Medical Billing Insurance Specialist

📋 Description

• Analyze, audit, and resolve outstanding, denied, or incorrectly paid claims.

• Review and respond to communications from payers.

• Submit appeals for denied claims when necessary.

• Contact insurance companies and navigate payer websites to secure and expedite insurance payments.

• Address patient billing inquiries effectively.

• Document all actions taken in the accounts receivable system in detail.

• Meet productivity expectations established by the supervisor.

• Identify, document, and inform the Team Lead of trends that lead to nonpayment or incorrect payment of claims.

• Handle inbound calls from insurance carriers and resolve issues.

• Participate in process improvement initiatives as required.

• Stay updated on regulations and procedures of Medicare and other third-party administrators.

• Manage any special projects assigned by the supervisor or team lead.

• Must be able to perform the essential functions of this position with or without reasonable accommodation.

⛳️ Requirements

• High school diploma.

• Over 1 year of experience in insurance follow-up, including knowledge of the appeals resolution process.

• Strong written and verbal communication skills.

• Analytical and problem-solving abilities with a keen attention to detail.

• Excellent organizational and follow-up skills.

• Comprehensive knowledge of revenue cycle management, including medical terminology, ICD-9, ICD-10, CPT-4 coding, Medicare reimbursement guidelines, and billing and collection practices.

• Ability to read and interpret Explanation of Benefits (EOBs).

• Highly self-motivated with the ability to work independently and meet deadlines.

• Capacity to remain adaptable during periods of change and adjust promptly and effectively.

• Must be able to learn, understand, and apply new technologies.

🏝️ Benefits

• Comprehensive health insurance options.

• Retirement savings plan with employer matching.

• Paid time off and holiday pay.

• Opportunities for professional development and advancement.

• Supportive work environment fostering teamwork and collaboration.