Molina HealthcareNewRemote Medical Review Nurse -UM/Post Appeals (Michigan RN license req) Molina HealthcareRemote Medical Review Nurse -UM/Post Appeals (Michigan RN license req)Jackson, MSRemote$29.05–$67.97 / hourJob QualificationsREQUIRED QUALIFICATIONS:• At least 2 years clinical nursing experience, including at least 1 year of utilization review (prospective, retrospective and concurrent clinical review), medical claims review, long-term services and supports (LTSS), claims auditing, medical necessity review and/or coding experience, or equivalent combination of relevant education and experience. Job SummaryUtilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate level of care utilizing MCG/InterQual, state/federal guidelines, billing and coding regulations, and Molina policies; validates the medical record and claim submitted support correct coding to ensure appropriate reimbursement to providers.
Baptist Memorial Health Care CorpSpecialist-Billing Baptist Memorial Health Care CorpSpecialist-BillingJackson, MSSpecialist-Billing in Memphis Tennessee United StatesJoin our Talent NetworkSkip to main contentMenuSearch JobsTalent NetworksRecruitment EventsLog-inCenter for Career DevelopmentAHP Baptist Workforce PortalKeyword Job Title skillsEnter a LocationRadius5 miles10 miles25 miles50 milesRadius LengthLoading jobBack to Search ResultsShare this jobshare to e-mailApply NowSpecialist-Billing Job ID 38340 Job Category Billing Claims and Revenue Work Type Full Time Work Schedule Days Department Patient Financial Services Facility BMHCC System Services Location Memphis TN Overview Job SummaryResponsible for the daily completion of both cliams edit denial and no response billing functions for timely follow up. Bills collects and submits all insurance and TPA claims according to payer guidelines and established procedures and workflowsReviews andor processes all credit balances from supplied reports.
West Tennessee Healthcare System LLCPatient Financial Services Rep I - (Ambulatory Billing) West Tennessee Healthcare System LLCPatient Financial Services Rep I - (Ambulatory Billing)Jackson, MSDemonstrate proficiency in at least one or more of the following: Billing processes of at least one specific payers billing and collection practices; Account Follow-Up processes of at least one specific payers billing and collection practices including credit balance resolution; Denials management processes to include denial/claim research, filing appeals, and resolution of denied patient accounts; Payment Posting and Cash Reconciliation processes; Self-Pay Processing / Customer Service including qualifying accounts for charity care, bad debt, and credit balance resolution. ESSENTIAL JOB FUNCTIONS: Reviews institutional and professional claims for appropriate use of procedure, modifiers and diagnostic codes to ensure maximum reimbursement using electronic billing systems and in-house computer systems to edit, modify, or change information on the UB04 and CMS-1500 claim forms for Medicare, Medicare Advantage, Medicaid/TennCare, BCBS, Commercial, and/or other third-party payers.
University of Mississippi Medical CenterProfessional Coder II - Professional Billing - Revenue Integrity University of Mississippi Medical CenterProfessional Coder II - Professional Billing - Revenue IntegrityClinton, MSEnvironmental and Physical Demands: Requires no exposure to unpleasant or disagreeable physical environment such as high noise level and exposure to heat and cold, no handling or working with potentially dangerous equipment, occasional working hours beyond regularly scheduled hours, occasional travelling to offsite locations, frequent activities subject to significant volume changes of a seasonal/clinical nature, constant work produced is subject to precise measures of quantity and quality, occasional bending, occasional lifting/carrying up to 10 pounds, occasional lifting/carrying up to 25 pounds, no lifting/carrying up to 50 pounds, no lifting/carrying up to 75 pounds, no lifting/carrying up to100 pounds, no lifting/carrying 100 pounds or more, occasional climbing, no crawling, occasional crouching/stooping, occasional driving, no kneeling, occasional pushing/pulling, frequent reaching, frequent sitting, frequent standing, occasional twisting, and frequent walking. One of the following medical coding certifications from the American Health Information Management Association (AHIMA) or the American Academy of Professional Coders (AAPC) is preferred post-hire within one (1) year: Registered Health Information Management Technician (RHIT).
Baptist Memorial Health Care CorpCompliance Bill Auditor Baptist Memorial Health Care CorpCompliance Bill AuditorJackson, MSMonitor the impact of audits on the facilitys resources and conduct focus audits to identify areas where change to organizational practices, policies, or procedures might be needed to enhance organizational efficiencies and effectiveness. Keyword Job Title skills Enter a Location Radius 5 miles 10 miles 25 miles 50 miles Radius Length Loading job Back to Search Results Share this job share to e-mail Apply Now.
Staffers Inc.Billing Clerk Staffers Inc.Billing ClerkGluckstadt, MSThe Billing Clerk will play an important role in the day-to-day accounting operations, supporting billing processes and assisting with accounts payable and receivable functions. This organization has experienced significant growth over the past two years and continues to expand, making it a great opportunity for someone looking to grow with a stable and supportive company.
Ergon IncBilling Director Ergon IncBilling DirectorFlowood, MSThe Director serves as the accounting subject matter expert SME for Order-to-Cash O2C processes and partners cross-functionally to support operational alignment compliance and scalability. The Billing Director leads and oversees the corporate Billing function ensuring the accurate timely and efficient execution of all end-to-end billing processes.
Baptist Memorial Health Care CorpSpecialist-Cash Posting Baptist Memorial Health Care CorpSpecialist-Cash PostingJackson, MSJoin our Talent Network to receive updates on new and noteworthy happenings at Baptist. Also responsible for the resolution of items within the departmental work queues with accurate system utilization and documentation.
Baptist Memorial Health Care CorpCustomer Service Coordinator- GI Specialists Baptist Memorial Health Care CorpCustomer Service Coordinator- GI SpecialistsJackson, MSJob ID 39100 Job Category: Administrative Non Clinical Support Work Type: Full Time Work Schedule: Days Department: GI Specialist Facility: GI Specialist Location: Memphis, TN. • Coordinates resources necessary to input accurate data both demographic and medical collect appropriate fees at time of service and assist patient with financial counseling when appropriate.
Molina Healthcare IncMedical Review Nurse -UM/Post Appeals (Michigan RN license req) Molina Healthcare IncMedical Review Nurse -UM/Post Appeals (Michigan RN license req)Jackson, MSREQUIRED QUALIFICATIONS: At least 2 years clinical nursing experience, including at least 1 year of utilization review (prospective, retrospective and concurrent clinical review), medical claims review, long-term services and supports (LTSS), claims auditing, medical necessity review and/or coding experience, or equivalent combination of relevant education and experience. Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate level of care utilizing MCG/InterQual, state/federal guidelines, billing and coding regulations, and Molina policies; validates the medical record and claim submitted support correct coding to ensure appropriate reimbursement to providers.
Natera IncOrgan Health Specialist - Abdominal Transplant Southeast Central Natera IncOrgan Health Specialist - Abdominal Transplant Southeast CentralJackson, MSRemote$180,000–$200,000 / yearIn this role, you will drive revenue growth and market development within transplant markets by cultivating and maintaining key relationships, executing strategic business plans, and promoting the adoption of both existing and newly launched products. Engage as a Critical Thinker: Analyze complex account workflows, billing hurdles, and clinical barriers within major transplant centers to deliver tailored, solution-oriented presentations to high-level decision-makers.
Option Care Health IncNewRevenue Cycle Specialist / AR Specialist / Medical Biller - Remote Option Care Health IncRevenue Cycle Specialist / AR Specialist / Medical Biller - RemoteJackson, MSRemoteBasic Qualifications & Interests: Basic level skill in Microsoft Excel (for example: opening a workbook, inserting a row, selecting font style and size, formatting cells as currency, using copy, paste and save functions, aligning text, selecting cells, renaming a worksheet, inserting a column, selecting a chart style, inserting a worksheet, setting margins, selecting page orientation, using spell check and/or printing worksheets). Basic level skill in Microsoft Word (for example: opening a document, cutting, pasting and aligning text, selecting font type and size, changing margins and column width, sorting, inserting bullets, pictures and dates, using find and replace, undo, spell check, track changes, review pane and/or print functions).
DaVita IncInsurance Counselor I (Jackson/Gulfport, MS) DaVita IncInsurance Counselor I (Jackson/Gulfport, MS)Jackson, MS$19.50–$25.50 / hourWashington Non-exempt: Bellingham: $19.13/hour, Burien: $21.63/hour, Everette: $20.77/hour, Unincorporated King County: $20.82/hour, Renton: $21.57/hour, Seattle: $21.30/hour, Tukwila: $21.65/hour, Remainder of Washington state: $17.13/hour. Provides a high-level of customer service to patients across multiple DaVita Dialysis facilities to ensure educational needs are met and to ensure patient questions or issues are addressed effectively.
Baptist Memorial Health Care CorpSpecialist-Payer Enrollment Baptist Memorial Health Care CorpSpecialist-Payer EnrollmentJackson, MSSupports the Manager and Director in the efforts to confirm the credentials and primary data source verifications of physicians and mid-level providers joining Baptist Medical Group. Providers excellent service to all customers: patients, providers, payers, clinic staff, Physician Revenue Cycle staff, Operations and Administration.
Baptist Memorial Health Care CorpSpecialist-Accounts Receivable Follow Up Baptist Memorial Health Care CorpSpecialist-Accounts Receivable Follow Upjackson, MSPerforms required actions to resolve the account balance promptly by submitting appeals, correcting account information, coordinating requests for medical records, requesting and/or performing posting of account adjustments, requesting an account rebill and any and all other actions necessary to secure account payment and/or bring the account to successful closure. Ability to type and key accurately, problem solving, written an d oral communication skills, financial counseling skills - knowledge of insurance billing (both hospital and professional settings) and collections - knowledge of insurance guidelines as it relates to CMS guidelines, TennCare and/or Medicaid based by state specified requirements.
Baptist Memorial Health Care CorpSpecialist-Accounts Receivable Follow Up Senior Baptist Memorial Health Care CorpSpecialist-Accounts Receivable Follow Up Seniorjackson, MSPerforms required actions to resolve the account balance promptly by submitting appeals, correcting account information, coordinating requests for medical records, requesting and/or performing posting of account adjustments, requesting an account rebill and any and all other actions necessary to secure account payment and/or bring the account to successful closure. Ability to type and key accurately, problem solving, written an d oral communication skills, financial counseling skills - knowledge of insurance billing (both hospital and professional settings) and collections - knowledge of insurance guidelines as it relates to CMS guidelines, TennCare and/or Medicaid based by state specified requirements.
University of Mississippi Medical CenterPatient Account Representative - Professional Govt FU University of Mississippi Medical CenterPatient Account Representative - Professional Govt FUClinton, MSPhysical and Environmental Demands: Requires occasional exposure to unpleasant or disagreeable physical environment such as high noise level and exposure to heat and cold, occasional handling or working with potentially dangerous equipment, occasional working hours beyond regularly scheduled hours, occasional travelling to offsite locations, no activities subject to significant volume changes of a seasonal/clinical nature, occasional work produced is subject to precise measures of quantity and quality, occasional bending, occasional lifting/carrying up to 10 pounds, occasional lifting/carrying up to 25 pounds, occasional lifting/carrying up to 50 pounds, occasional lifting/carrying up to 75 pounds, occasional lifting/carrying up to100 pounds, no lifting/carrying 100 pounds or more, no climbing, no crawling, occasional crouching/stooping, occasional driving, occasional kneeling, occasional pushing/pulling, frequent reaching, frequent sitting, frequent, standing, occasional twisting, and frequent walking. Basic knowledge of medical terminology, Basic knowledge of revenue cycle functions, Ability to pay attention to detail, Ability to maintain a professional appearance and attitude, Ability to read, write, type, and follow oral and written directions, Ability to work independently to effectively and efficiently perform assigned duties, and good interpersonal communication and organizational skills, and proven ability to work effectively with others.
University of Mississippi Medical CenterPatient Account Representative - Revenue Cycle University of Mississippi Medical CenterPatient Account Representative - Revenue CycleJackson, MSJob Summary: To perform patient financial service functions such as scanning, filing, receiving and reviewing correspondence, reviewing third-party and patient billing, and review and resolution of billing questions, at an introductory level. Responsibilities: Engages in core revenue cycle functions such as, billing, claims filing, data entry, charge entry, insurance follow up, denial management, payment posting, customer service, and billing records review.
University of Mississippi Medical CenterNewPatient Account Representative University of Mississippi Medical CenterPatient Account RepresentativeClinton, MSPhysical and Environmental Demands: Requires occasional exposure to unpleasant or disagreeable physical environment such as high noise level and exposure to heat and cold, occasional handling or working with potentially dangerous equipment, occasional working hours beyond regularly scheduled hours, occasional travelling to offsite locations, no activities subject to significant volume changes of a seasonal/clinical nature, occasional work produced is subject to precise measures of quantity and quality, occasional bending, occasional lifting/carrying up to 10 pounds, occasional lifting/carrying up to 25 pounds, occasional lifting/carrying up to 50 pounds, occasional lifting/carrying up to 75 pounds, occasional lifting/carrying up to100 pounds, no lifting/carrying 100 pounds or more, no climbing, no crawling, occasional crouching/stooping, occasional driving, occasional kneeling, occasional pushing/pulling, frequent reaching, frequent sitting, frequent, standing, occasional twisting, and frequent walking. Basic knowledge of medical terminology, Basic knowledge of revenue cycle functions, Ability to pay attention to detail, Ability to maintain a professional appearance and attitude, Ability to read, write, type, and follow oral and written directions, Ability to work independently to effectively and efficiently perform assigned duties, and good interpersonal communication and organizational skills, and proven ability to work effectively with others.
University of Mississippi Medical CenterCompliance Educator - Office of Integrity & Compliance University of Mississippi Medical CenterCompliance Educator - Office of Integrity & ComplianceJackson, MSPhysical and Environmental Demands: Requires occasional working hours significantly beyond regularly scheduled hours, occasional travelling to offsite locations, occasional activities subject to significant volume changes of a seasonal/clinical nature, constant work produced subject to precise measures of quantity and quality, occasional bending, occasional lifting and carrying up to 50 pounds, occasional crouching/stooping, occasional driving, constant sitting, frequent standing, occasional twisting, and frequent walking. Time Type: Full time FLSA Designation/Job Exempt: Yes Pay Class: Salary FTE %: 100 Work Shift: Day Benefits Eligibility: Grant Funded: No Job Posting Date: 02/13/2026 Job Closing Date (open until filled if no date specified):
University of Mississippi Medical CenterCompliance Analyst - Office of Integrity & Compliance University of Mississippi Medical CenterCompliance Analyst - Office of Integrity & ComplianceJackson, MSPhysical and Environmental Demands: Requires occasional working hours significantly beyond regularly scheduled hours, occasional traveling to offsite locations, occasional activities subject to significant volume changes of a seasonal/clinical nature, constant work produced subject to precise measures of quantity and quality, occasional bending, occasional lifting and carrying up to 50 pounds, occasional crouching/stooping, occasional driving, constant sitting, occasional standing, occasional twisting, and occasional walking. Preferred Qualifications: Certification from American Health Information Management Association (AHIMA), American Academy of Professional Coders (AAPC), Health Care Compliance Association (HCCA), Association of Clinical Research Professionals (ACRP), and/or Society of Clinical Research Professionals (SoCRA).
CVS Health CorpClaim Benefit Specialist CVS Health CorpClaim Benefit SpecialistWork At Home, MS$17–$28.46 / hourAnalyzes claims data and generate reports to identify trends, patterns, or areas for improvement to help inform process enhancements, policy changes, or training needs within the claims processing department. Performs claim documentation review, verifies policy coverage, assesses claim validity, communicates with healthcare providers and policyholders, and ensures accurate and timely claims processing.
Hub International InsuranceTPA Operations Specialist Hub International InsuranceTPA Operations SpecialistRidgeland, MississippiHUB International Limited (“HUB”) is one of the largest global insurance and employee benefits broker, providing a broad array of property, casualty, risk management, life and health, employee benefits, investment and wealth management products and services. This position is responsible for the accurate and timely execution of client claims funding activities, including weekly check register duties and multi-line claims invoicing across medical, prescription, and dental benefits.
Hub International LtdTPA Operations Specialist Hub International LtdTPA Operations SpecialistRidgeland, MSABOUT HUB INTERNATIONAL: HUB International Limited ("HUB") is one of the largest global insurance and employee benefits broker, providing a broad array of property, casualty, risk management, life and health, employee benefits, investment and wealth management products and services. This position is responsible for the accurate and timely execution of client claims funding activities, including weekly check register duties and multi-line claims invoicing across medical, prescription, and dental benefits.
CVS Health CorpFraud Waste and Abuse - Sr. Analyst CVS Health CorpFraud Waste and Abuse - Sr. AnalystWork At Home, MS$46,988–$112,200 / yearActivities include reviewing billing activity for state agency referrals, assisting in the investigation and triage of FWA complaints, coordination with other departments and assist in prevention activities including training of internal staff and internal departments. Analyst, Fraud, Waste, and Abuse (FWA) will assist in detecting, investigating, remediating and referring to state regulatory agencies incidents of FWA arising in connection with medical, behavioral, transportation, and other healthcare services.
University of Mississippi Medical CenterClinical Appearls Coordinator-PT University of Mississippi Medical CenterClinical Appearls Coordinator-PTClinton, MSSupports quality improvement initiatives by reviewing clinical practices for consistency, adherence to policy, and appropriate levels of care across settings; prepares reports and communicates findings to clinical and non-clinical staff. Conducts research, collaborates with departments to verify denials, perform clinical reviews, and prepares reports to support quality improvement initiatives and prevent future denials.
SfbliPremium Specialist SfbliPremium SpecialistJackson, MississippiApplies and processes direct payments through personal checks, credit card payments, payments made by phone, list bill, third party administrators such as Vanco, and money received from mail services and various departments. Your responsibilities will include: Assists agents, policyholders and internal departments with questions regarding premium collection methods including EFT transactions, direct billing and loan repayments.
Baptist Memorial Health Care CorpInsurance Representative Baptist Memorial Health Care CorpInsurance RepresentativeJackson, MSKeyword Job Title skills Enter a Location Radius 5 miles 10 miles 25 miles 50 miles Radius Length Loading job Back to Search Results Share this job share to e-mail Apply Now. Menu Search Jobs Talent Networks Recruitment Events Log-in Center for Career Development AHP Baptist Workforce Portal.
Rotech Healthcare Inc.Medical Equipment Customer Service Representative Rotech Healthcare Inc.Medical Equipment Customer Service RepresentativeRichland, MississippiWith hundreds of locations across 45 states, our team delivers high-quality products, exceptional service, and compassionate support that helps patients live more comfortably, independently, and actively. As a national leader in ventilators, oxygen therapy, sleep apnea treatment, wound care, diabetic solutions, and other home medical equipment, we empower patients to manage their health from the comfort of home.