Insurance Specialist

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

📋 Description

• Oversee the entire insurance claim process, encompassing eligibility verification, authorizations, claims submission, accounts receivable follow-up, denial resolution, and payment reconciliation.

• Confirm insurance eligibility, benefits, and authorization prerequisites.

• Submit, review, and monitor insurance claims to ensure prompt payment.

• Investigate and resolve denied, rejected, unpaid, or underpaid claims.

• Liaise with insurance carriers via phone calls, payer portals, and written communications.

• Analyze payment activities and reconcile account balances effectively.

• Keep precise documentation of accounts and claim activities.

• Diminish outstanding accounts receivable through efficient claim management and follow-up.

• Identify and address billing, coding, or payer processing challenges that affect reimbursement.

• Adhere to established standards for productivity, quality, and accuracy.

• Work with internal teams to tackle complex account challenges and support client objectives.

• Contribute to achieving operational and financial performance targets for hospital and physician clients.

⛳️ Requirements

• High School Diploma or GED.

• A minimum of 3 years of experience in insurance follow-up, denial management, medical billing, or healthcare revenue cycle operations.

• Familiarity with Medicare, Medicaid, and commercial payers.

• Experience with Epic and Cerner systems.

• Understanding of patient billing, claims submission, and reimbursement procedures.

• Proficiency in Microsoft Office applications (Outlook, Word, and Excel).

• Knowledge of medical terminology and coding principles.

• Experience using Meditech software.

• Familiarity with payer portals such as Availity, Experian, NaviNet, or comparable platforms.

• Background in hospital or physician revenue cycle operations.

• Previous remote experience in healthcare revenue cycle management.

• Must be available to work from 8:30 AM to 5:30 PM PST.

🏝️ Benefits

• Opportunity to work from home.

• Flexible remote work arrangement.

• Secure and private workspace ensured by company standards.

• Requirements for reliable internet connectivity.

• Verification of internet connectivity may be necessary during the hiring process.