What are the responsibilities and job description for the Insurance Specialist position at St. Nicholas Center for Children?
*The duties and responsibilities of this job are subject to change and employees will be required to perform the new duties and responsibilities as updates occur.
Primary Purpose:
This position is responsible for billing insurance companies and clients for all services rendered by St. Nicholas Center and collecting payment on all accounts receivable.
Responsibilities / Duties:
- Prepare and submit insurance claims to third party insurance carriers.
- Process EOB denials and audit patient charts/accounts in order to determine the reasons for denial.
- Determine which claims can be corrected and re-filed in a timely fashion, or, transfer the balance to the patient as their responsibility.
- Follows up on unpaid claims routinely until claims are paid, or ensures that balances are billed to patient’s beneficiaries.
- Establish payment plans on private accounts according to established accounts receivable policy.
- Prepare and mail monthly statements and/or account balances for each patient when necessary.
- Field questions regarding patient bills, research, rectify (if necessary), and answer accordingly.
- Keeps updated on all billing and benefit changes for third-party insurance carriers.
- Maintain new client intake and registration including: charts, patient demographics applicable diagnostic testing, and prescriptions.
- Protects organization’s value by keeping information confidential.
- Performs other duties as assigned.
- Knowledgeable and proficient in the proper billing codes and modifiers, diagnosis codes, and proper use for all of the services offered by St. Nicholas Center.
- Possess knowledge regarding HIPAA guidelines and remains in compliance with all rules and regulations regarding HIPAA.
- Assists in insurance credentialing process for therapists for billing and payment purposes.
- Assists in gaining authorization of services with insurance companies for clients.
- Assists in posting customer payments by recording cash, checks, and credit card transactions.
Qualifications:
Education – College degree in related field of study preferred. High school diploma along with medical office billing experience can be substituted for college degree.
Experience – Must have knowledge of business and routine accounting practices obtained via education or job experience in the field of medical billing.
Skills/Knowledge/Abilities–
- Ability to prioritize effectively and multi-task when necessary
- Knowledge of common medical billing and insurance filing practices
- Knowledge of accounts receivable
- Effective verbal and listening communication skills
- Attention to detail and high level of accuracy skills
- Effective organizational skills
- Working knowledge of Microsoft Office programs and Quickbooks accounting software
- Decision-making skills
GENERAL:
- Possess a valid Louisiana Driver’s License or state approved ID.
- Maintain a valid personal e-mail address and have access to the internet.
- Maintain a professional appearance which is appropriate for the work environment as specified in the Employee Policy Manual including but not limited to grooming and dress standards._
- Employment is contingent upon the successfully completion of a background checks prior to the commencement of employment._
Physical Requirements:
- Must possess the ability to sit for long periods of time, keyboard, bend, reach and lift up to 10 lbs.
Fiscal Responsibility (if applicable):
- Maintain Collections, Accounts Receivable Balances, and D.S.O. (Days of Service Outstanding) within Center acceptable levels.
Job Type: Full-time
Incentives: PTO, docked time, 401k, medical insurance, dental and vision insurance, no weekend hours, paid holidays.
Job Type: Full-time
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Work Location: In person