Reimbursement Insurance Claims Processor

5 days ago


Knoxville, Tennessee, United States StaffSource, LLC Full time
Job Summary

A strategic role that ensures accurate and timely reimbursement of services. Verify insurance coverage, manage claims, and resolve issues to guarantee smooth payments.

Key Responsibilities:

  • Insurance Verification
    • Confirm mental health service coverage and benefits.
    • Obtain pre-authorizations when required.
    • Check co-pays, deductibles, and coverage limits.
  • Claims Follow-Up
    • Submit and track insurance claims for timely payment.
    • Follow up on denied or unpaid claims, correcting errors and resubmitting as necessary.
    • File appeals for denied claims and provide additional information if required.
  • Denial Management
    • Identify common reasons for claim denials and work to minimize them.
    • Keep records of follow-up actions and claim statuses.
  • Patient Assistance
    • Explain insurance benefits and out-of-pocket costs to patients.
    • Answer billing and insurance questions.

Qualifications:

  • High school diploma or equivalent.
  • At least 2 years of experience in insurance verification, claims, or billing.
  • Familiarity with mental health insurance and medical billing.
  • Strong communication and organizational skills.
  • Experience with billing software and electronic medical records.


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