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The Little Clinic - Nashville, TN
posted about 2 months ago
About the position
The Corp H&W/Insurance Specialist at The Little Clinic is responsible for managing the revenue cycle process, focusing on the research and resolution of aging account receivables that are unpaid or incorrectly paid. This entry-level position emphasizes the importance of communication, analytical skills, and a thorough understanding of medical billing and coding practices. The role supports the mission of simplifying healthcare and promoting health and wellness in the community.
Responsibilities
- Research and resolve aging account receivables that are unpaid or incorrectly paid.
- Analyze, audit, and resolve outstanding, denied, or incorrectly paid claims.
- Review and respond to payer correspondence and submit appeals for denied claims.
- Contact insurance companies and navigate payer websites to secure and expedite payments.
- Resolve patient billing inquiries and document actions taken in the accounts receivable system.
- Meet productivity expectations as outlined by the supervisor.
- Recognize and document trends resulting in nonpayment or incorrectly paid claims and notify the Team Lead.
- Participate in process improvement initiatives as needed.
- Keep current with Medicare and other third-party administrator regulations and procedures.
- Manage special projects as requested by the supervisor or team lead.
Requirements
- High school diploma or GED.
- 1+ year of insurance follow-up experience, including knowledge of the appeals resolution process.
- Strong written and oral communication skills.
- Analytical and problem-solving capabilities with attention to detail.
- Excellent organizational and follow-up skills.
- Thorough knowledge of revenue cycle management, including medical terminology, ICD-9, ICD-10, CPT-4 coding, and Medicare reimbursement guidelines.
Nice-to-haves
- Ability to read and interpret EOBs.
- Highly self-motivated with the ability to work independently and meet deadlines.
- Flexibility during times of change and ability to adjust promptly and effectively.
- Ability to learn, understand, and apply new technologies.
Benefits
- Balanced, competitive benefits and rewards.
- Ongoing opportunities for growth and development.
