INSURANCE SPECIALIST (12680)

CULLMAN REGIONAL•Cullman, AL

19d•Onsite

About The Position

Identifies status on unpaid 3rd party claims in a timely manner. Uses most effective tools to obtain status so that effectiveness and productivity are maximized. Communicates payment expectations and removes payers stall tactics in a firm but professional manner. Reports problem accounts and/or consistent slow payers to management and provides examples. Involves the patient and/or insured to obtain information needed by payers to process the claim. Conducts three-way calls between patients and payers to address obstacles in getting claims processed. Obtains, or assists in obtaining, any additional documentation needed by a payer to process a claim. Works with their billing partner to identify trends in billing errors, so the edits can be developed to increase clean claim rate. Accurately and thoroughly documents all pertinent events regarding the account. Demonstrates and encourages team behavior and exceptional patient/guest experiences. Upholds and promotes patient safety and quality.

Requirements

High school diploma required or equivalent.
3 years of hospital business office or physician office preferred.
Must be proficient in Microsoft Office Suite of products.
Knowledge of ICD, CPT, revenue codes and modifiers is required.

Nice To Haves

Familiarity with payer website and portals is preferred.

Responsibilities

Identifies status on unpaid 3rd party claims in a timely manner.
Uses most effective tools to obtain status so that effectiveness and productivity are maximized.
Communicates payment expectations and removes payers stall tactics in a firm but professional manner.
Reports problem accounts and/or consistent slow payers to management and provides examples.
Involves the patient and/or insured to obtain information needed by payers to process the claim.
Conducts three-way calls between patients and payers to address obstacles in getting claims processed.
Obtains, or assists in obtaining, any additional documentation needed by a payer to process a claim.
Works with their billing partner to identify trends in billing errors, so the edits can be developed to increase clean claim rate.
Accurately and thoroughly documents all pertinent events regarding the account.
Demonstrates and encourages team behavior and exceptional patient/guest experiences.
Upholds and promotes patient safety and quality.