Insurance Claims & Denials Resolution Specialist

Vance Thompson Vision; Sioux Falls (SD); On-site; USD 42,000 - 60,000; Full time

Benefits offered by this job

Medical Insurance

PTO & Retirement

Shoe allowance

Education Allowance

Wellness Program & Lifestyle

Job summary

Vance Thompson Vision is seeking an Insurance Follow-Up Specialist to join our business office team. You will manage outstanding insurance claims, including rejections, and file secondary claims as needed.

You will also submit appeals on denials and process credits or refunds when necessary. Ideal candidates have an associate degree in Health Information Management and at least two years of medical insurance experience, with knowledge of billing regulations and terminology.

Qualifications

• Associate degree in Health Information Management or related field.
• At least two years’ experience in medical insurance or equivalent.
• Knowledge of medical insurance billing regulations and terminology preferred.

Responsibilities

• Process outstanding insurance claims, including rejected or failed claims from the clearinghouse.
• File claims to secondary insurance when needed.
• Submit appeals for denials or low reimbursements.
• Process insurance credits and request refunds for overpayments.
• Resolve denials through research, corrected claims, and adjustments.
• Review denials related to eligibility, COB, medical records, and simple billing errors.
• Identify and resolve no-response claims (unbilled, not received, invalid address).
• Answer daily calls and emails for the business office.

Skills

Detail-oriented

Multitasking

Adaptable

Prioritization

Education

Associate degree in Health Information Management

Job description

Vance Thompson Vision is seeking an Insurance Follow-Up Specialist to join our business office team. You will manage outstanding insurance claims, including rejections, and file secondary claims as needed.

You will also submit appeals on denials and process credits or refunds when necessary. Ideal candidates have an associate degree in Health Information Management and at least two years of medical insurance experience, with knowledge of billing regulations and terminology.