(Urgent Search) Reimbursement Specialist – Insurance Verification (UTMC Program) Position Available In Knox, Tennessee

Job Description:

Reimbursement Specialist•Insurance Verification (UTMC Program)Help Others, Make a Difference, Save a Life. Do you want to make adifference in people’s lives every day? Or help people navigate thetough spots in their life? And do it all while working where yourhard work is appreciated? You have a lot of choices in where youwork…make the decision to work where you are valued! Join theMcNabb Center Team as the Reimbursement Specialist•InsuranceVerification (UTMC Program) today! The Reimbursement Specialist•Insurance Verification (UTMC Program)

JOB SUMMARY

The purpose ofthe Reimbursement Insurance Verification Specialist is to obtainand verify a client’s commercial insurance coverage and to ensureprocedures are covered by an individual’s insurance. Specialistwill be responsible for entering data in an accurate manner andupdating client benefit information in the organization’s billingsystem and verifying that existing information is accurate. TheSpecialist will perform a variety of auditing andresolution-centered activities, answering pertinent questions aboutcoverage to internal and external sources, identifying insuranceerrors, and recommending solutions. Will be required to workregular office hours at the designated facility. JOB DESCRIPTIONEmployees in this job complete and oversee a variety ofprofessional assignments to evaluate, review, enter, monitor, andupdate client insurance and billing information.

JOBDUTIES/RESPONSIBILITIES NOTE

The job duties listed are typicalduties of the work performed. Not all duties assigned to everyposition are included, nor is it expected that all positions willbe assigned to every duty. Reviews the center’s CommercialNotification Forms and returns an Insurance Verification Forms tothe requesting staff within designated program timeframe. Verifiesinsurance information is up to date for the next day’s clientroster and updates any applicable pop-ups in the system For newclients, gives contact information, obtain client photo, updatesthe EMR with correct information and ensures the appropriate intakepacket paperwork has been signed and verified to ensure clientsunderstanding of policies. Prepares and updates the designatedfacility facesheets with insurance issues, patientresponsibilities, outstanding balances, and any non-payment statuschanges for the next day and places them in HIPAA compliant bluefolders for the appropriate providers. Analyzes designatedeligibility reports on a daily basis. Communicates with and advisesInsurance Verification Team Leader of all problems related toinsurance verification. Advises other departments of updated or newinsurance information as needed. Adheres to all policies andprocedures related to compliance with all federal and state billingregulations. Communicates with billing representatives regardingany insurance issues that may arise. Review and update theNon-Payment status documents for both Med appointments and Therapyappointments Maintains a positive and professional attitude. Readsall emails and responds accordingly in a timely manner. Listens toall voicemails and responds accordingly in a timely manner. Workswith members of various teams and/or departments on identifyingprocess improvements. Possess flexibility to work overtime asdictated by department/organization needs. Communicates withclients regarding any benefit and/or billing questions they mayhave. Performs specified client benefit duties to ensure allrequired information is obtained for insurance verification,billing, and claims follow-up. Collects all client responsibilitybalances via cash, check, money order or credit card and issuesreceipts for payments. Assists in determining proper courses ofaction for successful resolution to insurance issues. Completes allprogram related paperwork required for reporting purposes.

Possesses problem-solving skills to research and resolvediscrepancies, denials, appeals, collections. Reviews patient billsfor accuracy and completeness and obtains any missing information.

Sets up patient payment plans and works collection accounts.

Submits monthly recommendations to supervisor for write-offs withcomplete documentation by first of the following month all whilefollowing the A/R Reference Guide on how to complete write offs.

Performs additional duties as requested by Team Leads or ManagementTeam. This job description is not intended to be all-inclusive; andemployee will also perform other reasonably related jobresponsibilities as assigned by immediate supervisor and othermanagement as required. This organization reserves the right torevise or change job duties as the need arises. Moreover,management reserves the right to change job descriptions, jobduties, or working schedules based on their duty to accommodateindividuals with disabilities. This job description does notconstitute a written or implied contract of employment.

JOBQUALIFICATIONS

Advanced use of computer system software, Excel,Outlook and Microsoft (word processing and spreadsheetapplication). Knowledge of insurance guidelines for all Commercial,Medicare, Medicare Advantage, TennCare, Federal Medicaid andPrivate Pay financial classes. Exceptional customer service skillsfor interacting with patients regarding medical claims andpayments, including communicating with patients and family membersof diverse ages and backgrounds. Ability to work well in a teamenvironment and alone. Being able to triage priorities, delegatetasks if needed, handle conflict in a reasonable fashion andanalyze and resolve claims issues and related problems. Strongwritten and verbal communication skills. Maintain patientconfidentiality as per the Health Insurance Portability andAccountability Act of 1996 (HIPAA). Maintain a good understandingof the state, federal, and payer guidelines on billings,collections, refunds, and overpayments. Knowledge of the center’sPolicies and Procedures. Ability to maintain records and preparereports and correspondence related to the position. Ability to workdirectly with upper leadership regarding claims issues andresolutions. Possess effective communication skills for phonecontacts with insurance payers to resolve issues and to communicateeffectively with others.

COMPENSATION

Starting salary for thisposition is approximately $18.42 /hr based on relevant experienceand education.

Schedule:

Monday•Friday 8am•5pm

Travel :

N/AEquipment/Technical Competency :

Advanced use of computer systemsoftware, Excel, Outlook and Microsoft (word processing andspreadsheet application).

QUALIFICATIONS

•Reimbursement Specialist•Insurance Verification (UTMC Program)

Experience:

Extensiveknowledge of insurance in relation to proper billing, follow-up andverification duties. Education /

License :

High school diploma orequivalent required.

Location:

Knox County, Tennessee Apply todayto work where we care about you as an employee and where your hardwork makes a difference! Helen Ross McNabb Center is an EqualOpportunity Employer. The Center provides equal employmentopportunities to all employees and applicants for employment andprohibits discrimination and harassment of any type without regardto race, color, religion, age, sex, national origin, disabilitystatus, genetics, protected veteran status, sexual orientation,gender identity or expression, or any other characteristicprotected by federal, state or local laws. This policy applies toall terms and conditions of employment. Helen Ross McNabb Centerconducts background checks, driver’s license record, degreeverification, and drug screens at hire. Employment is contingentupon clean drug screen, background check, and driving record.

Additionally, certain programs are subject to TB Screening and/ortesting. Bilingual applicants are encouraged to apply.

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