Insurance Claims Specialist
5 days ago
Job Summary
The Insurance Claims Specialist provides timely follow-up of facility claims for all acute care based locations. Manages assigned portion of accounts receivable and aging reports, and responds to insurance company requests for information. Assists with coaching and training staff to ensure proper reimbursement of claims and identifies issues. The ideal candidate will have 3-4 years of experience in insurance follow-up and a strong understanding of healthcare financial management principles.
Key Responsibilities
- Manage assigned portion of accounts receivable and work the aging reports to ensure timely follow-up of facility claims.
- Review accounts to ensure proper reimbursement of claims and report any problems, issues, or trends to management.
- Research and write appeals to insurance companies on denied accounts and resubmit applicable insurance claims within 24 hours of receipt.
- Respond to insurance company requests for information and process insurance/patient correspondence within 48 hours of receipt.
- Meet productivity and quality assurance standards set by management.
- Assist with coaching and training of staff to ensure proper reimbursement of claims and identify issues.
- Perform other tasks and special projects as needed.
Requirements
- High School Diploma or GED (required)
- Bachelor's Degree in Accounting, Finance, or other related field (preferred)
- 3-4 years of experience in insurance follow-up (required)
- CRCR - Healthcare Financial Management Association (HFMA) certification within 1 year (required)
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