Optim - Savannah, GA
posted about 1 month ago
Full-time
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 a healthcare setting. This role involves extensive communication with insurance carriers and patients to ensure maximum payment on accounts, as well as handling electronic data interchange (EDI) transactions and reconciling submissions. The specialist will also identify issues affecting profitability and make decisions to optimize reimbursement.
Responsibilities
- Handle AR follow-ups on outstanding accounts receivable for payers and resolve denials.
- Manage all correspondence related to insurance or patient accounts.
- Contact insurance carriers, patients, and other facilities to maximize payment on accounts.
- Identify issues or changes to achieve profitability.
- Work with EDI transactions and ERA files, including reconciling carrier submissions, edits, and rejection reports.
- Research and resolve accounts appearing on Delinquent Insurance Report and Government Payor report.
- Make appropriate 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.
- 2 or more years of applicable work experience.
- High School diploma or GED.
Benefits
- Competitive Pay
- Company Benefits
- Vacation, Personal Time Off, and Sick Leave
- Holiday Pay
- 401K Plan
