Medical Insurance Specialist Position Available In Calhoun, Alabama

Medical Insurance Specialist The Surgery Center Oxford, AL 36203 THE

SURGERY CENTER

Oxford, Alabama Job Title:

Insurance Coordinator Overview:

The Insurance Coordinator’s primary function is to post payments received from insurance carriers or patients to the appropriate patient account, and bill patients for their portion of remaining balances after insurance carriers have paid. The coordinator is also responsible for insurance and patient refunds, filing secondary claims after posting primary insurance payments, collections accounts, and performing month-end procedures. The insurance Coordinator submits daily, weekly, and monthly reports to the Business Office manager and/or Administrator as requested. The position is under the overall supervision of the Business Office Manager and /or Administrator.

Position Scope:

The position responsibilities deal mainly with the receipt and proper posting of payments for services in a timely fashion, and reporting those functions to the appropriate supervisors.

Position Functions:

1.

Communication:

Effectively communicates with insurance carriers, physician’s offices, patient’s and their families and other clerical staff; 2.

Computer Skills:

Must utilize computer skills to access eligibility software programs and Internet based systems; 3.

Insurance Skills:

Evaluates receipt of payments based on contractual agreements, eligibility, reimbursement schedules, and procedures performed; 4.

Accounts Receivable:

Assists A/R Clerk in working accounts for proper payment of claims in a timely manner. 5.

Patient Billing:

Generates patient statements on a consistent basis and post payments to the appropriate accounts as received. Collections processes are followed when necessary. 6.

Banking:

Must be able to compare bank deposit slips for reconciliation of payments received; 7.

General Office Skills:

Moderate typing skills, general office skills such as telephone, filing, fax, and copier skills; 8.

Scheduling Skills:

Must be able to act as a back up for Surgery Schedulers during heavy workload periods; 9.

Reception:

must be able to act as back-up receptionist during absences or heavy workload periods; 10.

Coder:

must be able to act as back-up Coder during absences or heavy workload periods;

Position Activities:

• Demonstrates knowledge of insurance contractual agreements and fee schedules, benefits and eligibility, and payment posting principles;
• Maintains knowledge of surgical procedures, medical terminology, CPT codes and ICD diagnosis codes and corresponding coverage;
• Performs all month-end procedures for closing the period on the billing system and prints/distributes reports accordingly;
• Communicates reimbursement history or unfavorable payment practices for various insurance carriers to the Business Office Manager and/or Administrator;
• Schedules surgeries when workload of the main schedulers requires assistance.
• Evaluates HMO, PPO and other contractual agreements under the direction of the B.O.M and / or Administrator;
• Works closely with the Bookkeeper position in reconciling deposits and processing patient insurance company refunds in accordance with current procedures: Performs other duties as needed to ensure the safety and comfort of all customers as well as the efficient operation of the facility.

Education and Experience:

Must have a high school education or equivalent and at least two years experience in the field of medical insurance. Certification /

Licensure:

Certification by an approved organization for medical coding preferred.

Physical Requirements:

Must be able to sit for long periods of time; must have adequate dexterity for computer keyboarding, and adequate vision and hearing to operate a computer and telephone system efficiently. Must be able to understand and enunciate medical terminology;

Personal:

Must have excellent verbal and written communication skills and demonstrate proper telephone etiquette; must have an extensive knowledge of medical and insurance terminology; must possess a high degree of judgement and discretionary skills; must be able to work cooperatively with the Administrative Assistant, Business Office Manager, Director of Nursing, Anesthesia Department, physicians, physicians’ staffs, and facility’s clerical and clinical staff; The contents of this description are intended to describe the general nature and level of work being performed by people assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties and skills required of personnel so classified.

Job Type:

Full-time Pay:

$16.00 – $21.00 per hour Expected hours: 40 per week

Benefits:

401(k) matching Dental insurance Disability insurance Flexible spending account Health insurance Life insurance Paid time off Vision insurance Ability to

Commute:

Oxford, AL 36203 (Required) Ability to

Relocate:

Oxford, AL 36203: Relocate before starting work (Required)

Work Location:

In person