Overview

Insurance Services Specialist

The Insurance Services Representative position is responsible for all insurance follows up on assigned accounts from the Acclara management team. The core responsibilities of an insurance representative include research, insurance billing, and adjustment identification to ensure proper account resolution. This position requires the ability to work independently, accomplish goals, excellent customer service and communication skills, creativity, patience, and flexibility. Insurance Representatives rely on guidelines established by the organization to perform job functions and work under general supervision in a moderately fast-paced environment. Insurance Services Representatives usually report to the department lead or supervisor.
EDUCATION AND WORK EXPERIENCE:

High school diploma or equivalent. A minimum of two years of previous work experience as an insurance follow-up representative is required. Must have a full understanding of insurance follow-up processes (i.e. Billing, Collections, Managed Care, Medicare, Medicaid and Commercial Practices), and well-developed interpersonal skills.
REQUIRED JOB KNOWLEDGE & SKILLS:
Excellent verbal and written communication skills
Reliable attendance record
Knowledge of EOBs, CPT & ICD-10 codes, HCFAs, UB04s, HCPCS, DRGs and authorizations/referrals
Good problem-solving skills
Ability to learn/stay abreast of relevant policies
Computer literate/able to use basic functions of a computer
Ability to type a minimum of 30 wpm
Detail oriented and well organized
Outstanding listening skills
Ability to perform under pressure in a calm manner
Basic math skills
High degree of accuracy
Positive attitude
Flexible
Team player
CORE RESPONSIBILITIES AND JOB FUNCTIONS:
Core responsibilities include but are not limited to the items listed below:
Obtain Claim Status via the Telephone, Internet and/or Fax
Review and Interpret Contractual Terms for Managed Care, Commercial, Medicare, Medicaid and Workers’ Compensation
Obtain Supporting Documentation Regarding Insurance Follow-up Efforts
Identify Contractual and Administrative Adjustments
Billing via Electronic and Hardcopy Submission
Our Culture
We work hard to make Acclara a wonderful place to work. Our people are our greatest assets, and we encourage employees to grow and develop, assuming greater responsibilities and leadership roles.
Put the Patient First: The philosophy behind our approach is simple: drive revenue by putting the patient first. While our philosophy is simple, the key to our success is in the details.
Hard Work, Diligence to Every Detail, and Passionate Service
Other duties as needed and assigned by the team leader and/or supervisor.

WORK ENVIRONMENT:
Physical demands: While performing the duties of this job, the employee is occasionally required to walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; balance; stoop; talk or hear. Specific vision abilities required by the job include close vision, distance vision, color vision peripheral vision, depth perception, and the ability to adjust focus.
Work environment: The noise level in the work environment is usually moderate.


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