Insurance Specialist (Remote)

Meduit•Des Moines, IA

4d•Remote

About The Position

Insurance Specialists are highly focused on the resolution of insurance processing errors and denials and work to resolve hospital and physician billing challenges. You will utilize your expertise in patient billing, claims submission, and payer guidelines (Medicare, Medicaid, &, commercial insurers) to effectively work with insurance companies, resolve issues, and ensure accurate and timely payments.

Requirements

High School Diploma or GED.
Proficiency with Microsoft Outlook, Word, and Excel.
Ability to navigate multiple systems and applications simultaneously.
Download speed of 30 Mbps or higher and upload speed of 10 Mbps or higher are required.
Access to a secure, private workspace where confidential and protected health information can be viewed and discussed without interruption.
Reliable high-speed internet service required.
Candidates must be legally authorized to work in the United States at the time of hire.

Nice To Haves

2+ years of medical billing and insurance follow-up experience
Experience working with Medicare, Medicaid, and commercial insurance carriers.
Knowledge of claims resolution, denial management, and reimbursement processes.
Experience with Professional Billing and CMS-1500 claim forms.
Experience using NextGen and/or MS4 systems.

Responsibilities

Manage assigned claims inventory to reduce outstanding accounts receivable balances.
Investigate and resolve insurance claim denials, rejections, and processing errors.
Communicate professionally with patients and insurance carriers regarding billing and reimbursement matters.
Verify and update patient demographic, insurance, provider, and payer information.
Determine insurance eligibility, benefits, coverage details, and patient financial responsibility.
Obtain referrals, authorizations, and supporting documentation required for claims processing.
Utilize payer portals, billing systems, and revenue cycle software to perform account research and claim follow-up activities.
Explain billing charges, insurance benefits, payment obligations, and financial assistance resources.
Respond to inquiries regarding claims, benefits, payments, and account balances in a timely manner.
Collaborate with claims, collections, and revenue cycle teams to resolve account issues and improve payment outcomes.
Document account activity accurately and maintain compliance with payer and client requirements.