Insurance and Accounts Receivable Specialist

Job Summary

Required Qualifications

• •High School Diploma or GED
• •1-2 years of experience in a business office/billing setting
• •Microsoft Office applications
• •Insurance payers
• •CMS billing guidelines
• •Knowledge on new insurance plans each year
• •Must be able to walk, sit, stand, reach overhead, and bend to the floor
• •Must be able to talk and hear
• •Must be able to use dexterity of hands and fingers to operate a computer keyboard, mouse, and other office equipment
• •Must have close vision and ability to adjust focus
• •Must be able to lift and transport items up to 10 pounds occasionally
• •Must be able to travel to other company locations due to staffing and training needs
• •Must be able to travel by automobile
• •Must be alert to conditions that may impact the safety of patients, employees and visitors
• •Must be able to perform each essential function satisfactorily and regular attendance is required

Desired Qualifications

• •Demonstrate an understanding of Electronic Practice Management (EPM) and Electronic Health Records (EHR) within NextGen software
• •Understand the process from the time patient schedules an appointment, front desk procedure, coding, billing, application of payment, and collections
• •Work closely with patients, insurance companies, and co-workers to address or resolve any concerns while maintaining HIPAA compliance
• •Monitor remittance advice for details including denials and payment inconsistencies
• •Submit replacement claims and appeals to the insurance companies
• •Submit timely follow up requests for status
• •Assist as needed in processing insurance payments so that all accounts are up-to-date and accurate
• •Complete insurance Payer Audits quarterly to ensure payments are accurate per our contracted rates
• •Run service item reports to verify correct payment/information for processing claims
• •Understand how to set up new insurance and update all pertinent documents in MNGI
• •Research insurance portals
• •Maintain information from insurance bulletins
• •Compassionate patient care
• •Active listening
• •Problem solve, prioritization, and critical thinking
• •Attention to detail
• •Organization and time management
• •Multitask
• •Communicate effectively verbally and in writing
• •Work independently as well as in a team environment
• •Type proficiently and accurately