Uniontown Hospital - Uniontown, PA
posted about 1 month ago
Full-time - Entry Level
Uniontown, PA
1,001-5,000 employees
Hospitals
About the position
The Insurance Claims Specialist is responsible for managing the process of patient account review, correction, adjustment, and filing claims to third-party payers and/or patients. This role involves direct interaction with patients and third-party payers to ensure accurate information distribution and timely resolution of claims.
Responsibilities
- Performs claims processing to third party payer according to payer guidelines.
- Reviews and corrects billing edits prior to submitting claims.
- Reviews edits to ensure proper billing and verifies edits with the appropriate Department leaders, if needed.
- Works denials thoroughly and timely with little back-log.
- Performs follow up on account, working with third party payers, patient, employer, and physician office to resolve unpaid or underpaid accounts.
- Communicates problems hindering workflow to management in a timely manner.
- Posts copays collected at Medical Offices to vouchers and maintains unassigned payments.
- Processes collections accounts.
- Processes patient and insurance refund documentation.
Requirements
- High school diploma or equivalent.
- West Virginia state criminal background check required, and Federal, if applicable, for DHHR BMS regulated area.
- Previous hospital billing and/or credit and collection experience.
