Insurance Credit Specialist

This is a fully remote position, open to applicants in Tennessee.

📋 Description

• Evaluate and assess accounts and credit balance statements from insurance providers and patients.

• Examine explanations of benefits (EOBs).

• Reach out to insurance carriers to gather further information.

• Conduct thorough follow-ups with insurance companies via phone, email, and insurance websites at an acceptable daily rate.

• Resolve credit balance refunds for both patients and insurance.

• Investigate and address unapplied cash activity accounts.

• Record requests and issues received through mail, email, phone, written correspondence, or in person related to patient accounts.

• Address refund requests from insurance companies and patients within 30 days of receiving them in the credit balance work list.

• Determine the root causes of refund requirements and compile reports on recurring issues for management.

• Amend errors in the calculation and posting of insurance contractual adjustments.

• Uphold the confidentiality of protected health information (PHI).

• Execute job duties in alignment with MGRI's mission, values, policies, and procedures.

⛳️ Requirements

• High school diploma or equivalent (GED) is mandatory.

• An associate degree or bachelor's degree in healthcare administration or a related discipline is preferred.

• Experience in analyzing explanations of benefits (EOBs) from various insurance companies/payers.

• A minimum of one year of experience in insurance billing or follow-up for Medicare, Medicaid, and commercial payers is required.

• Familiarity with medical terminology is preferred.

• Understanding of CPT / ICD-10 coding.

• Basic knowledge of how insurance companies reimburse according to contracts.

• Capability to read and interpret insurance explanations of benefits (EOBs).

• Skill in performing precise follow-ups with insurance companies through phone, email, and insurance websites at an acceptable daily volume.

• Ability to maintain the confidentiality of protected health information (PHI).

• Must have authorization to work in the United States without employer sponsorship.

• Availability Monday to Friday, 40 hours a week, from 8 am to 5 pm in the employee’s time zone.

🏝️ Benefits

• Comprehensive medical, dental, and vision insurance.

• Coverage for life, accident, critical illness, and hospital indemnity insurance.

• Short-term and long-term disability insurance.

• Paid family leave.

• Paid time off.

• Tuition assistance for higher education and certifications.

• Loan assistance.

• 401(k) retirement plan with company matching.

• Mental, physical, and financial wellness initiatives.

• Complimentary gym memberships.

• Virtual care appointments.

• Access to mental health services.

• Discount programs.

• Opportunities for ongoing learning and career advancement.