Insurance Specialist

Loeye; Grand Ledge (MI); Presencial; USD 25.000 - 29.000; Jornada completa

Descripción de la vacante

L.O. Eye Care in Grand Ledge, MI is seeking an Insurance Specialist to join the Revenue Cycle team. The role focuses on claims processing, payments posting, and payer follow-up to ensure timely reimbursement.

Ideal candidates have 3–5 years in healthcare billing, strong medical terminology, and familiarity with CPT/ICD coding. This position is full-time and office-based with opportunities to mentor peers and lead tasks.

Formación

• High School Diploma or G.E.D required.
• Previous medical billing experience with knowledge of billing related reporting.
• Three to five years’ experience in health-care (billing or clinical).
• Experience working with medical payers and vision insurance.
• Demonstrated knowledge of medical terminology with high proficiency in general medical office procedures including HIPAA regulations.
• Working knowledge of medical billing systems, NextGen a plus.
• Working knowledge of CPT and ICD-9 & ICD-10 coding system.

Responsabilidades

• Enters billing charges via the practice management system and manual entry process, including correcting and refilling denied claims.
• Posts patient and insurance payments manually and electronically
• Follows up with assigned payers on rejections, denials, inquires, status, etc.
• Responsible for aged accounts receivables for assigned payers.
• Participates in daily phone queue rotation, providing exceptional customer service when responding to patient inquiries.
• Works cooperatively with management to deescalate any patient complaints received.
• Attends and participates in meetings and training.
• Complies with rule, regulations, policies, and procedures for collecting payments.
• Performs other duties as assigned.

Conocimientos

Medical billing

Billing reporting

Healthcare billing

Vision insurance

Medical terminology

HIPAA compliance

NextGen

CPT/ICD coding

Educación

High School Diploma or G.E.D

Herramientas

NextGen

Descripción del empleo

# Insurance SpecialistHot JobGrand Ledge, MI 48837## OverviewSalary Range$18.00 - $21.00 HourlyLevelExperiencedPosition TypeFull TimeJob ShiftDayEducation LevelHigh SchoolCategoryAdmin - Clerical## DescriptionAre you detail-oriented, organized, and passionate about making a difference in healthcare? As an Insurance Specialist, you'll play a vital role in our Revenue Cycle team, ensuring smooth and accurate claims processing. From handling claims creation to following up with providers, patients, and insurance companies, you’ll help keep everything running seamlessly!Why You’ll Love this Role:· Be a key player in a dynamic, fast-paced environment· Work closely with providers, patients, and insurers to ensure smooth claim processing· Take on leadership opportunities by mentoring peers and leading projectsIf you're ready to bring your expertise to a collaborative and supportive team, we’d love to hear from you!Supervisory responsibilitiesThis role serves as a lead or mentor for peers or assigned staff. No formal supervisory responsibilities assigned but may be assigned to lead tasks, groups, or projects.Essential FunctionsThe following list is a summary of the key function of the job and may not be inclusive of all duties assigned.· Enters billing charges via the practice management system and manual entry process, including correcting and refilling denied claims.· Posts patient and insurance payments manually and electronically· Follows up with assigned payers on rejections, denials, inquires, status, etc.· Responsible for aged accounts receivables for assigned payers.· Participates in daily phone que rotation, providing exceptional customer service when responding to patient inquiries.· Works cooperatively with management to deescalate any patient complaints received.· Attends and participates in meetings and training.· Complies with rule, regulations, policies, and procedures for collecting payments.· Performs other duties as assigned.Core CompetenciesAll employees of L.O. Eye Care are expected to demonstrate the following core competencies. Regardless of position or status. Additional job-specific competencies may be required of each position.· All employees of L.O. Eye Care are expected to demonstrate the following core competencies, regardless of position or status. Additional job-specific competencies may be required of each position.· Communication – Ability to communicate effectively both verbally and in writing.· Conscientious – Ability to feel obligated to do right or be good along with awareness of one’s own conduct, intentions, or character.· Teamwork – Ability to work well in groups, develop and maintain positive working relationships, help resolve conflict, and support team goals.· Adaptability – Ability to adapt to change, be open to new ideas, handle pressure and uncertainty, and adjust work plans to meet changing company needs.· Trustworthy – Ability to be worthy of confidence and create assured reliance on the character, ability, and truth of own self.· Patient Confidentiality – Ability to maintain patient confidentiality, and hold others accountable to such, in accordance with the highest ethical standards.Other DutiesPlease note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.Work Environment· Typical office environment.Physical demands/potential hazards· Must be able to sit for prolonged periods, must be able to use eyes, hands, and body to maintain office dexterity and mobility; may be required to lift typical office equipment up to 20 pounds.Travel Required· 0-25%Education and ExperienceEducational requirements that are job-related and consistent with business necessity.· High School Diploma of G.E.D required· Previous medical billing experience with knowledge of billing related reporting.· Three to five years’ experience in health-care (billing or clinical).· Experience working with medical payers and vision insurance.· Demonstrated knowledge of medical terminology with high proficiency in general medical office procedures including HIPPA regulations.· Working knowledge of medical billing systems, Nextgen a plus.· Working knowledge of CPT and ICD-9 and ICD-10 coding system.Leadership and management experienceLeadership requirements that are job-related and consistent with business necessity.N/AAdditional eligibility requirementsN/AWork authorization/security clearance requirementsMust be authorized to work in the USEEO StatementIt is the policy of L.O. Eye Care and its affiliates to provide equal employment opportunities without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, sexual orientation, genetic information or any other protected characteristic under applicable law. This policy relates to all phases of employment, including, but not limited to, recruiting, employment, placement, promotion, transfer, demotion, reduction of workforce and termination, rates of pay or other forms of compensation, selection for training, the use of all facilities, and participation in all company-sponsored employee activities. Provisions in applicable laws providing for bona fide occupational qualifications, business necessity or age limitations will be adhered to by the company where appropriate if applicable.## Qualifications# Education and experience*Educational requirements that are job-related and consistent with business necessity** High School Diploma or G.E.D. required.* Previous medical billing experience with knowledge of billing related reporting.* Three to five years’ experience in health-care (billing or clinical).* Experience working with medical payers and vision insurance.* Demonstrated knowledge of medical terminology with high proficiency in general medical office procedures including HIPAA regulations.* Working knowledge of medical billing systems, Nextgen a plus.* Working knowledge of CPT and ICD-9 & ICD-10 coding system.# Leadership and management experience*Leadership requirements that are job-related and consistent with business necessity* N/A**Additional eligibility requirements** **Work authorization/security clearance requirements**Must be authorized to work in the US# EEO StatementIt is the policy of L.O. Eye Care and its affiliates to provide equal employment opportunities without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, sexual orientation, genetic information, or any other protected characteristic under applicable law. This policy relates to all phases of employment, including, but not limited to, recruiting, employment, placement, promotion, transfer, demotion, reduction of workforce and termination, rates of pay or other forms of compensation, selection for training, the use of all facilities, and participation in all company-sponsored employee activities. Provisions in applicable laws providing for bona fide occupational qualifications, business necessity or age limitations will be adhered to by the company where appropriate if applicable.