Insurance Review Specialist - Clinic (Hybrid)

Position :

Insurance Review Specialist Location :

St.

John Outpatient Center:

9660 Wicker Avenue, St. John, IN 46373

Job Summary :

With direction provided by the Insurance Review Supervisor, interacts daily with patients, insurance carriers, and system staff members to ensure claims are submitted and accepted in a timely manner. Works on follow-up work queues and performs outstanding claim tracking, denial management, claim appeals, and retro-adjudication. Pursues accounts receivable balance resolution, statement processing, self-pay follow-up, and bad debt processes.

Education/ Experience Requirements:

High School graduate (or GED equivalent). 1-2 years insurance or medical billing experience preferred; physician practice setting strongly preferred. Possess in-depth knowledge of medical terminology and of the current CPT, ICD, and HCPCS coding systems. Comprehension of government and third party billing regulations required. Must be able to utilize Microsoft Office applications, perform internet navigation and research, and have prior experience using a computerized health information system. Needs to be familiar with operating general office equipment, including but not limited to: scanner, fax machine, photocopy machine, printer and adding machine. Ability to multi-task efficiently and effectively. Must be able to act calmly and effectively in a busy or stressful situation. Excellent attitude, interpersonal skills and communication abilities necessary to interact with patients, family members, physicians, and other hospital associates.