Insurance Specialist1

Responsibilities:

• Follow-up with and resolve outstanding accounts receivable balances.
• Call payers and patients as needed to resolve claim rejections.
• Respond to payer correspondence.
• Draft appeals for denied claims.
• Research requests for insurance payment retractions.
• Research overpayments and communicate to Treasury for resolution.
• Monitor and notify management of payer trends and/or claim processing issues.
• Investigate electronic claim rejections.
• Research claim information through web portals.
• Other duties as assigned.

Education/Experience:

• High School diploma or GED.  
• Previous experience working with insurance companies over the phone.
• Knowledge of third-party billing rules and regulations.
• Ability to maintain confidentiality.
• Working knowledge of coding and medical terminology.
• Excellent written and verbal communication skills.
• Strong problem solving skills and the ability to adapt to changes in policies, regulations, and procedures.
• High attention to detail.
• Ability to interact effectively with others.
• Ability to consistently meet production and quality goals.
• Proficient computer skills with knowledge of Microsoft Word and Excel.