Medical Insurance Specialist

This is a fully remote position, open to applicants in Arizona, +3 more states.

📋 Description

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

• Review and respond to correspondence from payers.

• Submit appeals as necessary for denied claims.

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

• Address patient billing inquiries.

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

• Meet the productivity expectations set by the supervisor.

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

• Handle inbound calls from insurance carriers and resolve issues.

• Engage in process improvement initiatives as required.

• Stay updated with Medicare and other third-party administrator regulations and procedures.

• Manage special projects as requested by the supervisor or team lead.

• Perform essential functions with or without reasonable accommodations.

⛳️ Requirements

• High school diploma.

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

• Strong verbal and written communication skills.

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

• Excellent organizational and follow-up abilities.

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

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

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

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

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

• Must reside in TN, AZ, FL, GA, or OH.

🏝️ Benefits

• Comprehensive health benefits.

• Opportunities for professional development.

• Flexible work environment.