INSURANCE SPECIALIST (13095)

Job Summary

  • Identifies status on unpaid 3rd party claims in a timely manner.
  • Uses most effective tools to obtain status so that effectiveness and productivity are maximized.
  • Communicates payment expectations and removes payers stall tactics in a firm but professional manner.
  • Reports problem accounts and/or consistent slow payers to management and provides examples.
  • Involves the patient and/or insured to obtain information needed by payers to process the claim.
  • Conducts three-way calls between patients and payers to address obstacles in getting claims processed.
  • Obtains, or assists in obtaining, any additional documentation needed by a payer to process a claim.
  • Works with their billing partner to identify trends in billing errors, so the edits can be developed to increase clean claim rate.
  • Accurately and thoroughly documents all pertinent events regarding the account.
  • Demonstrates and encourages team behavior and exceptional patient/guest experiences.
  • Upholds and promotes patient safety and quality.