Lead Insurance Review Specialist

1 week ago


Saint John the Baptist, United States Powers Health Full time
Job Title: Lead Insurance Review Specialist Job Summary: As a Lead Insurance Review Specialist at Powers Health, you will serve as a leader for the follow-up portion of the revenue cycle. You will monitor follow-up work queues and report and initiate action where needed. You will oversee and perform outstanding claim tracking, denial management, claim appeals, retro-adjudication, and reimbursement monitoring processes. You will also oversee and perform statement processing, self-pay follow-up, and bad debt processes. Key Responsibilities: * Monitor follow-up work queues and report and initiate action where needed * Oversee and perform outstanding claim tracking, denial management, claim appeals, retro-adjudication, and reimbursement monitoring processes * Oversee and perform statement processing, self-pay follow-up, and bad debt processes * Motivate and educate staff to perform tasks according to baseline goals and objectives Requirements: * High School graduate (or GED equivalent) * 1-2 years lead or supervisory experience preferred * 3-5 years professional/hospital billing experience required * Possess in-depth knowledge of medical terminology; and of the CPT, ICD-9-CM, ICD-10-CM, and HCPCS coding systems * Comprehension of government and third party billing regulations required * Must be able to utilize Microsoft office applications, perform internet navigation and research, and have prior experience using a computerized health information system * Needs to be familiar with operating general office equipment, including but not limited to: scanner, fax machine, photocopy machine, printer and adding machine * Ability to multi-task efficiently and effectively * Must be able to act calmly and effectively in a busy or stressful situation * Excellent attitude, interpersonal skills and communication abilities necessary to interact with patients, family members, physicians, and other hospital associates * Exhibits leadership qualities: planning, organizing, delegating, leading, teaching, etc. * Excellent verbal and written communication; excellent problem solving abilities Work Environment: This position is located at the St. John Outpatient Center in St. John, IN 46373.

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