Insurance and Accounts Receivable Specialist

MNGI•Minneapolis, MN

1d•Hybrid

About The Position

This full-time position is responsible for handling internal and external phone calls, understanding Electronic Practice Management (EPM) and Electronic Health Records (EHR) systems, and managing the billing and collections process. The role involves working with patients and insurance companies to resolve concerns while maintaining HIPAA compliance, monitoring remittance advice, submitting claims and appeals, processing insurance payments, and conducting payer audits. The specialist will also run service item reports, adhere to CMS billing guidelines, stay updated on new insurance plans, research insurance portals, and maintain insurance information.

Requirements

High School Diploma or GED required.
1-2 years of experience in a business office/billing setting.
Knowledge of Microsoft Office applications
Knowledge of insurance payers
Compassionate patient care
Active listening
Problem solve, prioritization, and critical thinking
Attention to detail
Organization and time management
Multitask
Communicate effectively verbally and in writing
Work independently as well as in a team environment
Type proficiently and accurately

Nice To Haves

Demonstrate an understanding of Electronic Practice Management (EPM) and Electronic Health Records (EHR) within NextGen software

Responsibilities

Ensure all internal and external phone calls (patients, staff, insurance companies, etc.) are handled in a professional manner with a customer service approach.
Demonstrate an understanding of Electronic Practice Management (EPM) and Electronic Health Records (EHR) within NextGen software as it relates to insurance, demographics, and release of information associated with the daily functions of the Business Office.
Understand the process from the time patient schedules an appointment, front desk procedure, coding, billing, application of payment, and collections.
Work closely with patients, insurance companies, and co-workers to address or resolve any concerns while maintaining HIPAA compliance.
Monitor remittance advice for details including denials and payment inconsistencies.
Submit replacement claims and appeals to the insurance companies; submit timely follow up requests for status.
Assists as needed in processing insurance payments so that all accounts are up-to-date and accurate.
Complete insurance Payer Audits quarterly to ensure payments are accurate per our contracted rates.
Run service item reports to verify correct payment/information for processing claims.
Must have knowledge and understanding of CMS billing guidelines for submitting accurate information on claims.
Knowledge on new insurance plans each year.
Research insurance portals
Maintain information from insurance bulletins
Understand how to set up new insurance and update all pertinent documents in MNGI
Any and all other duties as assigned.