Insurance Operations Specialist jobs in Wilmington, NC

The Remote Outstanding Insurance Specialist is a critical role responsible for effectively and efficiently managing the accounts receivable process for an assigned group of payors or supported region / company.

This is an in office position!

Responsibilities

• Responds to inquiries, questions, and concerns from patients regarding the status of claims in a clear, concise, and courteous manner.
• Conducts follow-up and submits reimbursement appeals for unpaid and / or inappropriately paid claims; ensures appropriate documentation of billing, follow-up, collection, and appeal efforts are recorded on accounts.
• Identifies, researches, and ensures timely processing of billing errors and corrections as they relate to claims; actively participates in problem identification and resolution and coordinates resolutions between appropriate parties.

Qualifications

Associate's degree (A. A.) or equivalent from an accredited college, university or technical school; or three to five years related experience and / or training;

or equivalent combination of education and experience.

• Previous high-volume collections experience with PPO’s, Worker' Comp, Medicare and Medicaid strongly preferred
• Working knowledge of CPT and ICD-10 codes
• Previous experience and demonstrated ability to thrive in a production-driven environment
• Excellent time management & multi-tasking skills
• Proficiency with Microsoft Outlook suite of products; demonstrated aptitude for learning new software programs
• Superior verbal and written communication skills

Last updated : 2024-09-05