[Hiring] Insurance Accounts Receivable Specialist @Wilmington Health

Role Description

Ensures prompt collection of the appropriate amount due.

Essential Duties/Responsibilities:

• Follow-up with carrier regarding outstanding claims as noted on the outstanding invoice report.
• File claims that require additional documentation.
• Verify benefits as requested by physician.
• Change insurance information as appropriate.
• Correspond to carrier for such things as appeals and or inquiries.
• Communicate all insurance regulation changes to supervisor.
• Contact patient and or carrier to follow-up on denials and termination of coverage.
• Respond to telephone calls; review and respond to correspondence.
• Process computer refunds due patients and insurance companies.
• Establish payment plans.

Other Duties:

• As assigned by manager.

Qualifications

• High school diploma or general education degree (GED).
• 3-5 years' experience in a medical office environment or equivalent combination of education and experience.
• 2-3 years of experience in medical billing, specifically with claims denials, appeals, corrected claims. May have a remote option at a certain point.

Preferred:

• Experience in Medical Office Administration.
• Knowledge of the OSHA and DOT regulations.

Requirements

ADA Physical Demands:

• Standing: Occasionally
• Sitting: Continuously
• Walking: Occasionally
• Kneeling/Crouching: Rarely
• Lifting: Rarely

Insurance Advisor Competencies:

• General Customer Service
• Professionalism/Integrity/Responsibility
• Teamwork/Process Focus
• Dependability/Punctuality
• Interpersonal Relationships/Communication
• Judgment/Decision Making/Problem Solving
• Quality/Quantity
• Initiative
• Safety/Housekeeping
• Organizational Skills/Time Management

Department Specific:

• Decision-making skills regarding ‘next step’ when working appeals.
• Resourceful in finding appropriate information to assist in resolving the issue at hand.
• Up-to-date with carrier changes as well as specialty-specific changes.
• Effectively communicate changes to departments and co-workers.
• Use all available tools and resources to accomplish job duties in an efficient and timely manner.
• Strong computer skills, i.e., Windows environment, word processing, spreadsheets, etc.
• Effective use of software and web-based carrier sites for submission of claim and requested documentation.
• Reliable source of information in regards to assigned carrier rules and requirements.