Insurance Specialist

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

📋 Description

• Monitor the status of claims through insurance portals or by contacting payers to ascertain adjudication and specifics.

• Contact payers and patients to address claim denials, contest processing decisions, and confirm insurance coverage.

• Validate patient insurance eligibility and ensure coordination of benefits.

• Review and assess correspondence from payers.

• Investigate issues related to electronic claim denials.

• Resubmit claims for processing corrections, to secondary insurances, or to updated addresses.

• Research inquiries regarding insurance payment retractions.

• Track and inform management of payer trends and issues related to claim processing.

• Achieve or surpass productivity and quality KPI targets.

• Perform additional duties as assigned.

⛳️ Requirements

• High School diploma or GED is required.

• Prior experience in health insurance billing is necessary.

• Familiarity with medical terminology is essential.

• Strong problem-solving abilities and the capacity to adapt to changes in policies, regulations, and procedures.

• Exceptional written and verbal communication skills.

• High degree of attention to detail.

• Ability to interact effectively with others.

• Capability to maintain confidentiality.

• Proficient in computer skills, with knowledge of Microsoft Word and Excel.

🏝️ Benefits

• Comprehensive health insurance coverage.

• Retirement savings plan with company matching.

• Paid time off and holiday pay.

• Opportunities for professional development and growth.