Optim - Savannah, GA
posted 2 months ago
Full-time - Mid Level
Remote - Savannah, GA
Miscellaneous Manufacturing
About the position
The Claims Pro Fee Insurance Specialist is responsible for managing accounts receivable (AR) follow-ups and resolving denials within the healthcare insurance billing process. This role involves extensive communication with insurance carriers, patients, and other facilities to ensure maximum payment on accounts, as well as handling electronic data interchange (EDI) transactions and reconciling submissions.
Responsibilities
- Handles AR follow-ups on outstanding accounts receivable for payers and resolves denials.
- Manages all correspondence related to insurance or patient accounts.
- Contacts insurance carriers, patients, and other facilities to maximize payment on accounts.
- Identifies issues or changes to achieve profitability.
- Works with EDI transactions and ERA files, including reconciling carrier submissions, edits, and rejection reports.
- Researches and resolves accounts appearing on Delinquent Insurance Report and Government Payor report.
- Makes decisions on accounts to maximize reimbursement.
Requirements
- Comprehensive knowledge of the AR process with strong experience in AR follow-ups, specifically in healthcare.
- Healthcare insurance billing experience.
- Organized, detail-oriented, able to multi-task, and work well with others.
- Computer literate with 2 or more years of applicable work experience.
- High School diploma or GED.
Benefits
- Paid holidays
- 401(k)
- Competitive Pay
- Vacation, Personal Time Off, and Sick Leave
- Holiday Pay
