Insurance Service Agent
Outdoorsy
Insurance Specialist
CorroHealth
full-time
Posted on:
Location: Hawaii • 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
About the role
- Resolve complex, higher-dollar unpaid/denied claims using proprietary software, phone calls, letters, client systems and insurance carrier web portals to obtain resolution
- Identify and report trends during account resolution (CPT/HCPCS errors/deletions, duplicate claims, revenue code mapping mismatches, missing charges, no claim on file)
- Perform financial account assessments including adjustments and NRP to patient
- Complete rebill functions within client systems
- Perform administrative tasks including medical record submissions, billing claims, patient assistance outreach, obtaining documents and insurance plan code updates
- Review corrected claim requests and approve for client assistance or correct the bill within client platform
- Review and submit payment verification assistance requests
- Maintain familiarity with client preferences and known issues across multiple client accounts
- Support special projects for clients as needed
- Other duties as assigned
Requirements
- Must reside in Hawaii to be considered
- High School Diploma or equivalent
- 3+ years relevant industry experience in registration, billing, collections
- 3+ years experience with insurance carrier claims resolution
- 3+ years Epic, Cerner, Meditech or other EMR experience preferred
- Knowledge of UB04 claim forms, EOB’s and medical records
- Experience with Hawaii payors
- ICD-9, ICD-10, CPT and HCPCS coding knowledge
- Ability to conduct detailed research to resolve complex claims
- Intermediate mathematics skills (addition, subtraction, ability to identify trends, etc.)
- Advanced knowledge of Excel and Power Point
- Ability to compile and summarize data
- Strong verbal and written communication skills
- Ability to analyze and interpret complex documents, contracts, notes, and other correspondence
- Ability to prioritize and multitask in a fast-paced environment
- Ability to work effectively in a remote environment
- Investigative mind set to identify issues and implement solutions
- Ability to perform work at a computer terminal for 6-8 hours a day; occasional lifting up to 20 lbs.
