Position Title:

Insurance Claim Specialist Reports to:

Billing Supervisor Job Status:

Full-Time FLSA Status:

Non-Exempt Positions Position Summary:

Employee will be analyzing and following up on billed medical claims to determine the appropriate course of action to resolve the claims accurately and expediently.

Essential Functions:

Resolve cash generating accounts expeditiously to bring in revenue for the company. Maintains current knowledge of third party, federal and state regulations, insurance coverage, rejection codes and billing requirements related to physician billing and follow-up. Follow up on commercial and governmental medical claims by phone calls to the insurance companies, websites, if available or any online resources Understanding of medical terminology, denial codes, CPT, and ICD-10 codes. Knowledgeable of insurance guidelines and requirements Proficiency and Experience in filing appeals on denied claims when appropriate while working each account/claim Ability to establish and maintain effective working relationships with employees and providers. Noting all actions taken with each claiming encounter on our system.

Competencies:

Commitment to excellence and high standards Ability to operate multiple software applications Microsoft Office skills, primarily knowledge of Excel (sorting, formatting, using simple formulas) Knowledge of basic medical terminology Ability to work effectively with Peers and with Management Ability to communicate clearly and effectively with patients and other staff Ability to work independently

Dependable & Punctual Education and Experience:

High school diploma or equivalent required 2+ years of medical billing experience Medical billing certification preferred. ECW and/or Waystar experience a plus

Work Environment:

Environmentally controlled office environment Fast paced environment with occasional high-pressure situations Frequent interaction with a diverse population including team members, providers, patients, and insurance companies Frequent sitting Frequent use of computer, keyboard, copy and fax machine and phone

Pay:

From $25.00 per hour

Benefits:

401(k) 401(k) matching Dental insurance Health insurance Health savings account Life insurance Paid time off Vision insurance

Experience:

Medical Billing:

2 years (Required)

License/Certification:

Medical Billing Certification (Preferred)

Work Location:

In person