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Insurance Claims Specialist

2 months ago

Dallas, Texas, United States Prestige Staffing Full time

Insurance Claims Specialist at Prestige Staffing



Compensation: $17- $19/hr. Based on Experience



Work Environment: On-Site




• Assignment Duration: 90 days

• Work Schedule: Monday to Friday, 8 AM - 4:30 PM

• Essential Skills: Proficient in Commercial and Government Insurance Collections; Experience with EPIC and Excel; Strong Interpersonal Skills; Ability to Handle High Call Volumes



As an Insurance Claims Specialist, you will be responsible for the collection processes related to assigned accounts.

You will engage with insurance company representatives via phone or written communication to rectify incorrect insurance payments and associated penalties, adhering to Managed Care agreements.

You will maintain organized collection records within the accounts receivable system.

Your role will involve contacting insurance providers to address payment issues and penalties owed, ensuring compliance with Managed Care agreements.

You will also check the status of claims, appeal or dispute payments, and penalties through effective communication with insurance representatives.

A solid understanding of CPT codes, contracting, per diem rates, and other relevant payment methodologies in the healthcare sector is essential.

You will ensure accurate documentation of collection efforts, including detailed records for follow-up actions.

Additionally, you will process accounts for write-off and legal actions, conducting thorough research and calculations based on Managed Care Rate Grids and Contracts to ascertain accurate amounts due.

You will enter data into Patient Accounting systems and databases to monitor payments and penalties, preparing necessary legal documentation for accounts considered uncollectable.

Through diligent review, you will verify the accuracy of account balances and rectify any contractual or payment discrepancies.

You will also manage correspondence related to accounts, ensuring timely responses and resolutions.