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Mercy Medical Center

Insurance Specialist

Career Insights for Medical Claims Processor / Representative

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What they do

A Medical Claims Processor or Representative reviews and processes medical insurance claims and determines whether an insurance policy will cover a medical procedure. Gathers information from policy holders and organizes insurance files; may process checks with payments to policy holders when a medical claim is approved.

$43,277 / year median in Iowa

-7% projected decline

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Job Description

Insurance Specialist Mercy Medical Center - 3.6 Cedar Rapids, IA Job Details Full-time 22 hours ago Qualifications Computer operation Phone communication Copy machines Math Fax machines Telephone systems Faxing Full Job Description This position is Monday through Friday with the hours of 8am-4:30pm Work Shift Day Scheduled Weekly Hours 40 Summary This position supports Mercy's philosophy of patient centered care by properly submitting charges to insurance companies for reimbursement. Will also be responsible for appropriately billing the patient and providing timely follow up on billing issues and denials. Job Description Job Duties Bills hospital UB-04 claims and professional 1500 claims. Verifies insurance coverage of hospital patients. Assists patients and family members in resolving billing concerns as indicated. Processes third party insurance claims as assigned and follows up according to departmental guidelines to ensure timely payment of account balances. Uses several systems to bill claims, scrub claims and work rejections. Updates demographic and insurance information to the billing system as appropriate. Maintains work queues according to procedure, clearly defining next actions and follow-up dates on all accounts. Documents all conversations and actions taken into the proper systems. Reviews insurance claims for completeness and accuracy prior to mailing. Prepares refunds for mailing. Follows Mercy's safety guidelines, carries out job-specific safety duties and responsibilities, and promptly reports any unsafe conditions, situations, incidents and injuries. Knowledge, Skills and Abilities Required ability to operate a computer, copy/fax machines and telephone system. Required strong written and verbal communication and math skills. Required strong organizational and time management skills. Required strong interpersonal skills. Required ability to work with minimal to no supervision. Preferred working knowledge of medical insurance plans and medical terminology. Preferred proficiency with MS Office. Preferred knowledge of EPIC software.
Professional Experience Preferred:
1 year of previous experience in a medical office, medical business office, or insurance industry Education High School Diploma or equivalent strongly preferred. Relevant experience to be considered in lieu of degree. Licensure, Certification, Registration None Pay Rate Type Hourly Mercy is an independent, community-based organization supporting the Cedar Rapids area for over 120 years. Mercy is an equal-opportunity employer. We value diversity, equity, and inclusion and therefore evaluate qualified applicants without regard to race, color, ethnicity, ancestry, sex, sexual orientation, gender identity, marital status, civil union status, parental status, religion, national origin, age, disability, veteran status, and other legally protected characteristics.