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Insurance Specialist

Insurance Specialist

Job ID 
2017-1593
Location 
US-FL-Maitland
Function 
Revenue Cycle Management
Employment Status 
Full-Time

More information about this job

Overview

  

Welcome to US Anesthesia Partners! We are one of Florida’s largest anesthesia practices and a founding clinical partner of USAP, the nation's largest anesthesia-focused physician services organization. We currently have an opportunity for a Insurance Specialist to join our fast paced Billing Operations / MSO Team located in Maitland, FL.  In exchange for your skills and experience, we offer a strong total compensation package including a full spectrum of health and wellness benefits, a Retirement Plan including a 401k and profit share component, flexible spending accounts, liberal time off program and much more.

 

The Insurance Specialist will ensure timely processing of appropriate insurance journals, filing of claims and follow-up on denials to create a positive revenue flow for the company.

 

 

Responsibilities

ESSENTIAL DUTIES:

  • Track denials for problem areas.
  • Process and follow up on appeals to insurance companies
  • Call or check electronically to verify eligibility and or claim status
  • Where appropriate obtain repricing from repricing agent and forward claim to correct payor.
  • Call hospital and/or surgeon or patient to verify correct information
  • Knowledge of insurance contracts to ensure proper payment according to contracted fee schedule.
  • Manage clearing house denial and rejected claims daily.
  • Run weekly reports of underpaid, unpaid or rejected claims.
  • Employee will adhere to company Corporate Compliance policy. In so doing employee must report
  • to immediate supervisor anything that violates the compliance policy.
  • Willingness and ability to follow directions and or company policy as directed by supervisor.
  • Work outstanding accounts receivable from collector que with proficiency.
  • Must be able to work 50 accounts daily.
  • Maintain accuracy rating of 90% or greater on audited accounts.

OTHER DUTIES:

  • Request records when necessary to file claims.
  • Refile claims not on file.
  • Obtain face sheets, charge sheets and make corrections in system where necessary.
  • Call insurance companies for clarity or corrections on EOBs’.
  • Attend seminars and in-services provided by various insurance carriers where applicable.
  • Review journal to include rebilling of accounts, contacting insurance companies and surgeons, working appeals, printing scanned EOBs’.
  • Follow-up on denials, make notes in system and change FC where appropriate.
  • Update billing cycle, send statement reminders, and change accounts to patient responsibility.
  • Follow-up with insurance corrections or changes to other departments.
  • Send paper documentation to insurance carriers (face sheets, anesthesia record). Know contract limits.

Qualifications

REQUIRED EXPERIENCE:

  • One to two years insurance billing experience.
  • Medical terminology, CPT, ICD-9 and ASA codes.
  • Intermediate computer skills.
  • Good communication skills.

 

EDUCATION:

  • High School graduate or equivalent.
  • Courses in coding and medical terminology and billing/reimbursement.

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