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Insurance Claims Account Specialist

Job Details

Headquarters - Mokena, IL
Full Time
High School
$44000.00 - $50000.00 Salary/year
Full Time: 80 hours per pay period
Billing & Insurance

Description

Position Summary:

The Insurance Claims Specialist is responsible for posting insurance payments from EOBs, following up and correcting errors on EOBs or submitted claims, and working denials. 

Work Schedule: This position is on-site with a schedule of Monday - Friday 7:30 am - 4:00 pm

Essential Functions:

  • Post insurance payments timely and balance to each EOB to ensure all lines are posted accurately.
  • Manage electronically posted EOBs, research flagged lines and resolve issues that prevented automatic posting utilizing the company’s billing system and other internal/external systems to research claim details.
  • Work denied claims included on EOBs, which involves using various external tools (Availity, UHCLink, UMR) and internal resources (billing system, Westside app) to research claim status. 
  • Appeal denials as necessary by submitting appropriate documentation to insurance carriers and following up regularly.
  • Review accounts receivable balances for outstanding insurance amounts due and follow up with payers to arrange payments.
  • Ensure patient account records are up-to-date and accurate.
  • Manage insurance company correspondence, which may include medical records requests, denials of coverage, refund requests, etc.
  • Set the tone of quality and effort expected of the team.
  • Adhere to all practice policies related to HIPAA.

Qualifications

Required Education, Experience and Credentials:

  • High school diploma or equivalent
  • One year of billing experience in a medical office or healthcare setting 

Knowledge, Skills and Abilities:

  • Excellent interpersonal and communication skills
  • Able to work effectively with all levels of the organization and in a diverse work group.
  • Proactive and independent with the ability to take initiative.
  • Excellent time management skills with a proven ability to meet deadlines.
  • Comfortable with technology, with the ability to learn multiple systems and software.
  • Proficient with Google Workspace
  • Must maintain discretion and client confidentiality.

Personal Attributes:

  • Interpersonal skills with strong verbal and written communication skills
  • Process oriented with strong attention to detail and accuracy
  • Accountability  
  • Integrity 
  • Problem Solving
  • Initiative 

Work Environment & Physical Demands 

  • Prolonged periods of sitting at a desk and working on a computer. 
  • Must be able to lift up to 15 pounds at times.

 

Travel Requirements

  • Not applicable


This is a full-time position. Full-time employees are eligible for a comprehensive range of benefits, including Medical, Dental, Vision, and Life Insurance; a 401(k) retirement plan with company match; Paid Time Off; Sick Time; and a robust Employee Assistance Program.  

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