Insurance Specialist

Job description

Education/Experience: - Follow up on claim status via insurance portals or calls to payers to determine adjudication and details. - Call payers and patients as needed to resolve claim rejections, challenge processing decisions, and verify insurance coverage. - Verify patient insurance eligibility and coordination of benefits. - Review and analyze payer correspondence. - Investigate electronic claim rejections. - Submit claims for processing corrections, to secondary insurances, or to updated addresses. - Research requests for insurance payment retractions. - Monitor and notify management of payer trends and/or claim processing issues. - Meet or exceed productivity and quality KPI goals. - Perform other duties as assigned. - High School diploma or GED - Previous health insurance billing experience - Working knowledge of medical terminology - Strong problem-solving skills and the ability to adapt to changes in policies, regulations, and procedures - Excellent written and verbal communication skills - High attention to detail - Ability to interact effectively with others - Ability to maintain confidentiality - Proficient computer skills with knowledge of Microsoft Word and Excel