Insurance Claims Specialist

4 weeks ago


Murfreesboro, Tennessee, United States Winston Medical Staffing Full time
Job Title: Accounts Receivable Representative

At Winston Medical Staffing, we are seeking a highly skilled and detail-oriented Accounts Receivable Representative to join our team.

Job Summary:

The Accounts Receivable Representative will be responsible for collecting outstanding insurance reimbursement due to contractual discrepancies. This role requires strong communication and organizational skills, as well as the ability to work well individually and in a team environment.

Key Responsibilities:

  • Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites.
  • Perform payment variance analysis to identify trends in underpaid claims.
  • Initiate appeals when necessary.
  • Basic knowledge of healthcare claims processing including: ICD-9, CPT, and HCPC codes, as well as UB-04.
  • Ability to analyze, identify and resolve issues causing payer payment delays.
  • Act cooperatively and courteously with patients, visitors, co-workers, management and clients.
  • Maintain confidentiality at all times.
  • Maintain a professional attitude.
  • Understand and comply with Information Security and HIPAA policies and procedures at all times.
  • Use, protect and disclose patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
  • Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties.
  • Report any security or HIPAA violations or concerns to the HIPAA Officers.

Requirements:

  • High school diploma or equivalent required.
  • 2+ years' experience in Commercial insurance collections, including submitting and following up on claims.
  • Experience in Hospital/Facility billing.
  • Ability to work well individually and in a team environment.
  • Proficiency with MS Office.
  • Strong communication skills/oral and written.
  • Strong organizational skills.


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