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Insurance Specialist
2 months ago
Insurance Specialist
On-site Gaithersburg, MD
Description:
Insurance Specialists are responsible for hospital and physician billing. The duties include working with payers to resolve issues and facilitate prompt payment of claims. Thorough knowledge and understanding of patient billing, claims submission, and payer specific requirements is a must. This position is highly focused on the resolution of insurance processing errors and denials. Payers include but are not limited to Medicare, Medicaid, Blue Cross, and commercial health insurance carriers.
• Speak to patients and insurance companies in a professional manner regarding their outstanding balances
• Explain charges, answer questions, and communicate a variety of requirements, policies, and procedures regarding patient financial care services and resources to patients, staff, payors, and agencies
• Answer questions by phone and provide quotes for services; identify financial resources, etc. in accordance with the client policies and procedures
• Reduce outstanding accounts receivable by managing claims inventory
• Gather information from patients, clients/family members, client clinical areas, government agencies, employers, third party payors and/or medical payment programs, etc. both in-person and by telephone to register patients, gather or update information, obtain referrals and pre-authorizations, complete appropriate forms, conduct evaluations, determine benefits and eligibility (insurance, public programs, etc.), determine financial responsibility and/or to identify sources of payment for services
• Request, input, verify, and modify patient's demographic, primary care provider, and payor information
• Utilize tools, including computer programs, when indicated
• Provide excellent customer service and timely response to questions and issues related to benefits, billing, claims, payments, etc.
• Utilize various databases and specialized computer software for revenue cycle activities including eligibility verifications, pre-authorizations, medical necessity, review/updating of patient accounts, etc.
• Input, retrieve, and modify information and data stored in computerized systems and programs; generate reports using computer software
• Work with Claims and Collections in order to assist patients and their families with billing and payment activities in order to increase cash flow
Day to Day Duties:
-Provide excellent customer service and timely response to questions and issues related to benefits, billing, claims, payments, etc.
Each specialist will be assigned an inventory to work. New accounts assigned every day.
Work off of a worklist on either EPIC or Cerner. *trained for each inventory*
Work account to account. Every account is different and the insurance company has either paid it and left a balance or denied it and the Insurance rep needs to assist
Could be coded incorrectly or certain coverage(need to have people who can understand how insurance is processed to push the account through)
Logging into payor websites.
Sometimes read through EOBs and it will clear the checklist.
Depending on what account, productivity expectation is around 50 a day.
-Communicating with team via teams chat for feedback or questions.
Skills:
Medical billing, Claim, Insurance, Medical, Health insurance, Medicare, Medicaid, Reimbursement, denied claims, denials, Health care, Payment posting, Medical claim, Insurance verification
Top Skills Details:
Medical billing, Claim, Insurance, Medical, Health insurance, Medicare, Medicaid, Reimbursement
Additional Skills & Qualifications:
1+ years with Denial Follow Up, Claim Follow Up, Medicare and Medicaid Insurance
Processing 9-10 accounts per hour
About Aston Carter:Please Note: Scammers are posing as Aston Carter. We'll never contact you via Gmail, Telegram, or WhatsApp and we'll never solicit money from you.
At Aston Carter, we're dedicated to expanding career opportunities for the skilled professionals who power our business. Our success is driven by the talented, motivated people who join our team across a range of positions – from recruiting, sales and delivery to corporate roles. As part of our team, employees have the opportunity for long-term career success, where hard work is rewarded and the potential for growth is limitless.
Established in 1997, Aston Carter is a leading staffing and consulting firm, providing high-caliber talent and premium services to more than 7,000 companies across North America. Spanning four continents and more than 200 offices, we extend our clients' capabilities by seeking solvers and delivering solutions to address today's workforce challenges. For organizations looking for innovative solutions shaped by critical-thinking professionals, visit Aston Carter is a company within Allegis Group, a global leader in talent solutions.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please call or email for other accommodation options. However, if you have questions about this position, please contact the Recruiter located at the bottom of the job posting. The Recruiter is the sole point of contact for questions about this position.
