Insurance Claims Specialist

Position Title: Insurance Claim Specialist

Reports to: Billing Supervisor

Job Status: Full-Time

Position Summary: Employee will be instrumental in analyzing and following up on billed medical claims to determine the appropriate course of action to resolve the claims.

Essential Functions:

· Resolve cash generating accounts expeditiously to bring in revenue for the company.

· Maintains current knowledge of third party, federal and state regulations, insurance coverage, rejection codes and billing requirements related to physician billing and follow-up.

· Follow up on commercial and governmental medical claims by phone calls to the insurance companies, websites, if available or any online resources

· Understanding of medical terminology, denial codes, CPT, and ICD-10 codes.

• Knowledgeable of insurance guidelines and requirements

· Experience in filing appeals on denied claims when appropriate while working each account/claim

· Ability to establish and maintain effective working relationships with employees and providers.

· Noting all actions taken with each claiming encounter on our system.

Competencies:

· Commitment to excellence and high standards

· Ability to operate multiple software applications

· Microsoft Office skills, primarily knowledge of Excel (sorting, formatting, using simple formulas)

· Knowledge of basic medical terminology

· Ability to work effectively with Peers and with Management

· Ability to communicate clearly and effectively with patients and other staff

· Ability to work independently

· Dependable & Punctual

Education and Experience:

· High school diploma or equivalent required

· 2 years of medical billing experience

Work Environment:

• Fast paced environment with occasional high pressure situations

• Frequent interaction with a diverse population including team members, providers, patients, and insurance companies

· Frequent sitting

· Frequent use of computer, keyboard, copy machine and phone

Job Type: Full-time

Pay: $13.00 - $16.00 per hour

Benefits:

• Dental insurance
• Health insurance
• Vision insurance

Schedule:

• Monday to Friday

Education:

• High school or equivalent (Preferred)

Experience:

• Medical Billing: 2 years (Required)

Benefit Conditions:

• Waiting period may apply
• Only full-time employees eligible

Work Remotely:

• No

Job Type: Full-time

Pay: $16.00 - $18.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Flexible schedule
• Health insurance
• Professional development assistance
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Education:

• High school or equivalent (Preferred)

Experience:

• Microsoft Office: 1 year (Preferred)
• Customer Service: 1 year (Preferred)

Work Location: In person

Salary : $13 - $16