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RAM Recruiting

Medicare/ HMO Biller

Lakewood, NJ

$18 - $23.25/hr

A growing healthcare organization is seeking an experienced Medicare HMO Biller to join its corporate billing team. This role is responsible for managing Medicare Advantage (HMO) claims and ensuring ...

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Guidance Care HMO

Managed Care Liaison

Lakewood, NJ · On-site

Guidance Care HMO is looking to hire Full Time employees in our Liaison Department. Our Liaison Department assists nursing homes with various billing inquiries and other issues related to Managed ...

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Hmo information

What are the typical responsibilities of an HMO Medical Officer on a daily basis?

As an HMO Medical Officer, your daily tasks often include reviewing patient medical records for pre-authorization or claims, consulting with physicians and healthcare providers on case management, and conducting medical audits to ensure compliance with policies. You’ll also participate in utilization review meetings and help develop clinical guidelines to improve care quality and operational efficiency. This role is highly collaborative, requiring regular interaction with both clinical and administrative staff. By balancing clinical expertise with healthcare management, you play a key role in delivering effective and sustainable patient care within the HMO structure.

What is the highest paid job in health care?

In healthcare, anesthesiologists are among the highest-paid professionals, often earning over $300,000 annually due to their specialized skills and extensive training. Other high-paying roles include surgeons and certain medical specialists, which require advanced degrees, certifications, and years of experience.

What is an HMO job?

An HMO (Health Maintenance Organization) job typically refers to a role within a healthcare organization that provides managed care services to patients. Employees in HMO roles may work in various capacities, such as case management, claims processing, provider relations, or patient coordination. Their primary responsibility is to ensure efficient healthcare delivery while managing costs and maintaining compliance with healthcare regulations.

What jobs pay 4000 a week without a degree?

Jobs related to healthcare management, such as HMO coordinators or administrators, can sometimes pay around $4,000 weekly, especially with experience and certifications. Other high-paying roles without a degree include sales managers, real estate brokers, or skilled trades like electricians and plumbers, which often require specialized training or licensing but not a college degree.

What are the key skills and qualifications needed to thrive in the Hmo position, and why are they important?

To thrive as an HMO (Health Maintenance Organization) Medical Officer, a medical degree with appropriate licensure and experience in clinical medicine are essential. Familiarity with healthcare management systems, medical auditing tools, and utilization review protocols are typically required. Strong analytical thinking, decision-making, and interpersonal communication skills help HMO Medical Officers navigate complex cases and work collaboratively with providers and administrative teams. These competencies are vital for ensuring high-quality, cost-effective patient care and compliance with organizational standards.

What's the easiest healthcare job to get?

A healthcare job in the HMO sector that typically requires minimal formal education is a medical receptionist or administrative assistant, which often only needs a high school diploma and basic computer skills. These roles usually have lower entry barriers and may offer on-the-job training, making them easier to obtain compared to clinical positions that require certifications or degrees.

What is the job description of a HMO personnel?

A HMO personnel is responsible for managing health maintenance organization operations, including member services, claims processing, provider network coordination, and ensuring compliance with healthcare regulations. They often handle member inquiries, maintain records, and support administrative functions within the organization.
More about Hmo jobs
What are the most commonly searched types of Hmo jobs? The most popular types of Hmo jobs are:
What states have the most Hmo jobs? States with the most job openings for Hmo jobs include:
What job categories do people searching Hmo jobs look for? The top searched job categories for Hmo jobs are:
Hmo jobs near you
Infographic showing various Hmo job openings in the United States as of June 2026, with employment types broken down into 1% As Needed, 89% Full Time, 7% Part Time, and 3% Contract. Highlights an 89% Physical, 4% Hybrid, and 7% Remote job distribution.

Medicare/ HMO Biller

RAM Recruiting

Lakewood, NJ

$18 - $23.25/hr

Full-time

Posted 4 days ago

Be an early applicant

Job description

A growing healthcare organization is seeking an experienced Medicare HMO Biller to join its corporate billing team. This role is responsible for managing Medicare Advantage (HMO) claims and ensuring timely, accurate reimbursement for skilled nursing facility services.

Responsibilities:
Process and submit Medicare HMO claims accurately and timely
Work with multiple Medicare Advantage plans and understand plan-specific requirements
Follow up on unpaid, underpaid, or denied claims and resolve discrepancies
Review EOBs and remittance advice to ensure correct reimbursement
Coordinate with facilities, case management, and admissions teams as needed
Maintain accurate billing records and aging reports
Ensure compliance with Medicare and payer regulations

Qualifications:
Previous experience billing Medicare HMO/Medicare Advantage claims required
Skilled Nursing Facility billing experience strongly preferred
Strong understanding of authorization requirements and payer rules
Ability to analyze denials and appeal when appropriate
Proficiency with billing systems and Microsoft Excel
Strong attention to detail and ability to manage multiple accounts

What We Offer:
Competitive compensation based on experience
Full-time, stable position in a corporate setting
Supportive billing leadership and collaborative team environment
Opportunity to grow within a healthcare organization

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