Insurance Claims Examiner

3 weeks ago


Saint John the Baptist, United States Powers Health Full time
Job Summary

We are seeking a highly skilled Insurance Review Specialist to join our team at Powers Health. As an Insurance Review Specialist, you will play a critical role in ensuring that claims are submitted and accepted in a timely manner.

Key Responsibilities
  • Interact daily with patients, insurance carriers, and system staff members to resolve claims and billing issues.
  • Work on follow-up work queues and perform outstanding claim tracking, denial management, claim appeals, and retro-adjudication.
  • Pursue accounts receivable balance resolution, statement processing, self-pay follow-up, and bad debt processes.
  • Utilize Microsoft office applications, perform internet navigation and research, and have prior experience using a computerized health information system.
  • Operate general office equipment, including scanner, fax machine, photocopy machine, printer, and adding machine.
Requirements
  • High School graduate (or GED equivalent).
  • 1-2 years insurance or medical billing experience preferred; Physician practice setting strongly preferred.
  • In-depth knowledge of medical terminology and of the CPT, ICD-9-CM, ICD-10-CM, and HCPCS coding systems.
  • Comprehension of government and third-party billing regulations required.
  • Excellent attitude, interpersonal skills, and communication abilities necessary to interact with patients, family members, physicians, and other hospital associates.


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