Sr. Insurance Specialist

Sr. Insurance Specialist will help our communities thrive by providing medical billing and accounting services to our patients. We are a culture that is unabashedly driven by purpose. We are making a difference to our patients and providers while growing at an accelerated rate.

Every day, we support the health journey of patients by authentically living our core values : Purpose Driven, Relationships Matter, Serve Others First, and Inspire Creativity. If you love serving others and would like to make a material difference in an industry-transforming organization, then we invite you to apply to this role. We are recognized as one of the Top 100 Places to Work by The Dallas Morning News, and we have been awarded as one of the fastest-growing privately held companies by SMU Cox.

Accountabilities

• Monitors accounts and performs appeals, coding corrections, payment application, refund management and collection duties in the practice management system.
• Uses Technical and Functional Experience
• Possesses up to date knowledge of the profession and industry
• Accesses and uses resources when appropriate
• Demonstrates Adaptability
• Handles day to day work challenges confidently
• Is willing and able to adjust to multiple demands, shifting priorities, ambiguity, and rapid change
• Shows resilience in the face of constraints, frustrations, or adversity
• Demonstrates flexibility
• Customer Service
• Demonstrates positive interpersonal relations in dealing with fellow employees, supervisors, physicians, patients as well as outside contacts so that productivity and positive employee / patient relations are maximized.
• Uses Sound Judgment
• Makes timely, cost effective, and sound decisions
• Role and Responsibilities :
• Monitors delinquent accounts and performs collection duties.
• Reviews reports, researches, and resolves issues.
• Reviews payment postings for accuracy and to ensure account balances are current.
• Works with co-workers to resolve insurance payment and billing errors.
• Monitors and updates delinquent accounts status.
• Recommends accounts for collection or write-off.
• Contacts patients to secure past due balances, verifies patient demographics and insurance providers, updates information in systems, and documents conversations.
• Answers patient payment, billing, and insurance questions and resolves complaints.
• May refer patients to Patient Benefits Representative to set up payment plans.
• Maintains credit balances of patients and payors ensuring timely refunds within government guidelines / regulations.
• Adheres to confidentiality, state, federal, and HIPPA laws and guidelines with regard to patient records.
• Performs other duties as requested or assigned.
• Creates monthly operations performance reports.
• Reports team performance to Manager and directors on a monthly basis
• Preforms team training.
• Provides quality assurance and creates remediation plans for individual contributors.
• Manages coverage schedule.
• Capable of performing root cause analysis and working independently to resolve billing and coding issues strategically.

Minimum Qualifications and Requirements

Preferred Experience

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