Insurance Claims Specialist

1 week ago


Reno, Nevada, United States Prime Healthcare Full time
About the Role

We are seeking a skilled Insurance Biller Collector to join our team at Prime Healthcare. As a key member of our revenue cycle team, you will play a critical role in ensuring the accurate and timely submission of claims to payers.

Key Responsibilities
  • Submit claims to the appropriate intermediaries and ensure compliance with payer regulations, including Medi-Cal and Medicare.
  • Obtain necessary authorizations for claim processing and payment.
  • Follow up on denied claims and resolve issues for final resolution.
  • Identify and code diagnosis and procedures using ICD9, CPT, HCPCS, and DRG codes.
  • Communicate effectively with clients and staff via phone and in person.
  • Maintain productivity standards and report on performance.
  • Update demographic information and comply with government program billing requirements.
  • Operate computer systems to input follow-up notes and retrieve collection and patient information.
  • Maintain proficiency in medical terminology.
Requirements
  • Previous billing experience in a hospital business office required.
  • Previous experience with government programs and collections preferred.
  • Knowledge of medical terminology.
  • Effective written and verbal communication skills.
  • Ability to multitask and prioritize needs to meet deadlines.
  • Analytical and problem-solving skills.
  • Customer service experience required.
  • High school graduate or GED equivalent required.
About Prime Healthcare

Prime Healthcare is a leading healthcare system with a 114-year history of providing quality care to our communities. We are committed to our core values of quality, compassion, and community. Join our team and be part of a dynamic organization that is making a difference in the lives of our patients and staff.



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