Insurance Review Specialist - Clinic

Community Healthcare System; New Brunswick; On-site; CAD 50,000 - 65,000; Full time

Job summary

A regional healthcare provider is seeking an Insurance Review Specialist in Canada, New Brunswick. This role involves daily interactions with patients and insurance carriers, ensuring timely claims submission and tracking while managing denials and appeals. The ideal candidate will possess a high school diploma, 1-2 years of insurance or medical billing experience, and familiarity with medical terminology and billing regulations. Excellent communication skills are essential for effective interactions with diverse stakeholders.

Qualifications

• 1-2 years of insurance or medical billing experience preferred.
• Experience in a physician practice setting strongly preferred.
• Knowledge of current CPT, ICD, and HCPCS coding systems required.
• Comprehension of government and third-party billing regulations required.

Responsibilities

• Interact with patients, insurance carriers, and system staff daily.
• Ensure claims submission and acceptance in a timely manner.
• Manage follow-up work queues and perform outstanding claim tracking.
• Handle denial management, claim appeals, and retro-adjudication.

Skills

Knowledge of medical terminology

Interpersonal skills

Communication abilities

Ability to multi-task

Problem-solving in stressful situations

Education

High School graduate (or GED equivalent)

Tools

Microsoft Office

Computerized health information system

General office equipment

Job description

Position

Insurance Review Specialist

Location

St. John Outpatient Center: 9660 Wicker Avenue, St. John, IN 46373

Job Summary

With direction provided by the Insurance Review Supervisor, interacts daily with patients, insurance carriers, and system staff members to ensure claims are submitted and accepted in a timely manner. Works on follow‑up work queues and performs outstanding claim tracking, denial management, claim appeals, and retro-adjudication. Pursues accounts receivable balance resolution, statement processing, self‑pay follow‑up, and bad debt processes.

Education / Experience Requirements

• High School graduate (or GED equivalent).
• 1-2 years insurance or medical billing experience preferred; physician practice setting strongly preferred.
• Possess in‑depth knowledge of medical terminology and of the current CPT, ICD, 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.