INSURANCE SPECIALIST

WHAT WE DO: Meduit is seeking highly qualified candidates to join our Insurance Specialist teams. If you are goal driven, hard-working, and have excellent communication or customer service skills, we invite you to apply with us today! Insurance Specialists are responsible for hospital and physician billing. The duties include working with payers to resolve issues and facilitate prompt payment of claims. Thorough knowledge and understanding of patient billing, claims submission, and payer specific requirements is a must. This position is highly focused on the resolution of insurance processing errors and denials. Payers include but are not limited to Medicare, Medicaid, Blue Cross, and commercial health insurance carriers.

Essential Duties and Accountabilities:

• Reduce outstanding accounts receivable by managing claims inventory
• Speak to patients and insurance companies in a professional manner regarding their outstanding balances
• Gather information from patients, clients/family members, client clinical areas, government agencies, employers, third party payors and/or medical payment programs, etc. both in-person and by telephone to register patients, gather or update information, obtain referrals and pre-authorizations, complete appropriate forms, conduct evaluations, determine benefits and eligibility (insurance, public programs, etc.), determine financial responsibility and/or to identify sources of payment for services
• Request, input, verify, and modify patient’s demographic, primary care provider, and payor information
• Utilize tools, including computer programs, when indicated
• Provide excellent customer service and timely response to questions and issues related to benefits, billing, claims, payments, etc.
• Answer questions by phone and provide quotes for services; identify financial resources, etc. in accordance with the client policies and procedures
• Utilize various databases and specialized computer software for revenue cycle activities including eligibility verifications, pre-authorizations, medical necessity, review/updating of patient accounts, etc.
• Input, retrieve, and modify information and data stored in computerized systems and programs; generate reports using computer software
• Explain charges, answer questions, and communicate a variety of requirements, policies, and procedures regarding patient financial care services and resources to patients, staff, payors, and agencies
• Work with Claims and Collections in order to assist patients and their families with billing and payment activities in order to increase cash flow
• Other duties as assigned

Education/Experience/ Minimum Qualifications:

• S. Diploma/GED
• Medical Billing/Follow-up experience
• Medicare, Medicaid, and commercial payor experience required
• Must be willing to submit for a background check
• May work occasional evenings and Saturdays
• Must have high integrity
• Have a positive attitude and demonstrate teamwork

Competencies: To perform this job successfully, an individual must be able to perform each essential job duty satisfactorily. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform essential job functions:

• Demonstrated organizational skills and the ability to prioritize and manage tasks based on established criteria
• Excellent verbal and written communication and interpersonal skills
• Ability to work independently with minimal supervision, within a team setting and be supportive of team members
• Proficient with Microsoft Office
• Ability to analyze issues and make judgments about appropriate steps toward solutions
• Knowledge of patient billing claims process
• Familiarity with insurance explanations of benefits and denial codes
• Knowledge of payor programs
• Strong and professional telephone communication skills
• Experience with electronic health record or similar software program
• Knowledge of medical terminology and coding
• Knowledge of applicable federal and state regulations

Special Position Requirements:

• Language Skills: Ability to read, analyze, and interpret information including training instructions and patient bills.
• Mathematical Skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
• Reasoning Ability: The person in this position frequently communicates with consumers who have inquiries about their bills. Must be able to exchange accurate information in these situations.
• Computer Skills: Constantly operates a computer and other office productivity machinery, such as a calculator, copy machine, and computer printer.

Work Requirements:

• Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Must be able to remain in a stationary position over 50% of the time. Constantly works in indoor weather conditions.
• Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually quiet.

Meduit is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, religion, sex, age, national origin, disability, military status, genetic information, sexual orientation, marital status, domestic violence victim status or status as a protected veteran or any other federal, state or local protected class.