Insurance Specialist ~ Commercial Medical Insurance
Perform the medical insurance billing processes to ensure timely and accurate payment of accounts. Supports the Objectives and Philosophy of White-Wilson Medical Center.
Work Practice Management and Clearinghouse reports to ensure all claims are filed with the appropriate insurance carrier
- Performs error/coding corrections via communication with provider offices
- Identifies error trends and communicates with management
- Notifies Coding Manager about insurance coding denial trends
- Posts payments, adjustments and other transactions manually or via ERA, in accordance with Department guidelines which require exact balancing
- Makes necessary changes or additions to patient insurance records
- Documents all actions in the appropriate notes field
- Provides requested medical records as requested by payers
- Files secondary insurance claims as needed
- Respond to patient, provider or payer telephone and written questions/requests and perform necessary corrections/actions
- Reviews all paper claims for completeness and accuracy prior to forwarding to payers
- Attends regular departmental and business office meetings to discuss issues and suggest resolutions
- Maintains strict confidentiality
- Displays a positive attitude and demonstrates a personal commitment to excellence
- Performs other duties as assigned
- Regular and reliable attendance is required
KNOWLEDGE AND SKILLS:
To perform this job successfully, an individual must be able to perform each essential responsibility satisfactorily. The requirements listed below are representative of the knowledge, skills and/or abilities required.
- High School diploma or GED equivalent required.
- Minimum one year in a medical business office environment and/or technical school training preferred.
- Excellent knowledge of medical billing processes, highly organized, detail-oriented and good at multitasking.