Insurance Claims Specialist

WVU Medicine • Vienna, WV

1d • Onsite

About The Position

Welcome! We’re excited you’re considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you’ll find other important information about this position. Responsible for the process of patient account review, correction, adjustment, and filing to third party payers and/or patients. Works directly with patients and third party payers as it relates to information distribution.

Requirements

• High school diploma or equivalent.
• State criminal background check and Federal (if applicable), as required for regulated areas.
• Excellent oral and written communication skills.
• Basic knowledge of medical terminology.
• General knowledge of accounts receivable and collections procedures.

Nice To Haves

• Previous hospital billing and/or credit and collection experience.

Responsibilities

• Performs claims processing to third party payer according to payer guidelines.
• Reviews and corrects billing edits prior to submitting claims.
• Reviews edits to ensure proper billing and verifies edits with the appropriate Department leaders, if needed.
• Works denials thoroughly and timely with little back-log.
• Performs follow up on account, working with third party payers, patient, employer, and physician office to resolve unpaid or underpaid accounts. Works follow-up reports thoroughly within the month.
• Communicates problems hindering workflow to management in a timely manner.
• Posts copays collected at Medical Offices to vouchers. Maintains unassigned payments.
• Processes collections accounts.
• Processes patient and insurance refund documentation.

What This Job Offers

• Job Type: Part-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 101-250 employees