Insurance Specialist

1 week ago


Sacramento, California, United States Dialysis Clinic, Inc. Full time
About the Role

Dialysis Clinic, Inc. is a leading nonprofit organization dedicated to providing individualized care for patients with chronic kidney disease. We are seeking a highly motivated and compassionate Insurance Specialist to join our team.

Key Responsibilities
  • Insurance Verification: Continually and accurately document eligibility, authorization, and other insurance coverage information for assigned patients by staying in contact with clinical staff and social workers, calling insurance companies, and providing online verification.
  • Claims Management: Review all primary payments and denials for accuracy, and send out initial claims, corrected claims, and appeals.
  • Payment Reconciliation: Review remits, accounts, and other correspondence to determine patient responsibilities for billing purposes, and maintain records of patient billing cycle for each clinic to ensure all billing is completed according to policy and procedure.
  • Documentation and Follow-up: Properly document all follow-up and steps taken in electronic systems to ensure accounts are being followed up on and in a timely manner.
  • Monthly Processes: Conduct month-end processes and close clinics by reconciling treatment totals, reviewing monthly charges, resolving discrepancies, and reviewing other monthly reports.
  • Contract Management: Review, enter, and coordinate updating current NDC codes being used at designated clinics, and ensure all claims go to payers via electronic clearing house, keying into portals, etc. once all charges have accurately been recorded onto the patient accounts.
  • Secondary Claims: Review Medicare and other primary payments to ascertain which accounts need to have secondary claims submitted to other payers.
  • Correspondence and Remits: Review correspondence and remits via cash management system to identify incorrect payments, inappropriate denials, or complete required adjustments, and follow up on incorrect postings, incorrect payments, and/or denials, and complete work to resolve account.
What We Offer
  • Comprehensive medical, dental, and vision benefits
  • Life and long-term care insurance provided at no additional expense to employee
  • Paid time off (PTO) including holidays
  • Extended Sick Bank (ESB) in addition to PTO – paid time for doctor appointments, sickness, or medical leave
  • Retirement plans with $.50 of each contributed dollar matched for eligible employees, up to 8 percent
  • Education reimbursement
  • Employee assistance program
  • Wellness program
  • Among others


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