Insurance Processing Specialist Volunteer Eyecare - 3.0 Knoxville, TN Job Details Full-time From $18 an hour 1 day ago Benefits Health insurance Dental insurance 401(k) Paid time off Vision insurance 401(k) matching Flexible schedule Qualifications Medicare Payment processing HIPAA High school diploma or GED Attention to detail Medical claims submission Time management

Full Job Description Insurance Processing Specialist Department:

Billing & Insurance Reports To:

Practice Directors Location:

Multi-Location Optometry Practice - 7

Locations Employment Type:

Full-Time Position Summary The Insurance Processing Specialist is responsible for managing key insurance and revenue-cycle functions for a multi-location optometry practice. This position plays an important role in ensuring that provider credentialing, medical insurance claims, insurance payments, and account records are processed accurately and timely. The ideal candidate is highly organized, detail-oriented, comfortable working with insurance companies and electronic billing systems, and knowledgeable about medical insurance billing within an optometry or healthcare environment. This position will work across all seven practice locations and collaborate with doctors, clinical staff, front-office teams, and management. Essential Responsibilities Provider Credentialing Manage the credentialing and re-credentialing process for optometrists and other providers with insurance companies and health plans. Complete and maintain provider enrollment applications, CAQH profiles, NPI information, licenses, certifications, malpractice insurance, and other required documentation. Track credentialing applications, effective dates, re-credentialing deadlines, and payer participation status. Communicate with insurance carriers regarding credentialing, enrollment, provider participation, and demographic updates. Maintain accurate credentialing records for all providers across the seven locations. Ensure provider information is updated when there are changes to addresses, locations, specialties, licenses, or other required information. Medical Insurance Claims Review, prepare, submit, and monitor medical insurance claims for optometry services. Verify that claims contain accurate patient, provider, diagnosis, procedure, modifier, and insurance information. Submit electronic and paper claims as required by individual insurance carriers. Monitor claim status and follow up on unpaid, rejected, denied, or pending claims. Research claim denials and identify the cause of billing issues. Correct and resubmit claims when appropriate. Communicate with insurance companies regarding claim status, benefits, payment issues, and reimbursement. Maintain accurate documentation of claim activity and follow-up. Identify recurring billing or claim issues and communicate trends to management. Insurance Payment Posting Post insurance payments and adjustments accurately and timely to patient accounts. Reconcile electronic remittance advice (ERA), explanation of benefits (EOBs), and insurance checks with posted transactions. Accurately post contractual adjustments, denials, write-offs, deductibles, coinsurance, and copay amounts according to practice and payer guidelines. Identify discrepancies between insurance payments and expected reimbursement. Research and resolve posting discrepancies. Ensure payments are posted to the correct patient, provider, location, and account. Assist with reconciliation of insurance deposits and daily/monthly billing activity. Identify underpayments and potential payer discrepancies for further review. Insurance & Revenue Cycle Support Maintain organized insurance and billing records for all seven locations. Assist with insurance verification or benefits-related questions when needed. Work closely with front-office staff to resolve insurance-related account issues. Communicate with doctors, managers, and staff regarding billing and credentialing concerns. Assist with accounts receivable follow-up and other revenue-cycle activities as assigned. Protect patient confidentiality and comply with HIPAA and applicable healthcare regulations. Stay informed about payer requirements, billing rules, and changes affecting optometry and medical insurance claims. Maintain a high level of accuracy while handling a large volume of insurance transactions. Qualifications High school diploma or equivalent required; additional medical billing or healthcare administration education preferred. 2+ years of experience in medical billing, insurance processing, credentialing, or healthcare revenue cycle preferred. Experience with medical insurance claims and payment posting required. Experience with optometry, ophthalmology, or another physician/healthcare specialty strongly preferred. Working knowledge of medical insurance terminology, EOBs, ERAs, CPT/HCPCS codes, ICD-10 codes, modifiers, and payer requirements. Experience with provider credentialing and insurance enrollment preferred. Familiarity with CAQH, NPI, Medicare, Medicaid, commercial insurance plans, and other healthcare payers is a plus. Experience working with practice management and/or electronic health record systems. Strong computer skills, including Microsoft Office or comparable software. Excellent organizational and time-management skills. Strong attention to detail and accuracy. Ability to prioritize tasks and meet deadlines. Professional and effective communication skills. Ability to work independently while also collaborating with a multi-location team. Ability to handle confidential patient and financial information appropriately. Preferred Experience Candidates with experience in any of the following are especially encouraged to apply: Optometry or ophthalmology billing Medical claims processing Insurance payment posting Provider credentialing CAQH enrollment and maintenance Payer enrollment Claims denial management Accounts receivable follow-up ERA/EOB reconciliation Multi-location healthcare practices Key Performance Expectations Success in this position will be measured by: Accurate and timely insurance claim submission Timely follow-up on unpaid and denied claims Accurate insurance payment and adjustment posting Maintaining current provider credentialing and enrollment information Reduction of billing errors and preventable denials Timely resolution of insurance-related issues Accurate reconciliation of insurance payments Effective communication with insurance carriers and internal staff Consistent support of the revenue cycle across all seven locations Work Environment This position supports a busy, growing optometry practice with seven locations and requires the ability to manage competing priorities while maintaining accuracy and confidentiality. The Insurance Processing Specialist will interact regularly with insurance carriers, providers, practice managers, front-office staff, and the billing team. Equal Opportunity Statement We are committed to providing an inclusive workplace and equal employment opportunities to all qualified applicants. Employment decisions are made without regard to legally protected characteristics under applicable federal, state, or local law.

Pay:

From $18.00 per hour Expected hours: 40.0 per week

Benefits:

401(k) 401(k) matching Dental insurance Flexible schedule Health insurance Paid time off Vision insurance

Work Location:

In person