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Insurance Specialist
This position is: Full Time
Position Location: Lake Charles, LA

JOB TITLE: Insurance Specialist

GENERAL SUMMARY OF DUTIES: Responsible for answering incoming telephone calls while explaining billing to patients and insurance companies. Performs various routine clerical tasks to ensure prompt posting of insurance EOB's, to ensure prompt turnaround of disability forms to patient, and to send out insurance claim forms.

SUPERVISION REQUIRED: Business Office Manager

SUPERVISION EXERCISED: None

ESSENTIAL FUNCTIONS:

  • Accept phone inquiries and occasional face-to-face inquiries regarding status of accounts, explaining charges, credits, balances, etc.
  • Re-file patients claims as needed, working with the insurance company and/or patient as needed.
  • Ensure that patient accounts are set up with proper insurance information and charges are billed to correct insurance bill types, sometimes pulling charts or calling patients to get correct insurance information.
  • File paper insurance claims for primary and secondary claims as necessary.

KNOWLEDGE, SKILLS & ABILITIES:

  • Typing, filing and computer knowledge is needed.
  • Previous knowledge of insurance is helpful.
  • Previous medical terminology helpful.
  • Adequate and appropriate levels of oral and written communication of the English language
  • CPT and ICD-10 coding
  • Insurance rules and guidelines for coding

EDUCATION REQUIREMENTS:

High school diploma or equivalent.

EXPERIENCE:

  • Basic keyboarding and computer
  • CPT and ICD-9 coding
  • Insurance rules and guidelines for coding
  • Insurance claims filing and denial work
  • Previous experience handling complaints
  • Workers Comp ia a plus

ENVIRONMENTAL/WORKING CONDITIONS: Office setting. Frequent telephone calls and other interruptions, which requires being able to handle a fast-paced work environment during entire time at work. Must be able to prioritize multiple projects. Must maintain strict confidentiality and exercise professionalism when interacting with staff, managers, supervisors, physicians, external customers, etc.

PHYSICAL/MENTAL DEMANDS: requires continuous standing, sitting, frequent walking, bending, and stooping. May require lifting 50 to 100 pounds. Exposure to possible Hazardous Materials/conditions and infectious diseases.

Requirements: Private insurance billing experience is required.

 

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