Insurance Claims Specialist
1 week ago
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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