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Insurance Claims Account Specialist
Insurance Claims Account SpecialistWestside Children's Therapy • Mokena, IL, US
Insurance Claims Account Specialist

Insurance Claims Account Specialist

Westside Children's Therapy • Mokena, IL, US
13 days ago
Job type
  • Full-time
Job description

Insurance Claims Specialist

Position Summary : The Insurance Claims Specialist is responsible for posting insurance payments from EOBs, following up and correcting errors on EOBs or submitted claims, and working denials. Work Schedule : This position is on-site with a schedule of Monday - Friday 7 : 30 am - 4 : 00 pm Essential Functions :

  • Post insurance payments timely and balance to each EOB to ensure all lines are posted accurately.
  • Manage electronically posted EOBs, research flagged lines and resolve issues that prevented automatic posting utilizing the company's billing system and other internal / external systems to research claim details.
  • Work denied claims included on EOBs, which involves using various external tools (Availity, UHCLink, UMR) and internal resources (billing system, Westside app) to research claim status.
  • Appeal denials as necessary by submitting appropriate documentation to insurance carriers and following up regularly.
  • Review accounts receivable balances for outstanding insurance amounts due and follow up with payers to arrange payments.
  • Ensure patient account records are up-to-date and accurate.
  • Manage insurance company correspondence, which may include medical records requests, denials of coverage, refund requests, etc.
  • Set the tone of quality and effort expected of the team.
  • Adhere to all practice policies related to HIPAA.

Qualifications

Required Education, Experience and Credentials :

  • High school diploma or equivalent
  • One year of billing experience in a medical office or healthcare setting

    • Knowledge, Skills and Abilities :

  • Excellent interpersonal and communication skills
  • Able to work effectively with all levels of the organization and in a diverse work group.
  • Proactive and independent with the ability to take initiative.
  • Excellent time management skills with a proven ability to meet deadlines.
  • Comfortable with technology, with the ability to learn multiple systems and software.
  • Proficient with Google Workspace
  • Must maintain discretion and client confidentiality.

    • Personal Attributes :

  • Interpersonal skills with strong verbal and written communication skills
  • Process oriented with strong attention to detail and accuracy
  • Accountability
  • Integrity
  • Problem Solving
  • Initiative

    • Work Environment & Physical Demands :

  • Prolonged periods of sitting at a desk and working on a computer.
  • Must be able to lift up to 15 pounds at times.

    • Travel Requirements :

  • Not applicable

    • This is a full-time position. Full-time employees are eligible for a comprehensive range of benefits, including Medical, Dental, Vision, and Life Insurance; a 401(k) retirement plan with company match; Paid Time Off; Sick Time; and a robust Employee Assistance Program.

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    Claim Specialist • Mokena, IL, US