Insurance Specialist I

Winona Health • Winona, MN

20h • Hybrid

About The Position

The Insurance Specialist I is responsible for managing daily reports, placing and removing billing holds, and monitoring past-due claims. This role ensures the timely and accurate billing of insurance through efficient management of assigned work queues within the patient accounting system. Additionally, they address billing inquiries or direct them to the appropriate staff for resolution as needed.

Requirements

• High school diploma or equivalent
• Basic computer skills: Microsoft Word, Excel, Outlook, Teams, etc.
• Strong communication skills both verbal and written, with the ability to handle difficult situations calmly and professionally
• Strong problem-solving skills and detail-orientated with strong organizational skills
• Ability to meet deadlines and performance targets
• Advanced time-management and organizational skills to handle multiple priorities with shifting timeframes
• Must possess effective customer service oriented communication skills
• Professional and respectful attitude, maintaining confidential information in compliance with HIPAA (Health Insurance Portability and Accountability Act) regulations, and ensuring patient privacy and data security

Nice To Haves

• Previous billing and/or claims management experience is preferred but not required

Responsibilities

• Generate and analyze Denial Reports to identify ineligible insurance on patient accounts, followed by research, and set up appropriate insurance.
• Runs and addresses Technical Denial Report for encounters that do not populate a work queue. This may involve contacting insurance companies for coding reviews and investigating unpaid claims.
• Generate and analyze multiple claims reports to ensure claims are in proper status and identify claims not progressing in the work queues.
• Review and resolve encounters held in a statement hold queues for Medicaid and Work Compensation claims, ensuring patients are being correctly billed.
• Monitor and resolve issues in the Ready to Bill work queue to ensure claims are processed without delays.
• Investigate and follow up on past-due claims in the Past Due work queue by checking claim statuses, correcting registration issues, and contacting insurance provider for claims which have not adjudicated timely.
• Serves as back up to Billing Specialist I and II role as needed.
• Document precise notes in the financial system for all transactions and correspondence, with timely follow-up as needed.
• Identify issues within role duties and recommend process improvements to enhance efficiency and accuracy in claim handling.
• Review, resolve, and distribute incoming insurance correspondence including mail and faxes, to the appropriate staff member.
• Perform additional duties as assigned by management.

Benefits

• Health Insurance: Options for medical, dental, and vision coverage, as well as mental health support and wellness incentives
• Income Protection: Short and long-term disability, plus additional benefits like accident, critical illness, hospital indemnity, legal assistance, and identity protection plans
• Retirement Planning: Access to a 403(b) retirement plan with employer contributions once eligibility requirements are met
• Work/Life Balance: Flexible scheduling, paid time off, and earned sick time to support personal well-being
• Education & Development: Paid training, tuition reimbursement, scholarships, and sponsored seminars to foster both personal and professional growth
• Employee Discounts: Special offers with local businesses, including the YMCA and cell phone providers

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED