Insurance Specialist - Birmingham Pathology Lab, FL

3030-Pathology - LMG - Insurance Specialist

DEPARTMENT:             Billing                                                                

JOB SUMMARY:          Successfully bills patient accounts to the appropriate insurance company for payment, reconciles insurance payment and denials, follows up with insurance companies as needed, and resolves issues regarding patient accounts.

EDUCATION/EXPERIENCE REQUIREMENTS:

• High school diploma or equivalent required.
• Related computer experience, working knowledge of Microsoft Office, Word, Excel
• Minimum two years’ experience in a medical/billing office setting with a strong knowledge of insurance, managed care, Medicare and Medicaid.

JOB RELATIONSHIPS:

• Reports directly to the Director of Billing.

PHYSICAL REQUIREMENTS:

• Prolonged sitting
• Repetitive hand, wrist and shoulder motion
• Lifting up to 25 lbs. occasion-ally
• Extensive reading ,writing, talking

EXAMPLE OF WORK  PERFORMED

The omission of specific statements or descriptions does not preclude management from assigning duties not listed herein if such duties are a logical assignment to the position.

ADMINISTRATIVE:

• Responsible for keying patient information into internal information system.
• Analyzes, works, and appeals denials from EOB’s and correspondence daily. Flags accounts appropriately.
• Fields patient phone calls.
• Process refunds to patients & insurance companies
• Post patient, insurance payments, adjustments & denials  
• Answers patient questions on plan issues if the Patient Account Specialists are not able to resolve issues.

• Monitors and reports immediately to management on any claim submission problems.

• Participates in special projects and/or assignments as requested by Manager /Director.
• Resolve insurance claim denials

PROFESSIONAL:

• Excellent organizational skills and ability to do detailed multi-tasks.
• Ability to deal effectively and professionally with patients as well as outside vendors.
• Working knowledge of office equipment.