Insurance Claims & Denials Specialist

VieMed; Lafayette (LA); On-site; USD 40,000 - 52,000; Full time

Job summary

Ultipro in Lafayette, LA seeks a Billing & Insurance Specialist to review policies and explanations of benefits, and manage denials and payments within the revenue cycle. The role emphasizes accuracy, communication with carriers, patients, and internal teams.

The ideal candidate has a high school diploma, 3–5 years in DME or medical billing, and knowledge of CPT/ICD-10 codes, HIPAA, and government regulations. Strong organizational skills and MS Office proficiency are essential.

Qualifications

• High School Diploma or equivalent.
• Knowledge of Explanation of Benefits from insurance companies.
• General knowledge of government, regulatory billing and compliance regulations/policies for Medicare & Medicaid.
• Working knowledge of CPT and ICD-10 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits.
• Enough knowledge of policies and procedures to accurately answer questions from internal and external customers.
• Utilizes initiative while maintaining set levels of productivity with consistent accuracy.

Responsibilities

• Review and understand Insurance policies and standard Explanation of Benefits.
• Review and understand medical documentation effectively.
• Resolve Back Collections tasks: denial appeals, payment review, balance billing, and claims generation.
• Establishes and maintains effective communication with insurance carriers, patients/family, and other internal teams for the patient’s benefit.
• Performs other clerical tasks as needed, such as: Answering patient/Insurance calls, Faxing and Emails.
• Communicates appropriately and clearly to Manager/Supervisor, and other superiors. Reports all concerns or issues directly to Revenue Cycle Manager and Supervisor.
• Other responsibilities and projects as assigned.

Skills

Organizational skills

MS Office

Attention to detail

Communication

Education

High School Diploma or equivalent

Job description

Ultipro in Lafayette, LA seeks a Billing & Insurance Specialist to review policies and explanations of benefits, and manage denials and payments within the revenue cycle. The role emphasizes accuracy, communication with carriers, patients, and internal teams.

The ideal candidate has a high school diploma, 3–5 years in DME or medical billing, and knowledge of CPT/ICD-10 codes, HIPAA, and government regulations. Strong organizational skills and MS Office proficiency are essential.