Insurance Specialist (Revenue Cycle) Remote opportunity for KY and So IN candidates only

Seven Counties Services•Louisville, KY

36d•Remote

About The Position

Only candidates who reside in the Louisville Metro area will be considered for this position. ESSENTIAL JOB FUNCTIONS Completes information on insurance forms. Completes 1500 HCFA insurance for specifications required by insurance companies to allow for timely payment. Maintains a workable knowledge regarding specifications in billing Medicare, Medicaid, Tricare and Commercial: monitoring those accounts to meet specifications. Monitors 1500 for demographic, CPT and charge accuracy. Monitors current fee schedule and recommends as necessary, in compliance with state and federal law. Assist insurance companies inquiring about accounts relative to insurance benefits deposition. Demonstrates knowledge of the personal computer and applicable keystrokes in the electronic transmission of claims, including the correction of claims with minimal interruption. Maintains a workable knowledge of the physician billing system. Follows up on unpaid claims for both insurance and patients via phone, fax or mail, knowing when to become assertive. Identifies overpayments on patient accounts and initiates refund and adjustment process in accordance with internal controls. Answer phone and assists customers promptly and courteously who age through geriatric or who are emancipated minors. Also assists physician offices promptly and courteously. IP Maintains a working knowledge of PCN, retrieving information as needed for daily work disposition. Maintains strict patient confidentiality. Performs special assignments as required. Able to demonstrate proper usage of office equipment. Researches line item EOB’s for incorrect payment levels and works directly with insurance companies for assurance of benefits and correct reimbursement through oral and written communication. Monitors and maintains control for balancing purposes. Monitors appropriate codes using the ICD-9 and the CPT formats. Prints, reviews and mails all insurance claims as needed on a regular basis. Responds to and/or directs all correspondence. Maintains direct line of communication with the providers and staff. Communicates with the AR Manager regarding problem areas. Maintains knowledge of Corporate Compliance issues pertaining to daily work. Performs other duties as assigned. Seven Counties is the provider of choice for mental and behavior health services in and around the Louisville Metro. Over 1,400 employees work in 25+ locations throughout Bullitt, Henry, Jefferson, Oldham, Shelby, Spencer and Trimble counties; making sure that the 31,000 people we serve annually have the best chance of living their best lives. At Seven Counties, we give our staff the opportunity to do what they do best with continued training, effective mentoring and competitive salaries and benefits. In an effort to protect our employees, clients and community, we require the COVID and Influenza vaccinations for all employees.

Requirements

High school graduate or equivalent required.
Productive typing ability equivalent to 30 w.p.m. required.
Considerable skill in interpersonal communications and the ability to work well with others as a team required.
Ability to keep accurate financial records and perform mathematical tasks required.
Knowledge of medical terminology, ICD-10 and CPT coding required.
Computer knowledge required.
Knowledge of Windows preferred
Minimum of two years of experience in a medical billing environment working with insurance and patient claims processing required.

Nice To Haves

Knowledge of E/M procedural coding preferred.

Responsibilities

Completes information on insurance forms.
Completes 1500 HCFA insurance for specifications required by insurance companies to allow for timely payment.
Maintains a workable knowledge regarding specifications in billing Medicare, Medicaid, Tricare and Commercial: monitoring those accounts to meet specifications.
Monitors 1500 for demographic, CPT and charge accuracy.
Monitors current fee schedule and recommends as necessary, in compliance with state and federal law.
Assist insurance companies inquiring about accounts relative to insurance benefits deposition.
Demonstrates knowledge of the personal computer and applicable keystrokes in the electronic transmission of claims, including the correction of claims with minimal interruption.
Maintains a workable knowledge of the physician billing system.
Follows up on unpaid claims for both insurance and patients via phone, fax or mail, knowing when to become assertive.
Identifies overpayments on patient accounts and initiates refund and adjustment process in accordance with internal controls.
Answer phone and assists customers promptly and courteously who age through geriatric or who are emancipated minors. Also assists physician offices promptly and courteously.
Maintains a working knowledge of PCN, retrieving information as needed for daily work disposition.
Maintains strict patient confidentiality.
Performs special assignments as required.
Able to demonstrate proper usage of office equipment.
Researches line item EOB’s for incorrect payment levels and works directly with insurance companies for assurance of benefits and correct reimbursement through oral and written communication.
Monitors and maintains control for balancing purposes.
Monitors appropriate codes using the ICD-9 and the CPT formats.
Prints, reviews and mails all insurance claims as needed on a regular basis.
Responds to and/or directs all correspondence.
Maintains direct line of communication with the providers and staff.
Communicates with the AR Manager regarding problem areas.
Maintains knowledge of Corporate Compliance issues pertaining to daily work.
Performs other duties as assigned.