Insurance Coordinator

Forrest General Hospital•Hattiesburg, MS

4d•Hybrid

About The Position

The Insurance Coordinator is responsible for ensuring accurate and timely reimbursement from third-party payers. The role coordinates insurance billing, claim follow-up, denial resolution, and communication with insurance companies, working collaboratively with clinical departments, patient access, coding, and finance to support efficient claims processing and compliance with payer and regulatory requirements. The position reviews, submits, and follows up on claims; resolves billing errors, denials, payment discrepancies, and underpayments; prepares appeals; monitors accounts receivable; and maintains accurate documentation of payer communications and account activity. It also supports coordination across departments to obtain needed information and documentation, stays current on payer policy changes, and recommends improvements based on denial trends. The position follows a hybrid work schedule. Regular onsite presence is required to support staff, attend meetings, and ensure operational effectiveness. Remote work is available as approved based on departmental needs and performance.

Requirements

High school diploma or equivalent.
Knowledge of Medicare, Medicaid, and commercial insurance.
Knowledge of medical terminology and CPT, HCPCS, and ICD-10 coding principles.
Strong analytical and problem-solving skills.
Excellent written and verbal communication skills.
Ability to manage multiple priorities and meet deadlines.

Nice To Haves

Associate’s or Bachelor’s degree in Accounting, Business, Healthcare Administration, or a related field.
2–4 years of healthcare billing, insurance follow-up, or revenue cycle experience.
Experience with hospital or physician billing.
Familiarity with electronic health records (EHR) and patient accounting systems.

Responsibilities

Review claims for completeness and accuracy before submission.
Submit electronic and paper claims to commercial, Medicare, Medicaid, and managed care payers.
Correct claim edits and resolve billing errors.
Monitor claim acceptance and rejections.
Follow up on unpaid, denied, or partially paid claims and contact insurance companies regarding claim status.
Document payer communications and follow-up activities in the patient accounting system, maintaining accurate account notes and records supporting appeals and payment resolution.
Research payer policies and reimbursement guidelines, and escalate complex reimbursement issues when appropriate.
Analyze denials, identify root causes and trends, and recommend process improvements.
Prepare and submit timely appeals with supporting documentation and monitor appeal outcomes.
Review accounts receivable aging reports and prioritize high-dollar and timely filing accounts.
Resolve payment discrepancies and underpayments, and request corrected claims or rebills as needed.
Coordinate with registration, coding, utilization review, case management, and providers to obtain needed information and documentation.
Maintain compliance with HIPAA and organizational policies, follow applicable billing guidelines, stay current on payer policy changes, and ensure timely filing requirements are met.
Meet daily productivity goals, resolve claims within established turnaround times, meet departmental cash collection goals, minimize accounts exceeding 90 days, reduce avoidable denials, and work collaboratively across departments.
Demonstrate accountability and ownership of assigned accounts.
Perform other duties as assigned.