Insurance Claims Specialist

4 weeks ago


Cary, North Carolina, United States Riccobene Associates Family Dentistry Full time

The Insurance Claims Specialist is a critical role responsible for managing the accounts receivable process for an assigned group of payors or supported region/company.

Key Responsibilities:
  • Ensure claims are processed accurately to secure timely payment.
  • Respond to inquiries, questions, and concerns from patients regarding the status of claims in a clear, concise, and courteous manner.
  • Conduct follow-up and submit reimbursement appeals for unpaid and/or inappropriately paid claims; ensure appropriate documentation of billing, follow-up, collection, and appeal efforts are recorded on accounts.
  • Identify, research, and ensure timely processing of billing errors and corrections as they relate to claims; actively participate in problem identification and resolution and coordinate resolutions between appropriate parties.
Requirements:
  • Associate's degree (A. A.) or equivalent from an accredited college, university or technical school; or three to five years related experience and/or training; or equivalent combination of education and experience.
  • Previous high-volume collections experience with PPO's, Worker' Comp, Medicare and Medicaid strongly preferred.
  • Working knowledge of CPT and ICD-10 codes.
  • Previous experience and demonstrated ability to thrive in a production-driven environment.
  • Excellent time management & multi-tasking skills.
  • Proficiency with Microsoft Outlook suite of products; demonstrated aptitude for learning new software programs.
  • Superior verbal and written communication skills.


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