Insurance Billing Specialist

Position Summary

The Insurance Specialist is responsible for review and resolution of outstanding insurance balances on hospital or physician patient accounts. The Insurance Specialist will be required to have flexibility to learning and comprehending complex hospital systems and keen analytical skills to evaluate appropriate next steps to bring aged account receivables to resolution. The Insurance Specialist will be responsible to ensure cash recovery goals are met and assigned hospital receivables are appropriately addressed according to company, client and federal guidelines.

Essential Duties & Responsibilities

1. Responsible for general office duties including but not limited to; filing, scanning, printing, data entry in support of all of all other insurance specialists.
2. Achieve assigned goals (resolutions, account review quality, productivity standards – specified by line of business)
3. Working knowledge of hospital systems, internal systems, and Microsoft Office
4. Demonstrates the ability to learn new systems quickly and develop proficient operating skills within a reasonably short time frame
5. Ability to understand directive given orally and written
6. Ability to prioritize job responsibilities and manage time for timely completion of assignments
7. Accurately perform tasks with a high level of attention to detail
8. Proficiency with company telephone system while placing outbound calls and accepting inbound calls.
9. Perform account research and route accounts through appropriate client workflows
10. Completes timely follow-up on assigned accounts
11. Perform account research and document findings in detailed manner
12. Prepares and makes appropriate requests for adjustment, billing, or appropriate review according to workflow or job aid directive
13. Communicate effectively with insurance companies for payment
14. Understanding of next steps needed to reach resolution of insurance balance
15. Ensure strong communication skills to convey intricate account information
16. Ensure all accounts are worked within client standards and Federal Regulations.
17. Maintain high quality account handling per client standards
18. Work within federal, state regulations, department/division & all Compliance Policies
19. Maintain clear, concise and accurate documentation of all attempts and/or contacts made and received for accounts in accordance with company and client specifications
20. Maintain continuing education, training in industry career development
21. Maintain current knowledge of and comply with all federal and state rules and regulations governing phone calls and collections including HIPAA, FDCPA, Privacy Act, FCRA, etc.
22. Attend training sessions as directed by management
23. Integrate information obtained through training sessions and policy changes immediately into daily routine

Education

Required:  High School Diploma or equivalent

Amount and Type of Experience

Required: Two (2) years of experience working in a hospital admissions or billing setting

IN LIEU OF EDUCATION

Amount and Type of Experience

Prefer candidates with one or two years of experience working in a hospital business office or billing setting. Competitive applicants have a working knowledge of medical terminology and are familiar with insurance and hospital billing policies and procedures.