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Regional Outstanding Insurance Specialist

3 months ago

Cary, United States Riccobene Associates Family Dentistry Full time
Job DescriptionJob Description

Riccobene Associates Family Dentistry is looking for a full-time Outstanding Insurance Specialist (This position is remote.)

The Outstanding Insurance Specialist is a critical role responsible for effectively and efficiently managing the accounts receivable process for an assigned group of payors or supported region/company. This is an in office position

Responsibilities

• Ensures claims are processed accurately to secure timely payment.

• Responds to inquiries, questions, and concerns from patients regarding the status of claims in a clear, concise, and courteous manner.

• Conducts follow-up and submits reimbursement appeals for unpaid and/or inappropriately paid claims; ensures appropriate documentation of billing, follow-up, collection, and appeal efforts are recorded on accounts.

• Identifies, researches, and ensures timely processing of billing errors and corrections as they relate to claims; actively participates in problem identification and resolution and coordinates resolutions between appropriate parties.

Requirements

  • Ensuring all claims are submitted within 24 hours of being batched. (exceptions credentialing)
  • Managing rejections, ensuring claims are sent out cleanly and quickly
  • To be tracked once DXC can provide. Clean Claim Rate (Goal 90%)
  • Quality touch per claim every 30 days.
  • Average of 30 claim touches per day.
  • Managing all region’s denials and claim adjudications (corrective claims, appeals, insurance refunds).
  • Working with team to achieve and maintain KPI’s and benchmarks

Benefits

  • Dental insurance
  • Health insurance
  • Life insurance
  • Paid time off
  • Vision insurance