Insurance Specialist
About The Position
The Insurance Specialist will be responsible for reviewing orders to ensure accuracy of codes, quantity, and pricing. This role involves following up with insurance companies to obtain payment for services rendered. Denial resolution may include requesting additional documentation, resubmission, filling corrected claims, using payer portals for claim research and processing, and claim adjustments. The specialist will also prepare and submit documentation to increase the likelihood of claims payment, answer questions from providers, patients, and insurance companies, and identify and resolve collection issues. Additional duties include performing necessary adjustments and refund requests, printing, organizing, and mailing hard copy claims, and performing claim follow-up in accordance with department protocols. A strong understanding of contract-specific billing and paying procedures is essential.
Requirements
- High School diploma/GED
- Strong customer service skills - phone and email (office experience required)
- Strong attention to detail
- Must have Microsoft Office Suite experience (Outlook, Excel, SharePoint) in an office setting
- Knowledge of contract specific billing and paying procedures
Responsibilities
- Review orders to ensure accuracy of codes, quantity, and pricing
- Follow-up with insurance company to obtain payment from services rendered
- Denial resolution may include requesting additional documentation from payer via phone/email/fax, resubmission, filling a corrected claim, using payer portals for claim research and claim processing functions, claim adjustment if there is no opportunity for resolution/payment
- Prepare and submit documentation to increase likelihood of claims payment
- Answer questions from providers, patients, and insurance companies
- Identifies and resolves collection issues
- Performs necessary adjustments and refund requests
- Print, organize, and mail hard copy claims
- Claim follow up in accordance with department protocols
Benefits
- Medical
- dental
- vision
- Critical Illness
- Accident
- Hospital
- 401(k) Retirement Plan
- Life Insurance (Voluntary Life & AD&D for the employee and dependents)
- Short and long-term disability
- Health Spending Account (HSA)
- Transportation benefits
- Employee Assistance Program
- Time Off/Leave (PTO, Vacation or Sick Leave)
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What This Job Offers
Career Level
Entry Level
Education Level
High school or GED
