Position Summary:
Insurance Specialist should possess a thorough working knowledge of the revenue cycle management process. Position is required to be a role model and demonstrate the company’s core values of respect, honesty, integrity, diversity, inclusion and safety of others. The Insurance Specialist is responsible for the research and resolution of aging account receivables to that are either unpaid or incorrectly paid.
Key Responsibilities:
- Resolves patient billing inquiries.
- Contact insurance companies and navigate payer websites in order to secure and expedite insurance payments.
- Submit appeals as needed for denied claims.
- Keep current with Medicare and other third party administrators regulations and procedures.
- Recognize, document and notify Team Lead of trends resulting in nonpayment or incorrectly paid claims.
- Meet productivity expectations as outlined by supervisor.
- Must be able to perform the essential functions of this position with or without reasonable accommodation.
- Document in detail all actions taken in accounts receivable system.
- Participate in process improvement initiatives as needed.
- Review and respond to payer correspondence.
- Answer and resolve inbound calls from insurance carriers.
- Analyze, audit and resolve claims outstanding, denied, or incorrectly paid
- Manage any special projects requested by supervisor or team lead.
Required Education & Experience:
- Highly self-motivated, with ability to work independently and meet deadlines
- High school diploma
- Ability to read and interpret EOB’s
- 1+ year of insurance follow-up including working knowledge of the appeals resolution process
- Must be able to learn, understand, and apply new technologies
- Thorough working knowledge of revenue cycle management including medical terminology,ICD-9,
- ICD-10, CPT-4 coding, Medicare reimbursement guidelines, billing and collection practices
- Strong written, and verbal communication skills
- Analytical and problem solving capabilities with close attention to detail.
- Excellent organizational and follow-up skills
- Ability to remain flexible during times of change and adjusts promptly and effectively