Insurance Specialist

Inland Imaging•Spokane, WA

1d•$20 - $31•Hybrid

About The Position

The Insurance Specialist is a Full Time, Regular position working Monday-Friday day shift at Inland Imaging Business Center. After training, this position may have the opportunity to work hybrid. The role involves addressing a large volume of unpaid or incorrectly paid claims to secure reimbursement. This position performs medical billing functions to third party claims, reviews unpaid claims and denials, and appropriately rebills the claim. The specialist will research and/or resolve patient complaints, research and resolve credit balances, and track and monitor denials for trending to establish plans of action to resolve systemic payer issues.

Requirements

High School Diploma/GED required
One year medical billing course is required
Patient accounts billing experience is desired
Working knowledge of Medinformatix or other patient accounting systems preferred
CPT and ICD-10 coding experience preferred
Good customer services skills
Experience with Microsoft Office Suite (Outlook, Word, Excel), Workday, Webex, Internet/Intranet, Meditech, Code Correct, Medinformatix, Waystar is highly desired.
Must be able to pass a background check required by RCW 43.43.830-840 to work with children under the age of 16, developmentally disabled persons or vulnerable adults.
Must not be included on the LIST OF EXCLUDED INDIVIDUALS provided by the Department of Health & Human Services, Office of the Inspector General (OIG).
Must be able to pass a post-offer, pre-employment drug test.

Nice To Haves

After training, this position may have the opportunity to work hybrid.
Valid state driver’s license and proof of insurance.
Two years medical billing course is desired
Working knowledge of IDX Flowcast BAR preferred
CPT and ICD-9 coding experience preferred
Experience with Microsoft Office products (Outlook, Word, Excel), Kronos; Replicon; Internet, Intranet, IDX (within 30 to 90 days), Meditech, Code Correct, Gateway EDI, Imagecast is highly desired.

Responsibilities

Reviews unpaid claims by calling for payment status, appealing denials and correcting and resubmitting claims when necessary.
Follows up with insurance companies for any unpaid or incorrect paid services provided to patients.
Helps patients understand how insurance companies process their billing claim.
Helps patients with collection questions when Collections Specialist is not available.
Writes off uncollectible balances with dollar values as high as $500 (dependent on experience).
Resolves claim edits (missing claim information) prior to the submission of the claim to insurance companies.
Reviews appropriateness and process refunds for all payers as appropriate.
Works with vendors to resolve payer issues.
Corrects posting discrepancies to reflect payor’s adjudication advice.
Researches payments received but not yet posted.
Coordinates with credentialing liaison on provider enrollment issues.
Attends monthly meeting to stay up to date with new policies and upcoming changes and communicate to leadership.
Works closely with referring physician offices to obtain retroactive authorizations or referral numbers.
Calls client on group bills for overdue accounts, provides information upon request and serves as liaison with leadership on charge discrepancies.
Trains with peers and performs peer to peer QA.
Supports the LLC Staff to provide eligibility status for patients on site.
Maintains strict confidentiality within the Inland Imaging companies and Inland’s customers.
Follows all Health and Safety policies and guidelines of Inland Imaging or its partners depending on work location.
Follows all company policies including those regarding harassment, non-retaliation, discrimination, respectful workplace, and related policies.
Follows all policies regarding HIPAA, non-disclosure of confidential information and company security.
Demonstrates self-directed learning and participation in continuing education through professional journals, approved seminars, etc.
Considers individual needs in communication with and assessment and treatment of patients of all ages.
Adheres to departmental standards and personnel policies by demonstrating professional demeanor in conduct and appearance.
Follows company departmental standards and personnel policies by using good teamwork and communication skills to help identify concerns and solutions, assisting where needed to ensure a smooth functioning department.
Performs other duties as required by displaying team spirit and self-growth, accepting, and performing other projects and responsibilities, and requesting other projects and responsibilities.
Attends quarterly quality assurance meetings.
Rotates to other shifts and locations as needed.
Treats all clients with dignity and respect.
Provides excellent customer service.
Conforms to Joint Commission and HIPAA regulations.
Complies with PHI (Protected Health Information).
Demonstrates the Inland Imaging Core Values: Show We Care, Do The Right Thing, Maximize Individual Potential, Challenge Convention.