Insurance Billing Specialist

Job Summary:

The Insurance Billing Specialist files insurance claims, posts payments to accounts, and performs various other tasks which relate to insurance billing and collections. The Insurance Billing Specialist demonstrates the ability to be a team member. Also, demonstrates knowledge and skills to appropriately communicate and interact with insurance companies, staff, patients, families and visitors of all age groups while being sensitive to their cultural and religious beliefs.

Job Responsibilities:

• Constantly demonstrates a strong working knowledge of accounting skills
• Demonstrate the ability to submit claims electronically in an efficient manner
• Demonstrate the knowledge to review and submit paper claims
• Displays the ability to pull copies of claims and attach EOBs in a timely manner
• Post and accurately distributes insurance payments to patient accounts
• Work the clinic accounts receivable in a timely and proficient manner
• Immediately file and key in secondary insurance once primary insurance EOB is received
• Appropriately files Medicaid crossovers in a timely manner
• Handle the filing of insurance forms within appropriate time constraints
• Research denied claims in a timely manner
• Appropriately prints and mails follow-up claims
• Corrects invalid diagnoses, CPT codes, etc., and resubmit all the necessary claims and documentation in a timely manner
• Requests patient refunds with appropriate documentation
• Call insurance companies for status on claims as necessary
• Demonstrate the ability to communicate with patients concerning accounts (insurance rejections, other required information, etc.)
• Reports for monthly manager's meeting concerning problems with insurance and patient account balances
• Returns requested information to insurance companies in a timely manner
• If applicable, correct and follow up with patient information from health center (i.e. of insurance cards, date of birth, etc.)
• Effectively collects all data necessary for preparation of insurance financial reports

• Maintains prompt and regular attendance

• Performs related work, as assigned

Job Requirements:

• High school diploma or GED, keyboard knowledge required
• Have at least one year of related or similar work experience
• Knowledge of basic record keeping and filing systems
• Demonstrate skills of written and oral communications, including taking minutes at meetings
• Ability to perform basic word processing procedures
• Ability to prepare reports and follow-up with minimal supervision
• Experience using EPIC and patient billing is highly preferred

Physical and Other Requirements:

• Must continually listen, visualize, have dexterity and eye-hand coordination, ability of simple grasping, speed work
• Must frequently sit, squat, reach, use both right and left forearm rotation, and walk
• Must occasionally kneel, twist, have ability to grasp firmly, lift and carry, push and pull in excess of 10 lbs.