Insurance Claims Specialist

4 weeks ago


Houma, Louisiana, United States Cardiovascular Institute of the South Full time
Job Summary

The Insurance Claims Specialist is responsible for working with insurance collections accounts, correcting and refilling claims as needed, and posting necessary adjustments daily. This role also involves working with mail, including refund requests, extensions, and requests for additional information. The ideal candidate will have a strong understanding of insurance, managed care, and other changes, including CPT and ICD coding, global, and CCI guidelines.

Key Responsibilities

  • Work with insurance collections accounts, correcting and refilling claims as needed, and posting necessary adjustments daily.
  • Work with mail, including refund requests, extensions, and requests for additional information.
  • Stay current on insurance, managed care, and other changes, including CPT and ICD coding, global, and CCI guidelines.
  • Answer patient questions concerning insurance or billing issues.
  • Work follow-ups on a regular basis.
  • Prepare and work outstanding reports.
  • Prepare and work credit balance report.
  • Maintain log of audits, including pre-payment audits.
  • Perform other related duties as assigned.

Requirements

  • High School graduate preferred.
  • Demonstrated ability to organize.
  • Possess time management skills.
  • Ability to understand and use a computer system.
  • Experience with telephone collections preferred, but not required.


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