Insurance Specialist

Base Pay Range:

$20.43 - $30.65

Job Description:

The Insurance Specialist is a Full-Time, Regular position working Monday-Friday, 7am-3:30pm at our Inland Imaging Business Center. May have the opportunity for a hybrid work schedule after training. 3 YEARS MEDICARE EXPERIENCE REQUIRED

Summary: Address large volume of unpaid or incorrectly paid claims to secure reimbursement.

General Description: Performs medical billing functions to third party claims. Reviews unpaid claims and straightforward denials and appropriately rebills the claim. Researches and/or resolves minor patient complaints. Researches and resolves credit balances, refunding appropriate party as needed.

Essential Duties/Responsibilities: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Reviews unpaid claims by calling for payment status, appealing denials and correcting and resubmitting claims when necessary.
• Follows up with insurance companies for any unpaid or incorrect paid services provided to patients.
• Helps patients understand how insurance companies process their billing claim.
• Helps patients with collection questions when Collections Specialist is not available.
• Writes off uncollectible balances with dollar values as high as $500 (dependent on experience).
• Resolves claim edits (missing claim information) prior to the submission of the claim to insurance companies.
• Review appropriateness and process refunds for all payers as appropriate.
• Other special projects and duties as assigned.

General Duties/Responsibilities:

• Ability to maintain strict confidentiality within the Inland Imaging companies and Inland’s customers.
• Honest, pleasant manner and good personal hygiene.
• Free of alcohol and drug abuse.
• Valid state driver’s license and proof of insurance.
• Excellent communication and interpersonal skills.
• Detail oriented; ability to multi-task; organized and able to work in a fast paced environment.
• Demonstrates self-directed learning and participation in continuing education through professional journals, approved seminars, etc.
• Adheres to departmental standards and personnel policies by demonstrating professional demeanor in conduct and appearance.
• Follows company departmental standards and personnel policies by using good teamwork and communication skills to help identify concerns and solutions, assisting where needed to ensure a smooth functioning department.
• Follows all Health and Safety policies and guidelines of Inland Imaging and its partners depending on work location
• Performs other duties as required by displaying team spirit and self-growth, accepting and performing other projects and responsibilities, and requesting other projects and responsibilities.
• Attendance is required for this position.
• Rotates to other shifts and locations as needed.

Supervisory Responsibilities:

• There is little or no supervisory responsibility in this position

Advocacy:

Treats all clients with dignity and respect Provides excellent customer service Conforms to Joint Commission and HIPAA regulations Complies with PHI (Protected Health Information) Demonstrates the Inland Imaging Core Values:

• Show We Care, Do The Right Thing, Maximize Individual Potential, Always Aim Higher

Qualifications:

• Education:
  
  High School Diploma/GED required
  • Two years medical billing course is desired
• Experience:
  
  Patient accounts billing experience is desired
  • Working knowledge of IDX Flowcast BAR preferred
  • CPT and ICD-9 coding experience preferred
  • Good customer services skills
• Licensure: N/A
• Certifications:
  
  N/A
• Computer
  
  Skills:
  
  Experienc…