What are the responsibilities and job description for the Medical Insurance Specialist position at Rehabilitation Associates, Inc.?
Rehabilitation Associates of Connecticut, Inc. is a Birth to Three Program providing early intervention services for children with developmental delays and disabilities. Our goal is to assist families with helping their infants and toddlers achieve maximum potential in day-to-day activities within their family and community. Our administrative staff are a collaborative and hard-working team looking for an additional member to support our insurance department.
The job responsibilities include the following:
- Process new child intake by securing required insurance information and entering into data system
- Verify patient eligibility for insurance reimbursement at intake, as well as when insurance plans are changed or updated in client record.
- Confirm parent consent before entering insurance information into data system
- Submit patient information into the company and state EHR system, submitting for prior authorization for claims, as needed.
- Utilize payer and provider portals i.e. PCG to obtain claim status and authorizations (i.e. 837 & 835 formats).
- Send copies of requested documentation and information to insurance companies, including providing accurate diagnosis (ICD-10) codes.
- According to system guidelines, consistently review denied, adjudicated and paid claims, to audit for potential or existing billing problems associated with specific accounts, and work towards repairing any inaccurate information for future claims and payments.
- Self-initiative to read and learn Birth to Three System insurance procedures.
- Cross train to support other office jobs as needed and work on special projects as requested.
Candidates should have:
- A basic understanding of mandated vs non-mandated insurance plans, health insurance plan exceptions, ERISA, HRA, HSA, FSA, etc.
- A high level of professionalism and the ability to maintain confidential information.
- 1 year or more of previous experience in the healthcare industry
- Strong computer skills, especially MS Office/Excel
- Strong attention to detail.
- The ability to multitask and communicate with team members about case documentation and recommending changes to processes within the team.
- High school diploma or GED.
Job Type: Full-time
Benefits:
- 401(k)
- Dental insurance
- Employee assistance program
- Employee discount
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Tuition reimbursement
Work Location: In person
