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Insurance Claims Specialist

2 months ago

SaintAubinsurGaillon, Normandie, United States Global Pharma Tek Full time

Job Title: Insurance Specialist

Job Summary:

We are seeking a highly skilled Insurance Specialist to join our team at Global Pharma Tek. As an Insurance Specialist, you will be responsible for performing dental and medical insurance services, including billing and reimbursement from private insurance companies and managed care organizations.

Key Responsibilities:

  • Filing dental insurance claims and pre-treatment estimates for privately insured patients
  • Obtaining and providing clinical documentation necessary for claims processing, including x-rays, chart notes, and letters of necessity
  • Investigating denied claims, following up on investigations, and submitting claims appeals
  • Scanning documentation in the electronic patient record, including insurance cards, explanation of payment, provider narratives, and insurance consent
  • Auditing patient records for accuracy and completion of billing, coding, and clinical documentation
  • Answering patient and provider questions regarding dental insurance benefits, claim status, and account summary
  • Assisting patients with in-house payment arrangements under the policies of the company

Requirements:

  • Specialized knowledge of insurance industry standards relating to billing and reimbursement
  • Strong understanding of accounts receivable and dental and medical terminology
  • Extensive and detailed understanding of dental and medical coding, electronic claims processing, and insurance policies and contracts
  • Ability to work closely with private insurance carriers and manage multiple insurance vendors
  • HIPAA compliance