Billing and Insurance Specialist | 40 Hours per Week | Klein Center

Great River Health•West Burlington, IA

1d•$19•Onsite

About The Position

A Brief Overview Coordinates and assists in the reimbursement for services provided in the long-term care setting. Accurately files insurance claims for the purpose of settling claims with insurance carriers. Resolves discrepancies in accounting records, resolves credits, verifies accuracy of all billing data, and corrects identified errors. Handles electronic billing functions which includes electronically filing claims and maintaining the electronic filing system. Prepares itemized statements, bills, or invoices; and records amounts due for services rendered. Keeps records of supporting documents. Contacts resident or payee to obtain or relay account information. Collect information from policyholders to verify accuracy of information on claim forms, company records, and related documents. Follows-up on outstanding accounts, making proper notations in the billing software. Work denials, follow appeal processes, and refile claims following through to completion. Investigate and resolve any billing discrepancies or insurance-related issues, working closely with insurance providers, residents/payees, and internal teams. Maintain knowledge of current government and/or carrier regulations relevant to industry. Performs data entry, adding, calculating, and operation of computers, equipment, and billing software. Provides assistance with resident trust accounts and front desk management. Ability to file long term care insurance claims timely each month. A general understanding of Medicaid application process, filing, IMPA, unmet medical claims, representative payees, and resident trust accounts. Assists with long term care supplies ordering and distribution. What you will do Prepare insurance claim forms and related documents and review them for accuracy and completeness. Follow-up on rejected, unpaid and denied claims until claims are paid or only self-pay balance remains. Investigate and resolve any billing discrepancies or insurance-related issues, working closely with insurance providers, patients, and internal teams. Reconcile accounts and maintain accurate balances. Perform AR follow up on aging accounts. Transmit claims for payment or further investigation. Contact insured or other involved persons to obtain missing information or resolve billing issues. Review insurance policy to determine coverage. Assist with front desk coverage. Cross train in supplies ordering and distribution. Provide customer service, such as assisting with inquiries and billing requests. Monitor for missing information, authorization/control numbers.

Requirements

H.S. Diploma or General Education Degree (GED)
Dependent Adult Abuse Mandatory Reporter - Iowa Department of Human Services within 30 Days Required

Nice To Haves

1-3 years' Experience working with computers
1-3 years Customer service experience
1-3 years General office or clerical experience.
Knowledge of principles and processes for providing customer service. This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.
Knowledge of administrative and clerical procedures and systems such as word processing, managing files and records, designing forms, and other office procedures and terminology.
Preferred knowledge in Microsoft Office including Word, Excel, and Outlook
Knowledge to use electronic equipment and computer applications specific to the job.
Possesses excellent time management and organizational skills.
Possesses problem solving skills
Ability to communicate effectively and document information accurately.
The ability to read and understand information and ideas presented in writing.
Ability to maintain confidentiality and discretion.
The ability to speak clearly so others can understand you, as well as the ability to read, write and understand the English language.
Knowledge of arithmetic.
Teaching others on processes.
Long-term care knowledge and experience preferred.

Responsibilities

Coordinates and assists in the reimbursement for services provided in the long-term care setting.
Accurately files insurance claims for the purpose of settling claims with insurance carriers.
Resolves discrepancies in accounting records, resolves credits, verifies accuracy of all billing data, and corrects identified errors.
Handles electronic billing functions which includes electronically filing claims and maintaining the electronic filing system.
Prepares itemized statements, bills, or invoices; and records amounts due for services rendered.
Keeps records of supporting documents.
Contacts resident or payee to obtain or relay account information.
Collect information from policyholders to verify accuracy of information on claim forms, company records, and related documents.
Follows-up on outstanding accounts, making proper notations in the billing software.
Work denials, follow appeal processes, and refile claims following through to completion.
Investigate and resolve any billing discrepancies or insurance-related issues, working closely with insurance providers, residents/payees, and internal teams.
Maintain knowledge of current government and/or carrier regulations relevant to industry.
Performs data entry, adding, calculating, and operation of computers, equipment, and billing software.
Provides assistance with resident trust accounts and front desk management.
Ability to file long term care insurance claims timely each month.
A general understanding of Medicaid application process, filing, IMPA, unmet medical claims, representative payees, and resident trust accounts.
Assists with long term care supplies ordering and distribution.
Prepare insurance claim forms and related documents and review them for accuracy and completeness.
Follow-up on rejected, unpaid and denied claims until claims are paid or only self-pay balance remains.
Investigate and resolve any billing discrepancies or insurance-related issues, working closely with insurance providers, patients, and internal teams.
Reconcile accounts and maintain accurate balances.
Perform AR follow up on aging accounts.
Transmit claims for payment or further investigation.
Contact insured or other involved persons to obtain missing information or resolve billing issues.
Review insurance policy to determine coverage.
Assist with front desk coverage.
Cross train in supplies ordering and distribution.
Provide customer service, such as assisting with inquiries and billing requests.
Monitor for missing information, authorization/control numbers.

Benefits

Competitive base pay
Matching retirement programs
Health, Dental and Vision plans
Health Savings and Flexible Spending Accounts
Employee discounts including car rental, cell-phone plans
Employer-paid, Long-Term Disability, Life, and AD&D
Paid time off (PTO)
Education Assistance Program
Employee Assistance Program
Employee Referral Bonus Program
Discounted cafeteria meals
Paid Parental Leave
Employee Service Recognition program
Voluntary plans including: Life, AD&D, Short-Term Disability, Critical Illness, Accident, Insurance, and Hospital Indemnity