Senior Insurance Specialist

Job Duties

• Verifies insurance coverage of hospital patients.

• Assists patients and family members in resolving billing concerns as indicated.

• Processes third party insurance claims as assigned and follows up according to departmental guidelines to ensure timely payment of account balances.

• Uses several systems to bill claims, scrub claims and work rejections.

• Updates demographic and insurance information to the billing system as appropriate.

• Maintains work queues according to procedure, clearly defining next actions and follow-up dates on all accounts.

• Documents all conversations and actions taken into the proper systems.

• Reviews insurance claims for completeness and accuracy prior to mailing.

• Assists in training of Insurance Specialists.

• Follows Mercy's safety guidelines, carries out job-specific safety duties and responsibilities, and promptly reports any unsafe conditions, situations, incidents and injuries.

Knowledge, Skills and Abilities

• Required ability to operate a computer, copy/fax machines and telephone system.

• Required strong written and verbal communication and math skills.

• Required strong organizational and time management skills.

• Required strong interpersonal skills.

• Required ability to work with minimal to no supervision.

• Preferred working knowledge of medical insurance plans and medical terminology.

• Preferred proficiency with MS Office.

• Preferred knowledge of EPIC software.

Professional Experience

• Required: 2 years previous experience in a medical office, medical business office, or insurance industry.

• Preferred: Proven track record of leadership ability.

Education

• High School Diploma or equivalent strongly preferred. Relevant experience to be considered in lieu of degree.

Licensure, Certification, Registration

• AAHAM (American Association of Healthcare Administrative Management), or CRCR (Certified Revenue Cycle Representative) Certification required.