Job Description
Job Purpose The Accounts Receivable Insurance Specialist will validate insurance coverage and accurately submit all qualified accounts for insurance billing within the client system. The Accounts Receivable Insurance Specialist will conduct appropriate insurance follow up and verify claim adjudication for all accounts as needed. Duties and Responsibilities Conduct detailed review at the account level to determine accuracy of insurance processing. Review EOB’s, plan coverage, previous billing history and calls insurance carriers when needed. Validate insurance via phone and internet to confirm eligibility for specific charges on specific dates of service Review client billing system to confirm charges were not previously billed or identify edits that need to be made prior to rebilling Work with insurance carriers and patients to resolve insurance related issues such as coordination of benefits, plan coverage limitations and line-item denials Work assigned inventory, work queues, reports, and across all Company product lines. Consistently meets internal and external deliverables with minimal involvement from management. Timely and courteous response to inbound communications (via telephone, e-mail, etc.) from patients, insurance carriers, internal or external clients regarding account status Identify/locate patient, insurance carrier or other third party that is liable for payment of account and initiates contact (via telephone, internet, etc.) to determine reason for non-payment, identify insurance options, and establish repayment arrangements Other duties as assigned Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards Understand and comply with Information Security and HIPAA policies and procedures at all times Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties Qualifications One year certificate from college or technical
