Insurance Claims Specialist

2 days ago


Carrollton, Texas, United States Tanner Health System Full time
Job Summary

The Insurance Specialist is a key member of our team at Tanner Health System, responsible for ensuring seamless interactions with commercial insurance providers. This role requires a high level of expertise in commercial billing requirements, with a focus on contracted and non-contracted commercial, VA, TriCare, and specialty insurance plans.

Key Responsibilities
  • Manage all commercial accounts receivable, including follow-up and resolution of outstanding claims.
  • Develop and maintain strong relationships with insurance providers, ensuring timely and accurate payment processing.
  • Utilize expertise in Availity, United Healthcare, Cigna, and other payer portals to efficiently process claims.
  • Collaborate with cross-functional teams to resolve complex billing issues and improve overall revenue cycle performance.
  • Provide exceptional customer service, responding to inquiries and resolving issues in a timely and professional manner.
Requirements
  • High School Diploma or equivalent required.
  • Two years of experience in insurance billing or collections, with a focus on commercial accounts receivable.
  • Strong knowledge of medical terminology, billing regulations, and insurance industry standards.
  • Excellent communication and problem-solving skills, with the ability to work effectively in a fast-paced environment.
  • Proficiency in Microsoft Office, including Word, Excel, and Outlook.
Preferred Qualifications
  • Epic experience and proficiency in other relevant software applications.
  • Knowledge of regulatory requirements, such as HIPAA and ICD-10.
  • Experience working in a hospital or healthcare setting, with a focus on patient accounts and revenue cycle management.


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