Insurance Coordinator

St Cloud Orthopedic Associates; Sartell (MN); On-site; USD 26,000 - 32,000; Full time

Job summary

St Cloud Orthopedic Associates in Sartell, MN is seeking an experienced Insurance Claims Specialist to review, process and investigate reimbursements, with a focus on maximizing payments.

You will handle denials, coordinate primary/secondary benefits, post payments, rebill when needed, and ensure accurate patient accounts while delivering courteous communications to patients and insurers. The role requires attention to detail, teamwork, and adherence to clinic policies.

Qualifications

• Three to five years in medical business office with emphasis in insurance reimbursement procedures.
• Knowledge of basic insurance processing and claims resubmission procedures.
• Knowledge of basic medical terminology and coding.
• Ability to work with a high level of accuracy and detail.
• Ability to investigate and resolve insurance denials independently.
• Ability to prioritize work and multi-task in a fast-paced environment.
• Strong written and oral communication skills.

Responsibilities

• Investigates a large volume of denied claims to discover errors that may have caused denial, makes corrections and resubmits claims.
• Coordinates benefits between primary and secondary insurance providers.
• Processes incoming checks and posts charges to patient accounts.
• Reviews monthly accounts receivable aging reports, re-bills patients as necessary.
• Communicates with patients and insurance companies to resolve questions and clarify coverage.
• Verifies demographic and insurance information for outreach patients.
• Takes payments on accounts in person or over the phone.
• Provides backup to switchboard and other office duties.

Skills

Insurance reimbursement

Attention to detail

Independent investigation

Customer service

Multi-tasking

Education

High school diploma or GED

Tools

Typing 40 wpm

Job description

Job Details

Job Location: St Cloud Orthopedics - Sartell, MN 56377

Salary Range: $19.00 - $23.00 Hourly

A. GENERAL SUMMARY OF DUTIES

Responsible for reviewing, processing and investigating insurance claims to assure receipt of maximum reimbursements available.

B. ESSENTIAL DUTIES

• Investigates a large volume of denied claims to discover errors that may have caused denial, makes corrections and resubmits claims. Errors may include incorrect procedure coding, incorrect insurance information, technical difficulties in electronic billing systems. Works mainly with an assigned group of insurance providers.
• Coordinates benefits between primary and secondary insurance providers.
• Processes incoming checks and posts charges to patient accounts.
• Reviews monthly accounts receivable aging reports, re-bills patients as necessary.
• Complies with clinic policies and procedures on regular work attendance.

C. OTHER DUTIES

• Communicates with patients and insurance companies via the telephone to effectively resolve account questions and complaints and to clarify insurance coverage. Occasionally meets with patients in person.
• Investigates changes in insurance coding or policies through review of web-sites, manuals, newsletters and attending meetings. Applies changes as appropriate based on information gathered. Educates co-workers on changes when necessary.
• Prepares miscellaneous correspondence to insurance companies such as letters of medical necessity, orders for physical therapy.
• Verifies demographic and insurance information for outreach patients.
• Takes payments on accounts either in person or over the phone.
• Provides back-up to switchboard operator and other business office personnel as needed, which may include answering phones, opening mail, and other miscellaneous duties.

D. EDUCATION

High School diploma or GED.

E. EXPERIENCE

Three to five years experience in medical business office, with an emphasis in insurance reimbursement procedures.

F. KNOWLEDGE, ABILITIES AND SKILLS

• Knowledge of basic insurance processing and claims resubmission procedures.
• Knowledge of basic medical terminology and coding.
• Ability to work with a high level of attention to accuracy and detail.
• Ability to work independently to investigate and resolve insurance denials in a timely manner.
• Ability to prioritize work and multi-task in a fast-paced environment.
• Ability to read, understand and follow written and oral instructions.
• Skills in using mathematical calculations to review patient accounts.
• Skills in using customer service principles to work cooperatively with patients in order to resolve questions and discrepancies.
• Skills in using computer (approx. 40 wpm), ten key calculator and other office machines.
• Skills in oral and written communication.

G. ADDITIONAL POSITION REQUIREMENTS

The job holder must demonstrate current competencies applicable to the job position.

This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.

Must pass a background check