Insurance Reviewer II
Springfield Clinic•Springfield, IL
•$18 - $26•Onsite
About The Position
The Insurance Reviewer II is responsible for completing assigned tasks involved in securing payment from third-party payors and reporting to management on observed trends and issues.
Requirements
- High School graduate or GED required.
- Previous experience in a medical billing office required.
- Computer, typing and calculator skills required.
- Must be able to work individually or on a team.
Nice To Haves
- Working knowledge of medical terminology preferred.
- Working knowledge of CPT and ICD-9 coding preferred.
Responsibilities
- Handle all phone calls and messages received specific to designated insurance area.
- Update registration screens when requested by patients or as necessary.
- Review and process all designated insurance vouchers received, rebilling charges not paid and processing adjustments as needed utilizing websites or telephone as necessary.
- Process all secondary billing as requested by patients or defined by procedure.
- Distribute incoming insurance mail received and respond to all audits, inquiries and additional information requests.
- Process corrections/adjustments as necessary to correct the patient's invoice.
- Process designated insurance reviews when requested to obtain additional payments on claims utilizing websites or telephone as necessary.
- Analyze and process front-end system edits for correct physician productivity and billing of claims.
- Analyze and process back-end system edits for correct registration and billing of claims.
- Analyze and process claims denied through clearinghouse.
- Investigate and process claims in the insurance work files and/or on the insurance reports.
- Must report all incidents to immediate Supervisor or Manager.
- Assist with special projects and assignments as directed.
- Must attend in-services and training relevant to position.
- Perform other job duties as assigned.
- Confidentiality required.
- Comply with the Springfield Clinic incident reporting policy and procedures.
- Adhere to all OSHA and Springfield Clinic training & accomplishments as required per policy.
- Provide excellent customer service and adhere to SC Way customer service philosophy.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
