Overview:
Insurance Specialist
Key Responsibilities:
* Insurance Follow-Up: Monitor and follow up on outstanding insurance claims to ensure timely resolution and payment.
* Technical Appeals: Prepare and submit detailed technical appeals for denied claims, ensuring compliance with payer-specific guidelines.
* Denial Management: Analyze and resolve claim denials by identifying root causes and implementing corrective actions.
* Payer Communication: Maintain effective communication with insurance payers to resolve issues, clarify claim requirements, and expedite claim processing.
Responsibilities:
It is the responsibility of every Novant Health team member to deliver the most remarkable patient experience in every dimension, every time.
* Our team members are part of an environment that fosters team work, team member engagement and community involvement.
* The successful team member has a commitment to leveraging diversity and inclusion in support of quality care.
* All Novant Health team members are responsible for fostering a safe patient environment driven by the principles of "First Do No Harm".
Qualifications:
* Education: High School Diploma or GED, required. 2 Year / Associate Degree, preferred.
* Experience: Minimum two years in medical billing or hospital coding, as a claims processor, medical claims for an insurance carrier, or Clerical/Billing experience in a medical office, preferred.
* Additional Skills (required):
* Excellent communication and organizational skills required. Ability to successfully complete generic and department specific skills validation and competency testing.
* Must display excellent customer service skills and excellent computer skills.
* Must be able to multi-task and be a team player.
* Must be able to work overtime as required.
* Must be self motivated, able to work independently without constant supervision and a critical thinker.
* Must be flexible, able to meet deadlines and adaptable to change.
* Ability to communicate effectively and professionally.
* Detail oriented and strong organizational skills.
* Aware of HIPAA laws.
* Familiar with Microsoft Office Applications.
* Must be able to manage time with tasks assigned.
* Additional Skills (preferred):
* Basic medical terminology.
* Insurance guidelines.
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