offered by the Hospital and Third Party Payers.
- Handles all customer calls both internal and external in a professional and courteous manner.
- Returns calls and emails as soon as possible, but must be returned within 24 hours.
- Follows the mission statement and values established by the facility.
What You Will Need:
- High School Diploma / GED or 3 years of relevant equivalent experience in lieu of diploma / GED.
- 0-2+ years working within the following sectors: healthcare, insurance, business, finance or customer service.
- Working knowledge can be of the following: insurance claims, billing, coding, follow-up, finance, accounting or customer service related responsibilities.
What Would Be Nice To Have:
- Previous billing background.
- Emphasis in hospital billing
- Excellent communication and interpersonal skills.
- Experience with Excel and Word.
The annual salary range for this position is $38,000.00-$63,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.
What We Offer: Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.
Benefits include:
- Medical, Rx, Dental & Vision Insurance
- Personal and Family Sick Time & Company Paid Holidays
- Position may be eligible for a discretionary variable incentive bonus
- Parental Leave
- 401(k) Retirement Plan
- Basic Life & Supplemental Life
- Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
- Short-Term & Long-Term Disability
- Tuition Reimbursement, Personal Development & Learning Opportunities
- Skills Development & Certifications
- Employee Referral Program
- Corporate Sponsored Events & Community Outreach
- Emergency Back-Up Childcare Program
About Guidehouse: Guidehouse is an Equal Opportunity EmployerProtected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.
Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.
If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at or via email at
All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse.
Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.
If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse's Ethics Hotline.
Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.
Medical Biller - Healthcare Claims

Posted 1 day ago
Job Viewed
Job Description
PFS Billing
**Travel Required** **:**
None
**Clearance Required** **:**
None
**What You Will Do** **:**
The **Medical Biller** is expected to perform all areas of initial billing, secondary billing, and payer audit follow-up for government and non-government claims. Must work with other departments to facilitate the meeting of both departmental and facility goals and objectives. Demonstrates an ability to find solutions to problems and keeps management informed of patterns regarding billing edits, compliance issues, payments and or other issues with specific payers.
Has an extensive knowledge of billing requirements mandated by payers and / or governmental regulations. This position will perform any and all related job duties as assigned.
**_The medical biller will be working a Hybrid schedule based at our San Marcos, CA office and from home._**
**Essential Job Functions**
+ Hospital Billing Emphasis
+ Correcting and billing electronic and hardcopy claims
+ Submits Adjusted claims
+ Provides Follow-up Billing
+ Prepares Billing Reconciliation
**Duties and Responsibilities**
+ Performs daily download and reconciliation of claims from patient accounting system to electronic billing system.
+ Transmits or releases claims at a minimum daily.
+ Works all assigned claims daily by resolving edits, validating claim, or placing on departmental hold by reason.
+ Follows-up on all assigned held claims or unreleased claims.
+ Bills claims via electronic billing system.
+ Reviews same day and 72 hour admission report to determine if accounts needed to be combined.
+ Ensures all address changes and or plan changes are forwarded to the appropriate people so the integrity of the insurance master is maintained.
+ Files adjusted billings based on audits and or changes in diagnosis or DRG.
+ Updates patient accounts with corrected demographic or insurance information.
+ Works all rejection and payer audit reports within 48 hours of receipt taking whatever action may be required to obtain account resolution.
+ Monitors all denials for trends and issues and reports finding to supervisor.
+ Bills or re-bills as necessary.
+ Ensures hospital is in compliance with all state and federal rules and regulations both billing and HIPAA.
+ Assigned special projects will be completed within the time frames given.
+ Appropriately documents electronic billing system and/or patient accounting system.
+ Attends training sessions and seminars offered by the Hospital and Third Party Payers.
+ Handles all customer calls both internal and external in a professional and courteous manner.
+ Returns calls and emails as soon as possible, but must be returned within 24 hours.
+ Follows the mission statement and values established by the facility.
**What You Will Need** **:**
+ High School Diploma / GED or 3 years of relevant equivalent experience in lieu of diploma / GED.
+ 1-3+ years working within the following sectors: healthcare, insurance, business, finance or customer service.
+ Working knowledge can be of the following: insurance claims, billing, coding, follow-up, finance, accounting or customer service related responsibilities.
**What Would Be Nice To Have** **:**
+ Previous billing background.
+ Emphasis in Hospital Billing
+ Excellent communication and interpersonal skills.
+ Experience with Excel and Word.
#IndeedSponsored
#LI-DNI
The annual salary range for this position is $42,000.00-$70,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.
**What We Offer** **:**
Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.
Benefits include:
+ Medical, Rx, Dental & Vision Insurance
+ Personal and Family Sick Time & Company Paid Holidays
+ Position may be eligible for a discretionary variable incentive bonus
+ Parental Leave
+ 401(k) Retirement Plan
+ Basic Life & Supplemental Life
+ Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
+ Short-Term & Long-Term Disability
+ Tuition Reimbursement, Personal Development & Learning Opportunities
+ Skills Development & Certifications
+ Employee Referral Program
+ Corporate Sponsored Events & Community Outreach
+ Emergency Back-Up Childcare Program
**About Guidehouse**
Guidehouse is an Equal Opportunity Employer-Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.
Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.
If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at or via email at . All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.
All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or . Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.
If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse's Ethics Hotline. If you want to check the validity of correspondence you have received, please contact . Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant's dealings with unauthorized third parties.
_Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee._
Medical Biller - Healthcare Claims

Posted 1 day ago
Job Viewed
Job Description
PFS Billing
**Travel Required** **:**
None
**Clearance Required** **:**
None
**What You Will Do** **:**
The **Medical Biller** is expected to perform all areas of initial billing, secondary billing, and payer audit follow-up for government and non-government claims. Must work with other departments to facilitate the meeting of both departmental and facility goals and objectives. Demonstrates an ability to find solutions to problems and keeps management informed of patterns regarding billing edits, compliance issues, payments and or other issues with specific payers.
Has an extensive knowledge of billing requirements mandated by payers and / or governmental regulations. This position will perform any and all related job duties as assigned.
**_The medical biller will be working a Hybrid schedule based at our San Marcos, CA office and from home._**
**Essential Job Functions**
+ Hospital Billing Emphasis
+ Correcting and billing electronic and hardcopy claims
+ Submits Adjusted claims
+ Provides Follow-up Billing
+ Prepares Billing Reconciliation
**Duties and Responsibilities**
+ Performs daily download and reconciliation of claims from patient accounting system to electronic billing system.
+ Transmits or releases claims at a minimum daily.
+ Works all assigned claims daily by resolving edits, validating claim, or placing on departmental hold by reason.
+ Follows-up on all assigned held claims or unreleased claims.
+ Bills claims via electronic billing system.
+ Reviews same day and 72 hour admission report to determine if accounts needed to be combined.
+ Ensures all address changes and or plan changes are forwarded to the appropriate people so the integrity of the insurance master is maintained.
+ Files adjusted billings based on audits and or changes in diagnosis or DRG.
+ Updates patient accounts with corrected demographic or insurance information.
+ Works all rejection and payer audit reports within 48 hours of receipt taking whatever action may be required to obtain account resolution.
+ Monitors all denials for trends and issues and reports finding to supervisor.
+ Bills or re-bills as necessary.
+ Ensures hospital is in compliance with all state and federal rules and regulations both billing and HIPAA.
+ Assigned special projects will be completed within the time frames given.
+ Appropriately documents electronic billing system and/or patient accounting system.
+ Attends training sessions and seminars offered by the Hospital and Third Party Payers.
+ Handles all customer calls both internal and external in a professional and courteous manner.
+ Returns calls and emails as soon as possible, but must be returned within 24 hours.
+ Follows the mission statement and values established by the facility.
**What You Will Need** **:**
+ High School Diploma / GED or 3 years of relevant equivalent experience in lieu of diploma / GED.
+ 0-2+ years working within the following sectors: healthcare, insurance, business, finance or customer service.
+ Working knowledge can be of the following: insurance claims, billing, coding, follow-up, finance, accounting or customer service related responsibilities.
**What Would Be Nice To Have** **:**
+ Previous billing background.
+ Emphasis in Hospital Billing
+ Excellent communication and interpersonal skills.
+ Experience with Excel and Word.
#IndeedSponsored
#LI-DNI
The annual salary range for this position is $38,000.00-$63,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.
**What We Offer** **:**
Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.
Benefits include:
+ Medical, Rx, Dental & Vision Insurance
+ Personal and Family Sick Time & Company Paid Holidays
+ Position may be eligible for a discretionary variable incentive bonus
+ Parental Leave
+ 401(k) Retirement Plan
+ Basic Life & Supplemental Life
+ Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
+ Short-Term & Long-Term Disability
+ Tuition Reimbursement, Personal Development & Learning Opportunities
+ Skills Development & Certifications
+ Employee Referral Program
+ Corporate Sponsored Events & Community Outreach
+ Emergency Back-Up Childcare Program
**About Guidehouse**
Guidehouse is an Equal Opportunity Employer-Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.
Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.
If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at or via email at . All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.
All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or . Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.
If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse's Ethics Hotline. If you want to check the validity of correspondence you have received, please contact . Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant's dealings with unauthorized third parties.
_Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee._
Medical Biller - Healthcare Claims

Posted 1 day ago
Job Viewed
Job Description
PFS Billing
**Travel Required** **:**
None
**Clearance Required** **:**
None
**What You Will Do** **:**
The **Medical Biller** is expected to perform all areas of initial billing, secondary billing, and payer audit follow-up for government and non-government claims. Must work with other departments to facilitate the meeting of both departmental and facility goals and objectives. Demonstrates an ability to find solutions to problems and keeps management informed of patterns regarding billing edits, compliance issues, payments and or other issues with specific payers.
Has an extensive knowledge of billing requirements mandated by payers and / or governmental regulations. This position will perform any and all related job duties as assigned.
**_The medical biller will be working a Hybrid schedule based either at the San Marcos, CA or El Segundo, CA offices and from home._**
**Essential Job Functions**
+ Hospital Billing Emphasis
+ Correcting and billing electronic and hardcopy claims
+ Submits Adjusted claims
+ Provides Follow-up Billing
+ Prepares Billing Reconciliation
**Duties and Responsibilities**
+ Performs daily download and reconciliation of claims from patient accounting system to electronic billing system.
+ Transmits or releases claims at a minimum daily.
+ Works all assigned claims daily by resolving edits, validating claim, or placing on departmental hold by reason.
+ Follows-up on all assigned held claims or unreleased claims.
+ Bills claims via electronic billing system.
+ Reviews same day and 72 hour admission report to determine if accounts needed to be combined.
+ Ensures all address changes and or plan changes are forwarded to the appropriate people so the integrity of the insurance master is maintained.
+ Files adjusted billings based on audits and or changes in diagnosis or DRG.
+ Updates patient accounts with corrected demographic or insurance information.
+ Works all rejection and payer audit reports within 48 hours of receipt taking whatever action may be required to obtain account resolution.
+ Monitors all denials for trends and issues and reports finding to supervisor.
+ Bills or re-bills as necessary.
+ Ensures hospital is in compliance with all state and federal rules and regulations both billing and HIPAA.
+ Assigned special projects will be completed within the time frames given.
+ Appropriately documents electronic billing system and/or patient accounting system.
+ Attends training sessions and seminars offered by the Hospital and Third Party Payers.
+ Handles all customer calls both internal and external in a professional and courteous manner.
+ Returns calls and emails as soon as possible, but must be returned within 24 hours.
+ Follows the mission statement and values established by the facility.
**What You Will Need** **:**
+ High School Diploma / GED or 3 years of relevant equivalent experience in lieu of diploma / GED.
+ 0-2+ years working within the following sectors: healthcare, insurance, business, finance or customer service.
+ Working knowledge can be of the following: insurance claims, billing, coding, follow-up, finance, accounting or customer service related responsibilities.
**What Would Be Nice To Have** **:**
+ Previous billing background.
+ Emphasis in hospital billing
+ Excellent communication and interpersonal skills.
+ Experience with Excel and Word.
#IndeedSponsored
#LI-DNI
The annual salary range for this position is $38,000.00-$63,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.
**What We Offer** **:**
Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.
Benefits include:
+ Medical, Rx, Dental & Vision Insurance
+ Personal and Family Sick Time & Company Paid Holidays
+ Position may be eligible for a discretionary variable incentive bonus
+ Parental Leave
+ 401(k) Retirement Plan
+ Basic Life & Supplemental Life
+ Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
+ Short-Term & Long-Term Disability
+ Tuition Reimbursement, Personal Development & Learning Opportunities
+ Skills Development & Certifications
+ Employee Referral Program
+ Corporate Sponsored Events & Community Outreach
+ Emergency Back-Up Childcare Program
**About Guidehouse**
Guidehouse is an Equal Opportunity Employer-Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.
Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.
If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at or via email at . All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.
All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or . Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.
If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse's Ethics Hotline. If you want to check the validity of correspondence you have received, please contact . Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant's dealings with unauthorized third parties.
_Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee._
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Medical Biller - Healthcare Claims

Posted 1 day ago
Job Viewed
Job Description
PFS Billing
**Travel Required** **:**
None
**Clearance Required** **:**
None
**What You Will Do** **:**
The **Medical Biller** is expected to perform all areas of initial billing, secondary billing, and payer audit follow-up for government and non-government claims. Must work with other departments to facilitate the meeting of both departmental and facility goals and objectives. Demonstrates an ability to find solutions to problems and keeps management informed of patterns regarding billing edits, compliance issues, payments and or other issues with specific payers.
Has an extensive knowledge of billing requirements mandated by payers and / or governmental regulations. This position will perform any and all related job duties as assigned.
**_The medical biller will be working a Hybrid schedule based either at the San Marcos, CA or El Segundo, CA offices and from home._**
**Essential Job Functions**
+ Hospital Billing Emphasis
+ Correcting and billing electronic and hardcopy claims
+ Submits Adjusted claims
+ Provides Follow-up Billing
+ Prepares Billing Reconciliation
**Duties and Responsibilities**
+ Performs daily download and reconciliation of claims from patient accounting system to electronic billing system.
+ Transmits or releases claims at a minimum daily.
+ Works all assigned claims daily by resolving edits, validating claim, or placing on departmental hold by reason.
+ Follows-up on all assigned held claims or unreleased claims.
+ Bills claims via electronic billing system.
+ Reviews same day and 72 hour admission report to determine if accounts needed to be combined.
+ Ensures all address changes and or plan changes are forwarded to the appropriate people so the integrity of the insurance master is maintained.
+ Files adjusted billings based on audits and or changes in diagnosis or DRG.
+ Updates patient accounts with corrected demographic or insurance information.
+ Works all rejection and payer audit reports within 48 hours of receipt taking whatever action may be required to obtain account resolution.
+ Monitors all denials for trends and issues and reports finding to supervisor.
+ Bills or re-bills as necessary.
+ Ensures hospital is in compliance with all state and federal rules and regulations both billing and HIPAA.
+ Assigned special projects will be completed within the time frames given.
+ Appropriately documents electronic billing system and/or patient accounting system.
+ Attends training sessions and seminars offered by the Hospital and Third Party Payers.
+ Handles all customer calls both internal and external in a professional and courteous manner.
+ Returns calls and emails as soon as possible, but must be returned within 24 hours.
+ Follows the mission statement and values established by the facility.
**What You Will Need** **:**
+ High School Diploma / GED or 3 years of relevant equivalent experience in lieu of diploma / GED.
+ 0-2+ years working within the following sectors: healthcare, insurance, business, finance or customer service.
+ Working knowledge can be of the following: insurance claims, billing, coding, follow-up, finance, accounting or customer service related responsibilities.
**What Would Be Nice To Have** **:**
+ Previous billing background.
+ Emphasis in hospital billing
+ Excellent communication and interpersonal skills.
+ Experience with Excel and Word.
#IndeedSponsored
#LI-DNI
The annual salary range for this position is $38,000.00-$63,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.
**What We Offer** **:**
Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.
Benefits include:
+ Medical, Rx, Dental & Vision Insurance
+ Personal and Family Sick Time & Company Paid Holidays
+ Position may be eligible for a discretionary variable incentive bonus
+ Parental Leave
+ 401(k) Retirement Plan
+ Basic Life & Supplemental Life
+ Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
+ Short-Term & Long-Term Disability
+ Tuition Reimbursement, Personal Development & Learning Opportunities
+ Skills Development & Certifications
+ Employee Referral Program
+ Corporate Sponsored Events & Community Outreach
+ Emergency Back-Up Childcare Program
**About Guidehouse**
Guidehouse is an Equal Opportunity Employer-Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.
Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.
If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at or via email at . All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.
All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or . Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.
If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse's Ethics Hotline. If you want to check the validity of correspondence you have received, please contact . Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant's dealings with unauthorized third parties.
_Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee._
Medical Biller - Healthcare Claims

Posted 1 day ago
Job Viewed
Job Description
PFS Billing
**Travel Required** **:**
None
**Clearance Required** **:**
None
**What You Will Do** **:**
The **Medical Biller** is expected to perform all areas of initial billing, secondary billing, and payer audit follow-up for government and non-government claims. Must work with other departments to facilitate the meeting of both departmental and facility goals and objectives. Demonstrates an ability to find solutions to problems and keeps management informed of patterns regarding billing edits, compliance issues, payments and or other issues with specific payers.
Has an extensive knowledge of billing requirements mandated by payers and / or governmental regulations. This position will perform any and all related job duties as assigned.
**_The medical biller will be working a Hybrid schedule of two days at either the San Marcos, CA or El Segundo, CA offices and three days from home._**
**Essential Job Functions**
+ Hospital Billing Emphasis
+ Correcting and billing electronic and hardcopy claims
+ Submits Adjusted claims
+ Provides Follow-up Billing
+ Prepares Billing Reconciliation
**Duties and Responsibilities**
+ Performs daily download and reconciliation of claims from patient accounting system to electronic billing system.
+ Transmits or releases claims at a minimum daily.
+ Works all assigned claims daily by resolving edits, validating claim, or placing on departmental hold by reason.
+ Follows-up on all assigned held claims or unreleased claims.
+ Bills claims via electronic billing system.
+ Reviews same day and 72 hour admission report to determine if accounts needed to be combined.
+ Ensures all address changes and or plan changes are forwarded to the appropriate people so the integrity of the insurance master is maintained.
+ Files adjusted billings based on audits and or changes in diagnosis or DRG.
+ Updates patient accounts with corrected demographic or insurance information.
+ Works all rejection and payer audit reports within 48 hours of receipt taking whatever action may be required to obtain account resolution.
+ Monitors all denials for trends and issues and reports finding to supervisor.
+ Bills or re-bills as necessary.
+ Ensures hospital is in compliance with all state and federal rules and regulations both billing and HIPAA.
+ Assigned special projects will be completed within the time frames given.
+ Appropriately documents electronic billing system and/or patient accounting system.
+ Attends training sessions and seminars offered by the Hospital and Third Party Payers.
+ Handles all customer calls both internal and external in a professional and courteous manner.
+ Returns calls and emails as soon as possible, but must be returned within 24 hours.
+ Follows the mission statement and values established by the facility.
**What You Will Need** **:**
+ High School Diploma / GED or 3 years of relevant equivalent experience in lieu of diploma / GED.
+ 0-2+ years working within the following sectors: healthcare, insurance, business, finance or customer service.
+ Working knowledge can be of the following: insurance claims, billing, coding, follow-up, finance, accounting or customer service related responsibilities.
**What Would Be Nice To Have** **:**
+ Previous billing background.
+ Emphasis in Hospital Billing
+ Excellent communication and interpersonal skills.
+ Experience with Excel and Word.
#IndeedSponsored
#LI-DNI
The annual salary range for this position is $38,000.00-$63,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.
**What We Offer** **:**
Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.
Benefits include:
+ Medical, Rx, Dental & Vision Insurance
+ Personal and Family Sick Time & Company Paid Holidays
+ Position may be eligible for a discretionary variable incentive bonus
+ Parental Leave
+ 401(k) Retirement Plan
+ Basic Life & Supplemental Life
+ Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
+ Short-Term & Long-Term Disability
+ Tuition Reimbursement, Personal Development & Learning Opportunities
+ Skills Development & Certifications
+ Employee Referral Program
+ Corporate Sponsored Events & Community Outreach
+ Emergency Back-Up Childcare Program
**About Guidehouse**
Guidehouse is an Equal Opportunity Employer-Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.
Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.
If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at or via email at . All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.
All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or . Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.
If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse's Ethics Hotline. If you want to check the validity of correspondence you have received, please contact . Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant's dealings with unauthorized third parties.
_Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee._
Medical Biller - Healthcare Claims

Posted 1 day ago
Job Viewed
Job Description
PFS Billing
**Travel Required** **:**
None
**Clearance Required** **:**
None
**What You Will Do** **:**
The **Medical Biller** is expected to perform all areas of initial billing, secondary billing, and payer audit follow-up for government and non-government claims. Must work with other departments to facilitate the meeting of both departmental and facility goals and objectives. Demonstrates an ability to find solutions to problems and keeps management informed of patterns regarding billing edits, compliance issues, payments and or other issues with specific payers.
Has an extensive knowledge of billing requirements mandated by payers and / or governmental regulations. This position will perform any and all related job duties as assigned.
**_The medical biller will be working a Hybrid schedule of two days at either the San Marcos, CA or El Segundo, CA offices and three days from home._**
**Essential Job Functions**
+ Hospital Billing Emphasis
+ Correcting and billing electronic and hardcopy claims
+ Submits Adjusted claims
+ Provides Follow-up Billing
+ Prepares Billing Reconciliation
**Duties and Responsibilities**
+ Performs daily download and reconciliation of claims from patient accounting system to electronic billing system.
+ Transmits or releases claims at a minimum daily.
+ Works all assigned claims daily by resolving edits, validating claim, or placing on departmental hold by reason.
+ Follows-up on all assigned held claims or unreleased claims.
+ Bills claims via electronic billing system.
+ Reviews same day and 72 hour admission report to determine if accounts needed to be combined.
+ Ensures all address changes and or plan changes are forwarded to the appropriate people so the integrity of the insurance master is maintained.
+ Files adjusted billings based on audits and or changes in diagnosis or DRG.
+ Updates patient accounts with corrected demographic or insurance information.
+ Works all rejection and payer audit reports within 48 hours of receipt taking whatever action may be required to obtain account resolution.
+ Monitors all denials for trends and issues and reports finding to supervisor.
+ Bills or re-bills as necessary.
+ Ensures hospital is in compliance with all state and federal rules and regulations both billing and HIPAA.
+ Assigned special projects will be completed within the time frames given.
+ Appropriately documents electronic billing system and/or patient accounting system.
+ Attends training sessions and seminars offered by the Hospital and Third Party Payers.
+ Handles all customer calls both internal and external in a professional and courteous manner.
+ Returns calls and emails as soon as possible, but must be returned within 24 hours.
+ Follows the mission statement and values established by the facility.
**What You Will Need** **:**
+ High School Diploma / GED or 3 years of relevant equivalent experience in lieu of diploma / GED.
+ 0-2+ years working within the following sectors: healthcare, insurance, business, finance or customer service.
+ Working knowledge can be of the following: insurance claims, billing, coding, follow-up, finance, accounting or customer service related responsibilities.
**What Would Be Nice To Have** **:**
+ Previous billing background.
+ Emphasis in Hospital Billing
+ Excellent communication and interpersonal skills.
+ Experience with Excel and Word.
#IndeedSponsored
#LI-DNI
The annual salary range for this position is $38,000.00-$63,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.
**What We Offer** **:**
Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.
Benefits include:
+ Medical, Rx, Dental & Vision Insurance
+ Personal and Family Sick Time & Company Paid Holidays
+ Position may be eligible for a discretionary variable incentive bonus
+ Parental Leave
+ 401(k) Retirement Plan
+ Basic Life & Supplemental Life
+ Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
+ Short-Term & Long-Term Disability
+ Tuition Reimbursement, Personal Development & Learning Opportunities
+ Skills Development & Certifications
+ Employee Referral Program
+ Corporate Sponsored Events & Community Outreach
+ Emergency Back-Up Childcare Program
**About Guidehouse**
Guidehouse is an Equal Opportunity Employer-Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.
Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.
If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at or via email at . All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.
All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or . Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.
If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse's Ethics Hotline. If you want to check the validity of correspondence you have received, please contact . Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant's dealings with unauthorized third parties.
_Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee._