[Hiring] Insurance Credit Specialist @Lifepoint Health

Role Description

The Insurance Credit Specialist must have the ability to review and analyze accounts and/or credit balance reports from insurance carriers and patients, including:

• Reviewing explanation of benefits
• Contacting insurance carriers for additional information
• Communicating with insurance carriers to gather information

This position requires fundamental knowledge of:

• How insurance companies pay according to contracts
• How to read and interpret an insurance explanation of benefits (EOB)
• Performing precise follow-up with the insurance company via phone, email, insurance websites, etc. at an acceptable volume per day

A Specialist, Insurance Credit who excels in this role:

• Resolves both patient & insurance credit balance refunds
• Researches and resolves unapplied cash activity accounts
• Documents any request or concern received via mail, e-mail, telephone, written correspondence, or in person on the patient’s account
• Responsible for responding to insurance companies & patient requests for refunds in a timely manner (within 30 days of receipt in credit balance work list)
• Identifies the originating cause of the need for a refund and compiles a report of recurring issues to management
• Responsible for correcting errors in the calculation and posting of insurance contractual adjustments
• Maintains confidentiality of all protected health information (PHI)
• Performs all job functions in a manner consistent with MGRI expectations as defined in the mission statement and values
• Adheres to policies and procedures as required by MGRI

Qualifications

• High school graduate or equivalent (GED) required
• Associate degree or bachelor’s degree in healthcare administration or another related field preferred
• Experience with analyzing explanation of benefits (EOBs) from various insurance companies/payers
• One year of experience in insurance billing/insurance follow-up for Medicare, Medicaid, commercial payers required
• Medical terminology knowledge preferred
• Knowledge of CPT / ICD-10 coding

Requirements

• Must be authorized to work in the United States without employer sponsorship

Benefits

• Comprehensive Benefits: Multiple levels of medical, dental and vision coverage for full-time and part-time employees
• Financial Protection & PTO: Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off
• Financial & Career Growth: Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match
• Employee Well-being: Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs)
• Professional Development: Ongoing learning and career advancement opportunities

Company Description

Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes:

• 63 community hospital campuses
• 32 rehabilitation and behavioral health hospitals
• More than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities

We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.

We employ and provide care to people from all walks of life. We are committed to promoting healing, providing hope, preserving dignity and producing value with an inclusive workforce in which diversity is leveraged, respected, and reflective of the patients, family members, customers and team members we serve.