Medical Insurance Specialist

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Job Description:

  • Analyze, audit and resolve claims outstanding, denied, or incorrectly paid
  • Review and respond to payer correspondence
  • Submit appeals as needed for denied claims
  • Contact insurance companies and navigate payer websites to secure and expedite insurance payments
  • Resolve patient billing inquiries
  • Document in detail all actions taken in the accounts receivable system
  • Meet productivity expectations as outlined by supervisor
  • Recognize, document and notify Team Lead of trends resulting in nonpayment or incorrectly paid claims
  • Answer and resolve inbound calls from insurance carriers
  • Participate in process improvement initiatives as needed
  • Keep current with Medicare and other third-party administrator regulations and procedures
  • Manage special projects requested by supervisor or team lead
  • Perform essential functions with or without reasonable accommodation

Requirements:

  • High school diploma
  • 1+ year of insurance follow-up including working knowledge of the appeals resolution process
  • Strong written, and oral communication skills
  • Analytical and problem solving capabilities with close attention to detail
  • Excellent organizational and follow-up skills
  • Thorough working knowledge of revenue cycle management including medical terminology, ICD-9, ICD-10, CPT-4 coding, Medicare reimbursement guidelines, billing and collection practices
  • Ability to read and interpret EOB's
  • Highly self-motivated, with ability to work independently and meet deadlines
  • Ability to remain flexible during times of change and adjusts promptly and effectively
  • Must be able to learn, understand, and apply new technologies
  • Must reside in TN, AZ, FL, GA, or OH

Benefits:

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