Insurance Claims Examiner
4 weeks ago
Job Summary
The Insurance Review Specialist will work under the supervision of the insurance review team to ensure timely submission and acceptance of claims. This role involves interacting with patients, insurance carriers, and system staff to resolve claims and accounts receivable balance issues.
Key Responsibilities
- Follow-up work queues and perform outstanding claim tracking, denial management, claim appeals, and retro-adjudication.
- Pursue accounts receivable balance resolution, statement processing, self-pay follow-up, and bad debt processes.
- Utilize Microsoft office applications, perform internet navigation and research, and have prior experience using a computerized health information system.
- Operate general office equipment, including scanner, fax machine, photocopy machine, printer, and adding machine.
- Multi-task efficiently and effectively in a busy or stressful situation.
Requirements
- High School graduate (or GED equivalent).
- 1-2 years insurance or medical billing experience preferred; Physician practice setting strongly preferred.
- In-depth knowledge of medical terminology and CPT, ICD-9-CM, ICD-10-CM, and HCPCS coding systems.
- Comprehension of government and third-party billing regulations.
- Excellent attitude, interpersonal skills, and communication abilities necessary to interact with patients, family members, physicians, and other hospital associates.
About Powers Health
Powers Health is a leading healthcare provider dedicated to delivering high-quality patient care and services. We are committed to creating a positive work environment that fosters growth, teamwork, and excellence.
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