Healthcare Claims Examiner

6 days ago


Saint John the Baptist, United States Powers Health Full time

Job Summary

The Insurance Review Specialist will work under the supervision of the insurance review team to ensure timely submission and acceptance of claims. This role involves interacting with patients, insurance carriers, and system staff to resolve claims and accounts receivable balance issues.

Key Responsibilities

  • Follow-up on outstanding claims and perform denial management, claim appeals, and retro-adjudication.
  • Pursue accounts receivable balance resolution, statement processing, self-pay follow-up, and bad debt processes.
  • Utilize Microsoft office applications, perform internet navigation and research, and have prior experience using a computerized health information system.
  • Operate general office equipment, including scanners, fax machines, photocopy machines, printers, and adding machines.
  • Multi-task efficiently and effectively in a busy or stressful situation.
  • Interact with patients, family members, physicians, and other hospital associates with excellent attitude, interpersonal skills, and communication abilities.

Requirements

  • High School graduate (or GED equivalent).
  • 1-2 years insurance or medical billing experience preferred; Physician practice setting strongly preferred.
  • 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.

About Powers Health

Powers Health is a healthcare organization dedicated to providing high-quality medical services to our patients. We are committed to excellence in patient care and strive to create a positive and supportive work environment for our staff.



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