Insurance Specialist (FT)

POSITION SUMMARY

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• Responsible for calculating patient financial responsibility based on network /benefits verification.

• Informs appropriate staff, patient or guarantor of their financial responsibility.

• Ensures accurate payer responsibility.

• Obtains precert/authorizations when required.

• Responsible for ensuring claims addresses are entered accurately and timely for billing parties (CBO, Lab etc.).

• Assists patients/guarantor with billing inquiries in a courteous and professional manner.

• Ensures accurate payer responsibility.

QUALIFICATIONS

• Knowledge, Skills and Abilities

  • Excellent customer service skills.

  • Reads and understands the English language.

  • Ability to think critically and analytically with little or no supervision

  • Ability to work effectively in situations of high stress and conflict and communicate goals and outcomes.

  • Ability to process information and prioritize

  • Possesses exceptional verbal and written communication skills

  • Possesses independent work habits, is self-reliant and self-directed

  • Ability to learn, adapt, and change as required by the job functions

  • Ability to maintain absolute confidentiality of material and information accessed and reviewed

  • Basic computer literacy

  • Ability to move freely, reach, bend, and complete light lifting

  • Ability to use good body mechanics while performing daily job functions and ability to follow specific OSHA guidelines

  • Ability to maintain attendance to meet standard job practices

• Education

  • High School diploma or GED required.

  • Medical terminology, knowledge of insurance and reimbursement procedures preferred.

  • Business courses such as medical terminology, accounting, finance, cash applications, typing, and word processing preferred.

• Licensure

  • None

• Experience

  • 2+ years front end customer service experience required.

  • 1+ year physician practice related experience or equivalent required.

  • Experience with Mysis computer system preferred.

  • Knowledge of third party payers, billing requirements and reimbursement methods required.

  • Prior accounts receivable, collections, or billing experience preferred.