Insurance Coordinator

St. Cloud Orthopedics; Sartell (MN); On-site; USD 42,000 - 58,000; Full time

Job summary

St. Cloud Orthopedics in Sartell, MN is seeking a skilled Medical Billing Specialist to review, process, and investigate insurance claims to maximize reimbursements.

You will handle denials, coordinate primary and secondary coverages, post payments, and rebill when needed, while ensuring accuracy and compliance. This role requires 3–5 years in a medical business office and a high school diploma; background check is required.

Qualifications

• High school diploma or GED is required.
• Three to five years experience in medical business office with emphasis on insurance reimbursement procedures.
• Strong knowledge of basic insurance processing, coding, and terminology.
• Must pass a background check.

Responsibilities

• Investigates a large volume of denied claims to discover errors, makes corrections and resubmits.
• Coordinates benefits between primary and secondary insurance providers.
• Processes incoming checks and posts charges to patient accounts.
• Reviews monthly accounts receivable aging reports and rebills as necessary.
• Communicates with patients and insurance companies to resolve questions and clarify coverage.
• Takes payments on accounts in person or over the phone.
• Provides back-up to switchboard operator and other office tasks as needed.

Skills

Insurance processing

Medical terminology

Coding knowledge

Attention to accuracy

Investigation of denials

Multi-tasking

Reading and following instructions

Customer service

Computer skills (40 wpm etc)

10-key calculator

Oral and written communication

Education

High School diploma or GED

Job description

GENERAL SUMMARY OF DUTIES

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

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.

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.

EDUCATION

High School diploma or GED.

EXPERIENCE

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

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.

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