Insurance Specialist

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

📋 Description

• Monitor claim statuses through insurance portals or by contacting payers to ascertain adjudication and specifics.

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

• Validate patient insurance eligibility and coordinate benefits.

• Examine and interpret payer communications.

• Investigate electronic claim denials.

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

• Research inquiries regarding insurance payment retractions.

• Track and inform management about payer trends and/or issues with claim processing.

• Achieve or surpass productivity and quality KPI targets.

• Carry out additional responsibilities as assigned.

⛳️ Requirements

• High School diploma or GED.

• Prior experience in health insurance billing.

• Familiarity with medical terminology.

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

• Exceptional written and verbal communication skills.

• High level of attention to detail.

• Capability to interact effectively with others.

• Ability to uphold confidentiality.

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

🏝️ Benefits

• Full-time remote work.