Health Information Specialist

Duties: Review and understand Insurance policies and standard Explanation of Benefits.Review and understand medical documentation effectively.Review and resolve request for medical records, related toClaims processingInternal and external auditsAuthorized external entitiesMonitors & maintains audit logs.Performs internal audits for quality assurance.Responsible for managing medical records of patients for insurance, private individuals and/or Government entities for home medical equipment.Establishes and maintains effective communication and good working relationships with patients/family, physicians’ offices, and other internal teams for the patient’s benefit.Performs other clerical tasks as needed, such asAnswering patient/Insurance callsFaxing and EmailsCommunicates appropriately and clearly to Manager/Supervisor, and other superiors. Reports all concerns or issues directly to Revenue Cycle Manager and SupervisorOther responsibilities and projects as assigned. Requirements: High School Diploma or equivalentKnowledge of Explanation of Benefits from insurance companiesWorking knowledge of government, regulatory billing and compliance regulations/policies for Medicare & MedicaidWorking knowledge of CPT and ICD-10 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits.Knowledge of policies and procedures to accurately answer questions from internal and external customers.Utilizes initiative while maintaining set levels of productivity with consistent accuracy. Experience: Minimum of 2 Years in DME experience required3-5 Years in DME or medical billing experience preferred Skills: Superior organizational skills.Proficient in Microsoft Office, including Outlook, Word, and Excel.Attention to detail and accuracy.Effective/professional communication skills (written and oral)