Optim - Savannah, GA
posted about 1 month ago
Full-time - Mid Level
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 handling correspondence related to insurance and patient accounts, contacting insurance carriers and patients to ensure maximum payment, and identifying issues to enhance profitability. The specialist will also work with EDI transactions and ERA files, reconciling submissions and resolving delinquent accounts.
Responsibilities
- Handles AR follow-ups on outstanding AR for payers and resolution of denials.
- Handles all correspondence related to an insurance or patient account.
- Contacts insurance carriers, patients, and other facilities as needed to maximize payment on accounts.
- Identifies issues or changes to achieve profitability.
- Works 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 appropriate decisions on accounts to maximize reimbursement.
Requirements
- Comprehensive knowledge of the AR process with strong experience doing 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' applicable work experience.
- High School diploma or GED.
Benefits
- Competitive Pay
- Vacation, Personal Time Off, and Sick Leave
- Holiday Pay
- 401K Plan
