Med-Metrix logo
Med-Metrix

Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.

Accounts Receivable Insurance Specialist

Accounts ReceivableAccounts ReceivableFull TimeRemoteMid LevelTeam 1,001-5,000

Location

United States

Posted

1 day ago

Salary

0

Seniority

Mid Level

No structured requirement data.

Job Description

Accounts Receivable Insurance Specialist

Med-Metrix

Role Description The Accounts Receivable Insurance Specialist will validate insurance coverage and accurately submit all qualified accounts for insurance billing within the client system. The specialist will conduct appropriate insurance follow-up and verify claim adjudication for all accounts as needed. - Conduct detailed review at the account level to determine accuracy of insurance processing. - Review EOB’s, plan coverage, previous billing history and call 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 meet internal and external deliverables with minimal involvement from management. - Provide timely and courteous responses 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 initiate contact to determine reason for non-payment, identify insurance options, and establish repayment arrangements. - Perform 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 necessary to perform assigned duties. Qualifications - One year certificate from college or technical school; or three to six months related experience and/or training; or equivalent combination of education and experience. - 2-3 years job-related experience. - Working knowledge of insurance follow-up processes required. - Must be proficient in reimbursement methodology. - Must be proficient in MS Office applications. - Strong interpersonal skills, ability to communicate well at all levels of the organization. - Strong problem-solving and creative skills with the ability to exercise sound judgment and make decisions based on accurate and timely analyses. - High level of integrity and dependability with a strong sense of urgency and results-oriented. - Excellent written and verbal communication skills required. - Gracious and welcoming personality for customer service interaction. Requirements - Physical Demands: Occasionally required to move around the work area; sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals, and telephones; extend arms; kneel; talk and hear. - Mental Demands: Must be able to follow directions, collaborate with others, and handle stress. - Work Environment: The noise level in the work environment is usually minimal. Company Description Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.

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