Insurance Advisor - FT (Hybrid/Remote Opt)

Wilmington Health Pllc; Wilmington (NC); Hybrid; USD 42,000 - 54,000; Full time

Job summary

Wilmington Health is seeking an Insurance Advisor for a full-time role that supports a hybrid/remote option in Wilmington, NC. You will handle claims, denials, and appeals, ensuring accurate billing and patient invoicing within a busy corporate health department.

The role requires a high school diploma or GED and 3–5 years in a medical office environment, with preferred experience in medical office administration and knowledge of OSHA/DOT regulations. BLS/CPR certification is a plus.

Qualifications

• High school diploma or GED.
• 3-5 years' experience in a medical office environment.
• Or equivalent combination of education and experience.
• Preferred: Experience in Medical Office Administration.
• Preferred: Knowledge of the OSHA and DOT regulations.
• Preferred: Experience with urine drug screen collection and breath alcohol tests processes.
• Preferred: BLS/CPR Certified.

Responsibilities

• Ensures prompt collection of the appropriate amount due.
• Follow-up with carrier regarding outstanding claims as noted on the outstanding invoice report.
• File claims that require additional documentation.
• Verify benefits as requested by physician.
• Change insurance information as appropriate.
• Correspond to carrier for such things as appeals and/or inquiries.
• Communicate all insurance regulation changes to supervisor.
• Contact patient and/or carrier to follow-up on denials and termination of coverage.
• Respond to telephone calls; review and respond to correspondence.
• Process computer refunds due patients and insurance companies.
• Defines relationship issues and acts as advocate for referring providers and office staffs to cross-functionally resolve outstanding issues with WH and ensures that resolutions are satisfactory and referral process is satisfactory.
• Works collaboratively with occupational health and corporate wellness to establish integrated strategic business plans to achieve corporate objectives for products and services.

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Insurance Advisor - FT (Hybrid/Remote Opt)

Accrues PDO Wilmington, NC, US

Title: Insurance Advisor Department: Corporate Health

FLSA Status: Reports to: Corporate Health Coordinator

Job Number: Approved/Revised Date: 11.13.19

About Wilmington Health

Since 1971, Wilmington Health has been committed to the care and health of our community in Wilmington as well as all of southeastern North Carolina. Wilmington Health is structured as a multi-specialty medical practice with primary care providers integrated into the system. In this way, Wilmington Health is able to provide a comprehensive and coordinated approach to the care of all our patients. Wilmington Health is committed to using collaborative, evidence-based medicine in providing the highest quality of care to the patients we serve.

Purpose:

Ensures prompt collection of the appropriate amount due

• Follow-up with carrier regarding outstanding claims as noted on the outstanding invoice report
• File claims that require additional documentation
• Verify benefits as requested by physician
• Change insurance information as appropriate
• Correspond to carrier for such things as appeals and or inquiries
• Communicate all insurance regulation changes to supervisor
• Contact patient and or carrier to follow-up on denials and termination of coverage
• Respond to telephone calls; review and respond to correspondence
• Process computer refunds due patients and insurance companies
• Defines relationship issues and acts as advocate for referring providers and office staffs to cross-functionally resolve outstanding issues with WH and ensures that resolutions are satisfactory and referral process is satisfactory.
• Works collaboratively with occupational health and corporate wellness to establish integrated strategic business plans to achieve corporate objectives for products and services.

Other Duties:

• As assigned by manager

QUALIFICATIONS

Required:

• High school diploma or general education degree (GED)
• 3-5 years' experience in a medical office environment
• or equivalent combination of education and experience

Preferred:

• Experience in Medical Office Administration
• Knowledge of the OSHA and DOT regulations
• Experience with urine drug screen collection and breath alcohol tests processes
• BLS/CPR Certified

Wilmington Health is an Equal Opportunity Employer committed to providing equal opportunities to all applicants and employees. We are committed to treating everyone equally and with respect regardless of race, age, sex, religion, national origin, citizenship, marital status, veteran’s status, sexual preference, disability, genetic information, or any other class protected under state or federal law.

ADA Physical Demands:

Rarely (Less than .5 hrs/day) Occasionally (0.6 – 2.5 hrs/day) Frequently (2.6 – 5.5 hrs/day) Continuously (5.6 – 8.0 hrs/day)

Physical Demand

Required?

Frequency

Standing

Occasionally

Walking

Occasionally

Kneeling/Crouching

Rarely

Lifting

Rarely

Required:

2-3 years of experience in medical billing, specifically with claims denials, appeals, corrected claims. May have a remote option at a certain point.