Insurance Claims Specialist

2 days ago


Lewisville, Texas, United States StoneGate Senior Living Full time
Insurance Biller Job Description

StoneGate Senior Living is seeking an experienced Insurance Biller to join our team. As an Insurance Biller, you will be responsible for verifying and facilitating insurance authorizations for Skilled Nursing patients.

Key Responsibilities:
  • Verify and process insurance claims for Skilled Nursing patients
  • Communicate with clinical liaisons, insurance carriers, and Skilled Nursing Facilities
  • Assist in the intake process for all patients by receiving referrals, gathering and recording pertinent information, verifying insurance/payor benefits, obtaining preauthorization, and completing the process to admit inpatients to the Skilled Nursing Facilities
  • Manage large loads of claims from multiple facilities within deadlines
  • Work closely with Team Members and billing issue resolutions
  • Communicate effectively with clinical reimbursement
  • Knowledge/understanding of Pharmacy exclusions and related billing procedures
Requirements:
  • High school diploma. College degree in Business preferred
  • Basic Accounting/bookkeeping skills needed
  • Must have Managed Care Insurance experience
  • Experience in Skilled Nursing authorizations preferred
  • Strong knowledge and understanding of Medicare, Managed Care, HMO/PPO plans, and authorization/referral requirements
  • Ability to understand medical terminology
  • Ability to multi-task and prioritize duties
  • Strong Excel skills
  • Excellent organizational skills
  • Uses a computer proficiently
  • Speaks and communicates English effectively, both in verbal and written format


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