Insurance Reviewer II

2 weeks ago


Springfield, United States Springfield Clinic Full time
The Insurance Reviewer II is responsible for completing assigned tasks involved in securing payment from third-party payors and reporting to management on observed trends and issues.

Job Relationships
Reports to the Insurance Review Supervisor

Principal Responsibilities
Handle all phone calls and messages received specific to designated insurance area.
Update registration screens when requested by patients or as necessary.
Review and process all designated insurance vouchers received, rebilling charges not paid and processing adjustments as needed utilizing websites or telephone as necessary.
Process all secondary billing as requested by patients or defined by procedure.
Distribute incoming insurance mail received and respond to all audits, inquiries and additional information requests.
Process corrections/adjustments as necessary to correct the patient's invoice.
Process designated insurance reviews when requested to obtain additional payments on claims utilizing websites or telephone as necessary.
Analyze and process front-end system edits for correct physician productivity and billing of claims.
Analyze and process back-end system edits for correct registration and billing of claims.
Analyze and process claims denied through clearinghouse.
Investigate and process claims in the insurance work files and/or on the insurance reports.
Must report all incidents to immediate Supervisor or Manager.
Assist with special projects and assignments as directed.
Must attend in-services and training relevant to position.
Perform other job duties as assigned.
Confidentiality required.
Comply with the Springfield Clinic incident reporting policy and procedures.
Adhere to all OSHA and Springfield Clinic training & accomplishments as required per policy.
Provide excellent customer service and adhere to SC Way customer service philosophy.

Education/Experience
High School graduate or GED required.
Previous experience in a medical billing office required.

Knowledge, Skills and Abilities
Working knowledge of medical terminology preferred.
Working knowledge of CPT and ICD-9 coding preferred.
Computer, typing and calculator skills required.
Must be able to work individually or on a team.

Working Environment
Office environment, sitting for long periods

PHI/Privacy Level
HIPAA1
  • Commercial Insurance Client Relations Specialist

    Found in: Appcast US C2 - 2 weeks ago


    Springfield, United States Nixon & Lindstrom Insurance Full time

    Nixon & Lindstrom Insurance is seeking an experienced Commercial Lines Client Relations Specialist to service and manage a commercial lines book of business and aid our sales team in marketing and binding new accounts. Duties/Responsibilities:Assist clients with customer service needs by corresponding and communicating via email and phone with clients,...

  • Commercial Insurance Client Relations Specialist

    Found in: Appcast Linkedin GBL C2 - 3 weeks ago


    Springfield, United States Nixon & Lindstrom Insurance Full time

    Nixon & Lindstrom Insurance is seeking an experienced Commercial Lines Client Relations Specialist to service and manage a commercial lines book of business and aid our sales team in marketing and binding new accounts. Duties/Responsibilities:Assist clients with customer service needs by corresponding and communicating via email and phone with clients,...

  • Life Health Insurance Agent

    Found in: Appcast Linkedin GBL C2 - 3 days ago


    Springfield, United States Missouri Insurance Advisors Full time

    Health and Life Insurance AdvisorStart Date: 05/20/2024Location: Springfield, MOCompensation:$52,000 base salary plus commission!On Target Earnings:Year 1: $70,000Year 2: $84,000Year 3: $98,000100% Paid for Health Insurance after 90 days with the company!Our innovative and growing company is on the hunt for sales oriented candidates that are interested in...


  • Springfield, United States Nixon & Lindstrom Insurance Full time

    Job DescriptionJob DescriptionNixon & Lindstrom Insurance is seeking an experienced Commercial Lines Client Relations Specialist to service and manage a commercial lines book of business and aid our sales team in marketing and binding new accounts.Duties/Responsibilities:Assist clients with customer service needs by corresponding and communicating via email...

  • Print Systems Analyst II

    Found in: Talent US C2 - 1 week ago


    Springfield, United States American National Full time

    Job PostingThe Document Automation Team within Life and Annuity Systems is currently seeking candidates for the position of Print Systems Analyst II for our Springfield, MO location. The position will assess client data and integrate into variable templates using conditional logic supported by a basic knowledge of programming, preparing proofs for client...


  • Springfield, United States Health New England Full time

    **Summary**: The Healthcare Analyst II is a senior analytics role responsible for supporting healthcare operational and strategic decision-making through the use of standardized analytics (descriptive and predictive), analysis, and robust program evaluation. Using appropriate industry standard processes and techniques, the Healthcare Analyst II serves a...


  • Springfield, United States Health New England Full time

    Job DescriptionJob DescriptionSummary:The Healthcare Analyst II is a senior analytics role responsible for supporting healthcare operational and strategic decision-making through the use of standardized analytics (descriptive and predictive), analysis, and robust program evaluation. Using appropriate industry standard processes and techniques, the Healthcare...


  • Springfield, United States Health New England Full time

    Job DescriptionJob DescriptionSummary:The Healthcare Analyst II is a senior analytics role responsible for supporting healthcare operational and strategic decision-making through the use of standardized analytics (descriptive and predictive), analysis, and robust program evaluation. Using appropriate industry standard processes and techniques, the Healthcare...


  • Springfield, United States Caring Health Center Full time

    General Description: Under the Health Information Systems & Technology Project Manager, the Health Information (HI) Systems Analyst (II) will serve as the clinical information systems subject matter expert. This role will support the management and performance of all health information data and health information systems/applications, with a primary focus...


  • Springfield, United States CareerBuilder Full time

    General Description: Under the Health Information Systems & Technology Project Manager, the Health Information (HI) Systems Analyst (II) will serve as the clinical information systems subject matter expert. This role will support the management and performance of all health information data and health information systems/applications, with a primary focus on...

  • Case Manager

    6 hours ago


    SPRINGFIELD, United States MassMutual Full time

    The OpportunityThe Case Manager acts in a transactional capacity to assist in the processing of New Business Applications. In this role, the Candidate will review, coordinate and issue life insurance application submissions in accordance with department quality and efficiency standards. As an Expert, the Candidate will develop and maintain specialty...


  • Springfield, United States The Massachusetts Mutual Life Insurance Company Full time

    As a Suitability Principal you will conduct back-office review and firm-acceptance of new and existing business and account maintenance submissions as well as suitability reviews for accounts clearing through National Financial Services (NFS). In thi Principal, Service, Operations, Brokerage, Business Partner, Retail, Insurance, Supervisor

  • Cybersecurity Operations Analyst II with Security Clearance

    Found in: Dice One Red US C2 - 2 weeks ago


    Springfield, United States Strategic ASI Full time

    Our client is seeking multiple Cybersecurity Operations Analyst II who could potentially be located in either Springfield, VA or Saint Louis, MO. What You'll Get to Do:* Coordinate and implement tasks, performing analysis, and building/documenting response activities required during cyber security incident response, including but not limited to actions such...

  • Account Executive

    Found in: beBee S US - 3 weeks ago


    Springfield, United States Independent Insurance Agents of Illinois Full time

    SUMMARY The Account Executive (AE) will provide professional, courteous account management and brokerage services to assigned clients, having the primary responsibility for account retention. Working alongside cognizant Producers (aka "Client Executives / Sales") as assigned, the AE shall be principally responsible for overseeing management of assigned...

  • All-Source Intelligence Analyst

    Found in: Dice One Red US C2 - 3 weeks ago


    Springfield, United States Eiden Systems Corporation Full time

    Eiden Systems Corporation is seeking an All-Source Intelligence Analyst (Level II), with an active TS/SCI clearance, to support a contract in the National Capital Region. What you will be doing: • Provides strategic, operational, and tactical analysis as required based on raw intelligence collected from a variety of information sources.• Applies...

  • Developmental Specialist II

    Found in: Talent US C2 - 3 weeks ago


    Springfield, United States Family Health Centers of San Diego Full time

    Impact Lives, Impact CommunityFamily Health Centers of San Diego (FHCSD) is passionate about providing exceptional health care to all, especially underserved communities with limited health care options. Founded by a Latina grandmother/community advocate over 50 years ago in Barrio Logan, FHCSD has grown into one of the largest community health systems in...

  • Regulatory Compliance Analyst II

    Found in: Talent US C2 - 17 hours ago


    Springfield, United States American National Full time

    Job PostingAs a Regulatory Compliance Analyst at American National you will use your strong attention-to-detail and polished written communication skills to make a direct impact on our business. The candidate for this role can work out of our corporate locations in Springfield, MO, or Glenmont, NY.  What Will You Do?• Ensure that the products we offer,...


  • Springfield, United States Vector Check Business Solutions, LLC Full time

    RISA20230410-CS008Cyber Security Engineering Specialist II – NSS – Springfield, VA Number of Positions: 1 Company: Rolston Information Systems Assurance, LLC (RISA) FSLA Classification: Exempt Location: Springfield, VA (WMA) (22150) Remote/Telework Authorized? No remote/telework is authorized. Work is performed 100% on site. Anticipated Start Date:...

  • Accountant II

    Found in: Resume Library US A2 - 2 weeks ago


    Springfield, Massachusetts, United States Blackhawk Network Full time

    Overview: The Accountant II for Accounts Payable will be responsible for vendor maintenance and annual 1099 processing. A candidate with strong organizational skills and the ability to multi-task in a changing environment will be important qualities to the success of this position. The position will be supporting the U.S. and Canada markets with multiple...

  • Registration & Fin Rep II

    Found in: Talent US C2 - 2 weeks ago


    Springfield, United States Baystate Health Full time

    Summary :  Under the direction of the Revenue Cycle Registration Supervisor/Manager, the BH Onsite Registration Representative is responsible for gathering, completing, identifying, and screening all patients for information related to patient check-in and hospital registration. The BH Onsite Registration Rep coordinates with hospital department...