Insurance billing specialist

JOB DESCRIPTION

Job Description

Insurance billing specialists, also called coding specialists, expedite the medical billing process. They use specialized knowledge of both medicine and insurance policies to communicate with insurance companies on behalf of medical personnel and patients. Insurance companies and programs, such as Medicare and Medicaid, determine reimbursements owed to patients based on the diagnosis and health condition codes assigned by these specialists.

Dental Insurance Billing Specialist Summary

  • Collect and entering claim information.
  • Post insurance and patients and manage accounts.
  • Submit claims and following up with insurance carriers on unpaid or rejected claims.
  • Answer patient inquires on account status and charges.
  • Typically reports to billing supervisor or provider office manager.

Knowledge, Skills, & Abilities

  • Enters information necessary for insurance claims such as patient, insurance ID, diagnosis and treatment codes and modifiers, and provider information. Insures claim information is complete and accurate.
  • Submits insurance claims to clearinghouse or individual insurance companies electronically or via paper CMS-1500 form.
  • Answer patient questions on patient responsible portions, copays, deductibles, write-off’s, etc. Resolves patient complaints or explains why certain services are not covered.
  • Follows up with insurance company on unpaid or rejected claims. Resolves issue and re-submits claims.
  • Prepares appeal letters to insurance carrier when not in agreement with claim denial. Collect necessary information to accompany appeal.
  • Prepares patient statements for charges not covered by insurance. Insures statements are mailed on a regular basis.
  • May work with patients to establish payment plan for past due accounts in accordance with provider policies.
  • Provides necessary information to collection agencies for delinquent or past due accounts.
  • Posts insurance and patient payments using medical claim billing software.
  • May perform “soft” collections for patient past due accounts. This may include contacting and notifying patients via phone or mail.
  • For patients with coverage by more than one insurer, prepares and submits secondary claims upon processing by primary insurer.
  • Follows HIPAA guidelines in handling patient information.
  • May periodically create insurance or patient aging reports using the medical practice billing software.These reports are used to identify unpaid insurance claims or patient accounts.
  • Understands managed care authorizations and limits to coverage such as the number of visits. This is encountered often when billing for specialties.
  • May have to verify patient benefits eligibility and coverage.
  • Ability to look up ICD 9 diagnosis and CPT treatment codes from online service or using traditional coding references.

Interested please contact Snelling Staffing: 402-330-0100

LOCATION

omaha, Nebraska 68144

PAY

$18

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4055 Valley View Lane, Suite #700
Dallas, TX, 75244

(800) 411-6401

(972) 239-7575