What are the responsibilities and job description for the Insurance Specialist position at L.O. Eye Care?
Are you detail-oriented, organized, and passionate about making a difference in healthcare? As an Insurance Specialist, you'll play a vital role in our Revenue Cycle team, ensuring smooth and accurate claims processing. From handling claims creation to following up with providers, patients, and insurance companies, you’ll help keep everything running seamlessly!
Why You’ll Love this Role:
- Be a key player in a dynamic, fast-paced environment
- Work closely with providers, patients, and insurers to ensure smooth claim processing
- Take on leadership opportunities by mentoring peers and leading projects
If you're ready to bring your expertise to a collaborative and supportive team, we’d love to hear from you!
Supervisory responsibilities
This role serves as a lead or mentor for peers or assigned staff. No formal supervisory responsibilities assigned but may be assigned to lead tasks, groups, or projects.
Essential Functions
The following list is a summary of the key function of the job and may not be inclusive of all duties assigned.
- Enters billing charges via the practice management system and manual entry process, including correcting and refilling denied claims.
- Posts patient and insurance payments manually and electronically
- Follows up with assigned payers on rejections, denials, inquires, status, etc.
- Responsible for aged accounts receivables for assigned payers.
- Participates in daily phone que rotation, providing exceptional customer service when responding to patient inquiries.
- Works cooperatively with management to deescalate any patient complaints received.
- Attends and participates in meetings and training.
- Complies with rule, regulations, policies, and procedures for collecting payments.
- Performs other duties as assigned.
Core Competencies
All employees of L.O. Eye Care are expected to demonstrate the following core competencies. Regardless of position or status. Additional job-specific competencies may be required of each position.
- All employees of L.O. Eye Care are expected to demonstrate the following core competencies, regardless of position or status. Additional job-specific competencies may be required of each position.
- Communication – Ability to communicate effectively both verbally and in writing.
- Conscientious – Ability to feel obligated to do right or be good along with awareness of one’s own conduct, intentions, or character.
- Teamwork – Ability to work well in groups, develop and maintain positive working relationships, help resolve conflict, and support team goals.
- Adaptability – Ability to adapt to change, be open to new ideas, handle pressure and uncertainty, and adjust work plans to meet changing company needs.
- Trustworthy – Ability to be worthy of confidence and create assured reliance on the character, ability, and truth of own self.
- Patient Confidentiality – Ability to maintain patient confidentiality, and hold others accountable to such, in accordance with the highest ethical standards.
Other Duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
Work Environment
- Work from home and/or typical office environment.
Physical demands/potential hazards
- Must be able to sit for prolonged periods, must be able to use eyes, hands, and body to maintain office dexterity and mobility; may be required to lift typical office equipment up to 20 pounds.
Travel Required
- 0-25%
Education and Experience
Educational requirements that are job-related and consistent with business necessity.
- High School Diploma of G.E.D required
- Previous medical billing experience with knowledge of billing related reporting.
- Three to five years’ experience in health-care (billing or clinical).
- Experience working with medical payers and vision insurance.
- Demonstrated knowledge of medical terminology with high proficiency in general medical office procedures including HIPPA regulations.
- Working knowledge of medical billing systems, Nextgen a plus.
- Working knowledge of CPT and ICD-9 and ICD-10 coding system.
Leadership and management experience
Leadership requirements that are job-related and consistent with business necessity.
N/A
Additional eligibility requirements
N/A
Work authorization/security clearance requirements
Must be authorized to work in the US
EEO Statement
It is the policy of L.O. Eye Care and its affiliates to provide equal employment opportunities without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, sexual orientation, genetic information or any other protected characteristic under applicable law. This policy relates to all phases of employment, including, but not limited to, recruiting, employment, placement, promotion, transfer, demotion, reduction of workforce and termination, rates of pay or other forms of compensation, selection for training, the use of all facilities, and participation in all company-sponsored employee activities. Provisions in applicable laws providing for bona fide occupational qualifications, business necessity or age limitations will be adhered to by the company where appropriate if applicable.
