Insurance Specialist
On-site · Richmond, Virginia, United States
Job Summary
Insurance Specialist role supporting a busy plastic surgery practice with weight loss clinic services. Responsibilities include verifying eligibility, obtaining pre-authorizations, submitting claims to the clearinghouse, and acting as a liaison between patients, clinical staff, and insurance carriers. Must stay current with CPT, ICD-10, and HCPCS coding for plastic surgery, understand No Surprises Act implications, generate eligibility and claims reports, ensure documentation supports billing, and maintain patient confidentiality. Requires a high school diploma (associate degree preferred) and at least three years of insurance-claims experience in a medical or surgical specialty setting; experience with practice management software, EHRs, and insurance clearinghouses (NexTech/Availity/TriZetto) is desirable.
Required Qualifications
- High school diploma or equivalent is required
- Associate's degree in medical billing, healthcare administration, or related field preferred
- Minimum of three years of experience as an insurance specialist
- Experience in plastic surgery, dermatology, or similar surgical specialty practice preferred
- Proficiency with practice management software, EHR systems, TriZetto and Availity or similar insurance clearinghouses; NexTech preferred
- Excellent written and verbal communication skills
- Strong problem-solving and analytical abilities
- HIPAA knowledge
- Microsoft Office Suite proficiency
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