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Forest County PotawatomiPosted 1 month ago

Insurance Staff Support Specialist

On-siteCrandon, Wisconsin, United States

Full TimeSenior LevelHigh School Or EquivalentMedium

Job Summary

Re-price Contract Health Services and employee health claims for hospital and physician clients across internal and external portals. Maintain facility CMS Rate Notifications databases, update Section 506 Recovery reimbursement data, and prepare documents for stop-loss and catastrophic health fund reimbursements. Compile documents for destruction, verify on-site destruction, and distribute daily reports and letters from claims examiners. Answer customer service calls, manage mail sorting and distribution, and assist with in-house check runs and purchasing requisitions. Requires HIPAA and Insurance Marketplace CAC certification, two years of health insurance experience, and proficiency in Word, Excel, and Access.

Required Qualifications

  • High school diploma or GED
  • Must obtain and maintain HIPAA and Insurance Marketplace CAC certification
  • Knowledge of medical terminology and health/medical insurance
  • Skill in operating business computers and office machines, including in a Windows environment, specifically Word, Excel, Access, and PowerPoint
  • Ability to communicate effectively and represent organization in a professional manner
  • Must successfully pass all applicable background checks and drug screens

Desired Qualifications

  • Two (2) years of work experience in a medical office, medical facility, health insurance or employee benefits preferred
  • Four (4) years of work experience in a medical office, medical facility, health insurance or employee benefits preferred
  • Experience with Indian Health Service preferred

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