INSURANCE SPECIALIST (13852)

Cullman Regional; Cullman (AL); On-site; USD 42,000 - 66,000; Full time

Job summary

Cullman Regional is hiring for a Full Time Health Care billing position in Cullman, AL. The role focuses on identifying unpaid third-party claim statuses, obtaining required documentation, and communicating with payers and patients to resolve issues.

The ideal candidate has 3 years of hospital business office experience, is proficient with Microsoft Office, and understands ICD/CPT codes and payer portals. Strong attention to detail and patient-centered service are essential.

Qualifications

• High school diploma or equivalent.
• 3 years hospital business office or physician office experience preferred.
• Proficient with Microsoft Office Suite.
• Knowledge of ICD, CPT, revenue codes and modifiers.
• Familiarity with payer websites and portals preferred.

Responsibilities

• Identifies status on unpaid 3rd party claims in a timely manner.
• Uses most effective tools to obtain status so that effectiveness and productivity are maximized.
• Communicates payment expectations and removes payers stall tactics in a firm but professional manner.
• Reports problem accounts and/or consistent slow payers to management and provides examples.
• Involves the patient and/or insured to obtain information needed by payers to process the claim.
• Conducts three-way calls between patients and payers to address obstacles in getting claims processed.
• Obtains, or assists in obtaining, any additional documentation needed by a payer to process a claim.
• Works with their billing partner to identify trends in billing errors, so the edits can be developed to increase clean claim rate.
• Accurately and thoroughly documents all pertinent events regarding the account.
• Demonstrates and encourages team behavior and exceptional patient/guest experiences.
• Upholds and promotes patient safety and quality.

Skills

MS Office

ICD/CPT codes

Payer portals

Education

High school diploma

Job description

Job Details: Job Location: Cullman Regional Medical Center - Cullman, AL 35056, Position Type: Full Time, Job Shift: Any, Job Category: Health Care, Job Summary

• Identifies status on unpaid 3rd party claims in a timely manner.
• Uses most effective tools to obtain status so that effectiveness and productivity are maximized.
• Communicates payment expectations and removes payers stall tactics in a firm but professional manner.
• Reports problem accounts and/or consistent slow payers to management and provides examples.
• Involves the patient and/or insured to obtain information needed by payers to process the claim.
• Conducts three-way calls between patients and payers to address obstacles in getting claims processed.
• Obtains, or assists in obtaining, any additional documentation needed by a payer to process a claim.
• Works with their billing partner to identify trends in billing errors, so the edits can be developed to increase clean claim rate.
• Accurately and thoroughly documents all pertinent events regarding the account.
• Demonstrates and encourages team behavior and exceptional patient/guest experiences.
• Upholds and promotes patient safety and quality.

Qualifications: Education

• High school diploma required or equivalent.

Experience

• 3 years of hospital business office or physician office preferred.

Additional Skills/Abilities

• Must be proficient in Microsoft Office Suite of products.
• Knowledge of ICD, CPT, revenue codes and modifiers is required.
• Familiarity with payer website and portals is preferred.