[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 insurance companies via phone, email, insurance websites, etc.

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
• Responds 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
• Corrects 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