Insurance Claims Specialist

1 month ago


Cape Coral, Florida, United States Lee Health Full time

Location:Santa Barbara Professional Center -224 Santa Barbara BlvdCape Coral FL 33991

Department: Patient Business Office

Work Type: Full Time

Shift: Shift 1/8:00:00 AM to 4:30:00 AM

Minimum to Midpoint Pay Rate:$ $18.75 / hour

Summary

Manages accounts receivable to ensure timely and accurate billing and reimbursement of patient accounts. Assists customers and co-workers with inquiries and promotes positive customer and internal relations. Does the appropriate follow-up of weekly and monthly reports on assigned accounts, (collection calls, emails, adjustments, billing etc.) while utilizing all appropriate programs and tools available to enhance productivity and continuously improve efficiency. Calculates appropriate adjustments and contract calculations, while assuring that accounts are updated and reflect accurate information at all times. Files contractual underpayment denial appeals to insurance companies using the most efficient means available and utilizes appropriate audit codes. Responsible for processing all job-related correspondence from insurance companies, patients or from internal system departments according to department policy. Reviews all Credit balances including analysis of the EOBs to accurately determine if there is a true overpayment on the account.

Must promote positive employee and customer relations and have the ability to work independently or within a positive team environment is essential. Must have the capability to track problems and trends and report them to the Management. Applies applicable adjustments and utilizes all avenues of reimbursement prior to assigning an account to self-pay. This job requires the ability to be multi-task oriented while using critical thinking skills to appropriately handle complexity and stress of the position and with regard to the ever-changing needs of the Health System while displaying excellent customer service at all times. A friendly personality and positive attitude required. Previous healthcare or financial related experience necessary. Previous experience with insurance collections within a hospital or medical office setting is also preferred.

RequirementsEducational RequirementsDegree/Diploma ObtainedProgram of StudyRequired/
Preferred
and/orHigh School Diploma or EquivalentRequiredorExperience RequirementsMinimum Years RequiredArea of ExperienceRequired/
Preferred
and/or1 YearBilling/InsurancePreferredState of Florida Licensure RequirementsLicensesRequired/
Preferred
and/orNot RequiredCertifications/Registration RequirementsCertificates/RegistrationsRequired/
Preferred
and/or

US:FL:Cape Coral



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