Medical Claims Insurance Specialist - Remote

The Little Clinic; Nashville (TN); Remote; USD 35,000 - 50,000; Full time

Job summary

A leading healthcare provider is seeking an Insurance Follow-Up Specialist to manage and resolve account receivables. The ideal candidate will have a high school diploma and over one year of experience in insurance follow-up. You will be responsible for ensuring timely payments, communicating with payers, and documenting all actions in the accounts receivable system. This role requires excellent communication skills and a strong analytical mindset. Join us to make a difference in patient care by ensuring smoother billing processes.

Qualifications

• 1+ year of insurance follow-up experience.
• Thorough working knowledge of revenue cycle management.
• Ability to read and interpret EOBs.

Responsibilities

• Research and resolve aging account receivables.
• Contact insurance companies to secure insurance payments.
• Manage special projects as requested by supervisors.

Skills

Strong written communication skills

Strong oral communication skills

Analytical capabilities

Problem solving capabilities

Organizational skills

Attention to detail

Self-motivation

Flexibility

Education

High school diploma

Tools

EOB interpretation

Job description

Qualifications

Possess a thorough working knowledge of the revenue cycle management process. Responsible for the research and resolution of aging account receivables to that are either unpaid or incorrectly paid. Demonstrate the company's core values of respect, honesty, integrity, diversity, inclusion, and safety.Minimum Position Qualifications:

• High school diploma
• 1+ year of insurance follow-up including working knowledge of the appeals resolution process
• Strong written, and oral communication skills
• Analytical and problem solving capabilities with close attention to detail.
• Excellent organizational and follow-up skills
• Thorough working knowledge of revenue cycle management including medical terminology,ICD-9, ICD-10, CPT-4 coding, Medicare reimbursement guidelines, billing and collection practices
• Ability to read and interpret EOB's
• Highly self-motivated, with ability to work independently and meet deadlines
• Ability to remain flexible during times of change and adjusts promptly and effectively
• Must be able to learn, understand, and apply new technologies
• Analyze, audit and resolve claims outstanding, denied, or incorrectly paid
• Review and respond to payer correspondence.
• Submit appeals as needed for denied claims.
• Contact insurance companies and navigate payer websites in order to secure and expedite insurance payments.
• Resolves patient billing inquiries.
• Document in detail all actions taken in accounts receivable system.
• Meet productivity expectations as outlined by supervisor.
• Recognize, document and notify Team Lead of trends resulting in nonpayment or incorrectly paid claims.
• Answer and resolve inbound calls from insurance carriers.
• Participate in process improvement initiatives as needed.
• Keep current with Medicare and other third party administrators regulations and procedures.
• Manage any special projects requested by supervisor or team lead.
• Must be able to perform the essential functions of this position with or without reasonable accommodation.