Insurance Specialist – AR

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

📋 Description

• Address intricate, high-value unpaid or denied claims utilizing proprietary software, phone communications, written correspondence, client systems, and insurance carrier web portals.

• Detect and report patterns during account resolution, which may include CPT/HCPCS errors or omissions, duplicate claims, inconsistencies in revenue code mapping, absent charges, and claims lacking documentation.

• Execute financial account evaluations, encompassing adjustments and NRP to patients.

• Carry out rebilling processes within client systems.

• Submit medical records along with billing claims.

• Engage in patient assistance outreach initiatives.

• Retrieve documents from client systems and refresh insurance plan codes.

• Assess corrected claim requests and approve client assistance or amend bills within the client platform.

• Review and submit requests for payment verification assistance.

• Keep updated on client preferences and known issues across various client accounts.

• Assist with special projects for clients as necessary.

• Undertake additional responsibilities as assigned.

⛳️ Requirements

• High School Diploma or its equivalent.

• A minimum of 5 years of relevant industry experience in registration, billing, and collections is required.

• At least 3 years of experience in insurance carrier claims resolution is mandatory.

• Preferred experience includes 3 years with Epic, Cerner, Meditech, or other EMR systems.

• Required knowledge of UB04 claim forms, EOBs, and medical records.

• Familiarity with ICD-9, ICD-10, CPT, and HCPCS coding is essential.

• Capability to perform detailed research for resolving complex claims.

• Intermediate mathematics skills (addition, subtraction, ability to identify trends, etc.).

• Advanced proficiency in Excel and PowerPoint.

• Ability to compile and summarize data effectively.

• Excellent verbal and written communication abilities.

• Proficient in analyzing and interpreting complex documents, contracts, notes, and other communications.

• Competence in prioritizing and multitasking in a dynamic environment.

• Ability to work efficiently in a remote setting.

• An investigative mindset to identify issues and develop solutions.

🏝️ Benefits

• Competitive hourly salary.

• Equipment Provided.

• Medical/Dental/Vision Insurance.

• 401k program.

• PTO: 80 hours accrued annually.

• 9 paid holidays.

• Tuition reimbursement.

• Opportunities for professional growth and more!