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Orange City Area Health System

Business Office Insurance Specialist

Career Insights for Medical Claims Processor / Representative

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Based on Iowa data

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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

Description :
The Business Office Insurance Specialist is responsible for managing insurance claims and ensuring timely reimbursement for services provided in inpatient, outpatient, and clinical contexts. This role involves monitoring patient charge work queues, resolving discrepancies, processing claims, posting charges, and resolving any other issues related to insurance payments. This role also involves preparing and processing work comp and third-party liability claims and follow payments. The specialist will work closely with their colleagues in the Business Office, patients, insurance companies, and other hospital departments to facilitate smooth billing operations.
Number of Hours :
Full-time:
40 hours/week
Schedule :
Monday -
Friday Education Requirements:
Associate's degree in healthcare, business, or related field required. Certified Professional Biller (CPB), Certified Professional Coder (CPC) or similar certification preferred.
Experience Requirements:
Minimum of two years of experience in medical billing, insurance claims processing, and claim reimbursement or a related field preferred. Will train the correct candidate. Strong understanding of insurance policies and procedures, excellent communication and interpersonal skills, attention to detail, and proficiency in medical billing software. Experience with EPIC is preferred.
Job Type:
Permanent Benefits:
401(k) 401(k) matching Dental insurance Disability insurance Health insurance Paid time off Vision insurance
Work Location:
In person