Insurance Claims Specialist

1 week ago


Huntersville, North Carolina, United States CEENTA Full time
Job Summary

We are seeking a highly skilled Insurance Specialist to join our team at CEENTA. As an Insurance Specialist, you will be responsible for creating and sending medical claims to insurance companies and patients, ensuring accurate information is reported to facilitate timely billing. Your attention to detail and ability to work independently will be essential in following up on unpaid claims, clarifying discrepancies, and reviewing bills to confirm eligibility.

Key Responsibilities
  • Review and correct claims for missing or inaccurate information
  • Verify coverage and eligibility for medical services
  • Communicate with insurance companies and patients as needed
  • Utilize Epic to prepare claims and manage the revenue cycle process
  • Collect and clear unpaid claims, addressing discrepancies and denials
  • Investigate and appeal denied claims
  • Manage correspondence and emails linked with OnBase and MediStreams
  • Assist customer service, payment posters, and managers with patient concerns and outstanding claims
Requirements
  • Proficient in Microsoft Excel and Electronic Medical Record systems
  • Understanding of primary code classifications: ICD-10-CM, ICD-10-PCS, CPT, and HCPCS
  • Excellent communication skills with healthcare companies
  • Ability to work independently and solve routine issues
Working Conditions

This is a full-time, 40-hour weekly position with the possibility of overtime. The work environment is remote, and the employee should have a dedicated workspace with high-speed internet and a headset. The employee will be required to work on-site occasionally for training and meetings.

The physical and mental demands of this position include sitting for extended periods, typing, and repetitive mouse clicking. The employee must be able to problem-solve, work under pressure, and make quick decisions. A clean driving record and consistent transportation are also required.



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