What are the responsibilities and job description for the Insurance Specialist position at White-Wilson Medical Center,P.A.?
Job Description
Job Description
POSITION SUMMARY :
Responsible for monitoring denials, appeals, and resolutions from insurance carriers and working proactively to collect from insurance carriers.
ESSENTIAL RESPONSIBILITIES :
- Works claims tracking reports in a practice management system.
- Works clearinghouse rejection and denial reports.
- Communicates with provider offices.
- Identifies error trends and communicates with management.
- Makes necessary changes or additions to patient insurance records.
- Documents all actions in the appropriate notes field.
- Provides requested medical records as requested by payers.
- Files secondary insurance claims for all patients.
- Responds to patient, provider or payer telephone and written questions / requests and perform necessary corrections / actions.
- Reviews all paper claims for completeness and accuracy prior to forwarding to payers.
- Notifies Coding Manager about insurance coding denials.
- Consistently displays a positive attitude and a personal commitment to excellence.
- Remains current on insurance issues and which insurances are accepted by White-Wilson Medical Center.
- Attends all department meetings and clinic required meetings.
- Maintains strict confidentiality.
Competencies :
Required Education and Experience :
Physical Demands :
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
While performing the duties of this job, the employee is regularly required to talk or hear. This position on occasion will require you to lift objects up to 10lbs. Strong verbal and written communication skills required. The employee frequently is required to sit for long periods of time; stand; walk; use hands to finger, handle or feel; and reach with hands and arms. Ability to exercise good judgment and positively influence and lead others, including handling confrontations with poise and efficiency. Repetitive motion of upper body required for extended use of computers and telephones.
Position Type / Expected Hours of Work :
This is a full-time position in an outpatient medical business office setting. Days and hours of work are Monday through Friday between the hours of 6 : 30am to 5 : 00pm. Based on business need, the ability to work a flexible schedule, including some overtime as approved in advance.
Travel :
This position does not require any travel.
Work Environment :
This position requires regular and reliable on-site attendance.
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.
EEO Statement
White-Wilson Medical Center, P.A. and affiliates are equal opportunity employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.
