Medical Insurance Claims Specialist

Description

OVERALL RESPONSIBILITIES:

The ICS is responsible for monitoring and follow-up of durable medical equipment claims, orders, and invoices.  Additionally, the ICS is responsible for coordinating the timely and accurate follow-up of rejected, denied, underpaid, and delinquent insurance claims.  The ICS works to resolve claims issues with the processing teams and management to maximize collections in an ethical and compliant manner as set forth in the company compliance plan.

SPECIFIC DUTIES:

• Review rejections, denials, and A/R Reports for unpaid or underpaid claims
• Work with insurance payers to resolve unpaid or underpaid claims.
• Communicate denial and/or non-payment trends to management.
• Handle daily correspondence and requests for information from insurance companies and patients.
• Consistently achieve goals for total A/R, Days in A/R, and old account collection.
• Perform other duties as assigned and directed.

OVERALL RESPONSIBILITIES:

The ICS is responsible for monitoring and follow-up of durable medical equipment claims, orders, and invoices.  Additionally, the ICS is responsible for coordinating the timely and accurate follow-up of rejected, denied, underpaid, and delinquent insurance claims.  The ICS works to resolve claims issues with the processing teams and management to maximize collections in an ethical and compliant manner as set forth in the company compliance plan.

SPECIFIC DUTIES:

• Review rejections, denials, and A/R Reports for unpaid or underpaid claims
• Work with insurance payers to resolve unpaid or underpaid claims.
• Communicate denial and/or non-payment trends to management.
• Handle daily correspondence and requests for information from insurance companies and patients.
• Consistently achieve goals for total A/R, Days in A/R, and old account collection.
• Perform other duties as assigned and directed.

Qualifications

• Advanced level experience with Brightree software preferred.
• Minimum of 2 years’ experience posting insurance charges and payments and working medical accounts receivables preferred.
• Knowledge of medical insurance, managed care plans, deductibles, co-pay and contractual adjustments.
• Knowledge of durable medical equipment billing.
• Excellent written and verbal communication skills.
• Ability to design, build, and present results to management.
• Fast and accurate data-entry skills required.
• Intermediate MS Word and Excel experience
• Multi-task oriented skills.

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