Insurance Claims Specialist

1 week ago


Centennial, Colorado, United States Nexus HR Services Full time
Job Title: Insurance A/R Specialist

We are seeking an experienced Insurance A/R Specialist to join our team at Nexus HR Services.

About the Job

The Insurance A/R Specialist will be responsible for ensuring timely reimbursement by accurately processing and following up on insurance claims. This role requires strong communication skills, attention to detail, and a commitment to delivering exceptional service.

Key Responsibilities:

  • Follow up on insurance account balances for designated divisions.
  • Utilize the claims control module for AR follow-up.
  • Contact insurance plans to check the status of outstanding claims and resubmit or appeal as necessary.
  • Submit medical records to facilitate claims processing.
  • Review and correct claim denials identified by the payment specialist.
  • Respond to incoming billing-related phone calls.
  • Perform pre-bill and claims corrections as required.
  • Serve as backup for the Guarantor AR specialist.

Requirements:

  • High School Diploma or GED.
  • Minimum of 5 years of experience in medical billing.
  • At least 2 years of direct billing experience.
  • Certified coder background preferred.
  • Experience with Vitera EHR is a plus.
  • Proficient in CPT/HCPCS/ICD-9/ICD-10 coding.
  • Excellent verbal and written communication skills.
  • Proficient in MS Office Suite (Excel, Word, Access).

Benefits:

  • 401(k) and 401(k) matching.
  • Health, dental, and vision insurance.
  • Life and disability insurance (short-term and long-term).
  • Flexible spending accounts (FSA).
  • Health Savings Accounts (HSA).
  • Employee Assistance Program (EAP).
  • Paid time off (PTO) and holiday pay.
  • Wellness programs.

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