Insurance Specialist (Revenue Cycle) Remote opportunity for KY and So IN candidates only

Seven Counties Services•Louisville, KY

22d•Remote

About The Position

This is a remote opportunity for candidates residing in the Louisville Metro area. The Insurance Specialist will be responsible for completing insurance forms, specifically 1500 HCFA forms, to ensure timely payment. This role requires maintaining knowledge of billing specifications for Medicare, Medicaid, Tricare, and Commercial insurance, and monitoring accounts to meet these specifications. The specialist will also monitor 1500 forms for accuracy in demographics, CPT, and charges, and recommend fee schedule adjustments in compliance with laws. Responsibilities include assisting insurance companies with account inquiries, demonstrating proficiency in electronic claim transmission and correction, and maintaining knowledge of the physician billing system. The role involves following up on unpaid claims via phone, fax, or mail, identifying and processing overpayments, and assisting customers and physician offices promptly and courteously. The specialist will also retrieve information from PCN, maintain patient confidentiality, and perform special assignments. Researching EOBs for incorrect payment levels and communicating with insurance companies for benefit assurance and correct reimbursement is crucial. Monitoring and maintaining control for balancing, using ICD-9 and CPT codes, printing and mailing insurance claims, and responding to correspondence are also key duties. Maintaining communication with providers, staff, and the AR Manager, and staying knowledgeable about Corporate Compliance issues are essential. The role requires the ability to demonstrate proper usage of office equipment.

Requirements

High school graduate or equivalent required.
Productive typing ability equivalent to 30 w.p.m. required.
Considerable skill in interpersonal communications and the ability to work well with others as a team required.
Ability to keep accurate financial records and perform mathematical tasks required.
Knowledge of medical terminology, ICD-10 and CPT coding required.
Computer knowledge required.
Minimum of two years of experience in a medical billing environment working with insurance and patient claims processing required.

Nice To Haves

Knowledge of E/M procedural coding preferred.
Knowledge of Windows preferred.

Responsibilities

Completes information on insurance forms, including 1500 HCFA insurance forms, to ensure timely payment.
Maintains knowledge of billing specifications for Medicare, Medicaid, Tricare, and Commercial insurance, and monitors accounts to meet these specifications.
Monitors 1500 forms for demographic, CPT, and charge accuracy.
Monitors current fee schedule and recommends adjustments as necessary, in compliance with state and federal law.
Assists insurance companies with inquiries regarding accounts and insurance benefits.
Demonstrates knowledge of personal computer and electronic claim transmission, including correction of claims.
Maintains knowledge of the physician billing system.
Follows up on unpaid claims for both insurance and patients via phone, fax, or mail.
Identifies overpayments on patient accounts and initiates refund and adjustment processes.
Answers phone and assists customers, physician offices promptly and courteously.
Maintains working knowledge of PCN, retrieving information as needed.
Maintains strict patient confidentiality.
Performs special assignments as required.
Researches line item EOB’s for incorrect payment levels and works with insurance companies for benefit assurance and correct reimbursement.
Monitors and maintains control for balancing purposes.
Monitors appropriate codes using ICD-9 and CPT formats.
Prints, reviews, and mails all insurance claims as needed.
Responds to and/or directs all correspondence.
Maintains direct line of communication with providers and staff.
Communicates with the AR Manager regarding problem areas.
Maintains knowledge of Corporate Compliance issues pertaining to daily work.
Performs other duties as assigned.
Able to demonstrate proper usage of office equipment.