Insurance Specialist

About Us

Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success.

About the Role

Insurance Specialists are responsible for accurately identifying insurance claims denials and/or claims processing errors to resolve accounts.

Responsibilities

• Resolve unpaid/denied claims by leveraging proprietary software system, making phone calls, generating letters, accessing client systems and insurance carrier web portals in the pursuit of getting a claim resolved.
• Review medical documentation such as UB04 claim forms, EOB’s and medical records to determine the appropriate course of action for claim resolution.
• Maintain familiarity with client preferences and known issues.
• Meet monthly production and quality expectations.
• Comply with HIPAA privacy laws.
• Other duties as assigned.

Requirements

• High School Diploma or equivalent
• At least 1-2 years of physician and/or hospital AR follow up experience required
• Knowledge of UB04 claim forms, EOB’s and medical records preferred
• At least one year of Epic, Cerner, Meditech or other EMR experience preferred
• Knowledge of basic computer functions
• Ability to work effectively in a remote environment
• Strong verbal and written communication skills
• Basic mathematics skills (addition, subtraction, calculate percent, etc.)
• Ability to analyze and interpret documents, contracts, notes, and other correspondence
• Ability to multitask in a fast-paced environment
• Organization skills with a strong attention to detail

Physical Demands

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described.

• Regular eye-hand coordination and manual dexterity is required to operate office equipment.
• The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required.
• At times, Team Members are subject to sitting for prolonged periods.
• Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs.
• Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.