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Insurance Specialist

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Full-time Remote 13d ago

Location:

North Carolina Remote, NC, US

Company:

Novant Health is a healthcare organization dedicated to providing remarkable patient experiences with a focus on community involvement and teamwork.

Summary:

The Insurance Specialist will monitor and follow up on outstanding insurance claims while preparing technical appeals for denied claims. Candidates should have relevant experience in medical billing or coding and possess strong communication skills.

Requirements:

Credentials: High School Diploma or GED, 2 Year / Associate Degree

Experience: Minimum two years in medical billing or hospital coding, Claims processor experience, Medical claims for an insurance carrier, Clerical/Billing experience in a medical office

Job Description:

Job Summary

Insurance Specialist

Key Responsibilities:

  • Insurance Follow-Up: Monitor and follow up on outstanding insurance claims to ensure timely resolution and payment.
  • Technical Appeals: Prepare and submit detailed technical appeals for denied claims, ensuring compliance with payer-specific guidelines.
  • Denial Management: Analyze and resolve claim denials by identifying root causes and implementing corrective actions.
  • Payer Communication: Maintain effective communication with insurance payers to resolve issues, clarify claim requirements, and expedite claim processing.

Responsibilities

It is the responsibility of every Novant Health team member to deliver the most remarkable patient experience in every dimension, every time.

  • Our team members are part of an environment that fosters teamwork, team member engagement and community involvement.
  • The successful team member has a commitment to leveraging diversity and inclusion in support of quality care.
  • All Novant Health team members are responsible for fostering a safe patient environment driven by the principles of "First Do No Harm".

Qualifications

  • Education: High School Diploma or GED, required. 2 Year / Associate Degree, preferred.
  • Experience: Minimum two years in medical billing or hospital coding, as a claims processor, medical claims for an insurance carrier, or Clerical/Billing experience in a medical office, preferred.
  • Additional Skills (required):
    • Excellent communication and organizational skills required. Ability to successfully complete generic and department specific skills validation and competency testing.
    • Must display excellent customer service skills and excellent computer skills.
    • Must be able to multi-task and be a team player.
    • Must be able to work overtime as required.
    • Must be self-motivated, able to work independently without constant supervision and a critical thinker.
    • Must be flexible, able to meet deadlines and adaptable to change.
    • Ability to communicate effectively and professionally.
    • Detail oriented and strong organizational skills.
    • Aware of HIPAA laws.
    • Familiar with Microsoft Office Applications.
    • Must be able to manage time with tasks assigned.
  • Additional Skills (preferred):
    • Basic medical terminology.
    • Insurance guidelines.

Job Opening ID

62043