Main Function

The Insurance Specialist is responsible for the filing of insurance claims, including review of aged accounts receivable and outstanding claims reports utilizing appropriate CPT procedure and ICD-10 diagnosis codes.

Customer Service - This position is split between home and office.

Responds promptly to Physician and team member requests and inquiries

Participates as an active, positive member of the TOI team

Duties and Responsibilities

· Processes all insurance claims for assigned area

· Analyzes and resolves physician claim rejects and denials.

· Identifies trends/problems in billing process and presents viable solutions

· Processes mail receipts for their respective patient types by posting payment to appropriate account, and review EOB for correct adjustment

· Submits adjustment and refund requests with appropriate documentation

· Reviews aged accounts receivable and outstanding claims reports for appropriate tracking Compiles monthly reports as requested

· Assists with physician billing and documentation training

· Performs related work as required.

Qualifications

· High school diploma or equivalent

· Three to Five years of experience in medical billing environment

· One year of work experience in a medical setting

· Knowledge of medical terminology

· Word processing and computer experience

· Must have experience creating spreadsheets, reports, and trends data

Mental/Physical Requirements

· Ability to work well under pressure with diverse groups of professionals and physicians

· Ability to communicate written and oral ideas and plan effectively

· Requires good communication and organizational skills

· Requires reasoning ability and good independent judgment

· Requires tolerance of standing or sitting posture up to (4 hours) continuously, for a total of up to (10 hours) per (12 hours)

· Required to operate computer keyboard, mouse, and monitor for a total of up to (8 hours) per (12 hours)

Job Type: Full-time

Pay: $16.00 - $22.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Education:

• High school or equivalent (Preferred)

Work Location: In person

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