Insurance Review Specialist - Clinic (hybrid)

Position: Insurance Review Specialist

Location: St. John Outpatient Center, St. John, IN 46373 (Hyrbrid after 6 months)

Job Summary:

Under the insurance review team's supervision, the Insurance Review Specialist will interact daily with patients, insurance carriers, and system staff members to ensure claims are submitted and accepted in a timely manner. Insurance Review Specialists work on follow-up work queues and performs outstanding claim tracking, denial management, claim appeals, and retro-adjudication.  Insurance Review Specialists will pursue accounts receivable balance resolution, statement processing, self-pay follow-up, and bad debt processes. 

Education/ Experience Requirements:

·       High School graduate (or GED equivalent).

·       1-2 years insurance or medical billing experience preferred; Physician practice setting strongly preferred.

·       Possess in-depth knowledge of medical terminology; and of the CPT, ICD-9-CM, ICD-10-CM, and HCPCS coding systems.

·       Comprehension of government and third party billing regulations required.

·       Must be able to utilize Microsoft office applications, perform internet navigation and research, and have prior experience using a computerized health information system.

·       Needs to be familiar with operating general office equipment, including but not limited to: scanner, fax machine, photocopy machine, printer and adding machine.

·       Ability to multi-task efficiently and effectively.

·       Must be able to act calmly and effectively in a busy or stressful situation.

·       Excellent attitude, interpersonal skills and communication abilities necessary to interact with patients, family members, physicians, and other hospital associates.