Insurance Specialist

Job Description:

This position supports Mercy's philosophy of patient centered care by properly submitting charges to insurance companies for reimbursement. Will also be responsible for appropriately billing the patient and providing timely follow up on billing issues and denials.

Job Duties

• Bills hospital UB-04 claims and professional 1500 claims.
• Verifies insurance coverage of hospital patients.
• Assists patients and family members in resolving billing concerns as indicated.
• Processes third party insurance claims as assigned and follows up according to departmental guidelines to ensure timely payment of account balances.
• Uses several systems to bill claims, scrub claims and work rejections.
• Updates demographic and insurance information to the billing system as appropriate.
• Maintains work queues according to procedure, clearly defining next actions and follow-up dates on all accounts.
• Documents all conversations and actions taken into the proper systems.
• Reviews insurance claims for completeness and accuracy prior to mailing.
• Prepares refunds for mailing.
• Follows Mercy's safety guidelines, carries out job-specific safety duties and responsibilities, and promptly reports any unsafe conditions, situations, incidents and injuries.

Knowledge, Skills and Abilities

• Required ability to operate a computer, copy/fax machines and telephone system.
• Required strong written and verbal communication and math skills.
• Required strong organizational and time management skills.
• Required strong interpersonal skills.
• Required ability to work with minimal to no supervision.
• Preferred working knowledge of medical insurance plans and medical terminology.
• Preferred proficiency with MS Office.
• Preferred knowledge of EPIC software.

Professional Experience

• Preferred: 1 year of previous experience in a medical office, medical business office, or insurance industry

Licensure, Certification, Registration

• None

Pay Rate Type

Hourly