Insurance Specialist
1 week ago
Location: Chapel Hill, NC 27514
Duration: 03 Months+ (High Possible for Extension)
Contract Type: Contract
Job Summary:
- This Insurance Specialist position offers both dental and medical insurance services for the client.
- The Insurance Specialist works in all areas of billing and reimbursement, including private dental insurance companies and managed care organizations.
- This role requires specialized knowledge of insurance industry standards related to billing and reimbursement, along with a strong understanding of accounts receivable.
Responsibilities:
- This position collaborates closely with private insurance carriers, particularly those contracted with the clinics. It also requires a comprehensive understanding of dental and medical terminology, dental procedural and diagnostic coding, medical-dental cross-coding, electronic claims processing, and the policies and contracts of multiple insurance vendors.
- The responsibilities of this role include filing dental insurance claims and pre-treatment estimates for privately insured patients; obtaining and providing the clinical documentation necessary for claims processing, such as x-rays, chart notes, and letters of necessity; investigating denied claims, following up on those investigations, and submitting appeals for those denied claims; verifying essential documentation including insurance cards, insurance explanations of payment, provider narratives, and insurance consent; and regularly auditing patient records for accuracy and completeness of billing, coding, and clinical documentation.
- This position will require extensive communication with various insurance companies, along with effective use of insurance portals.
- Effective communication and deductive reasoning are essential skills. Compliance with HIPAA regulations is mandatory. Other duties as assigned.
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