Insurance

• Initiates insurance follow-up on unresolved appealed or unpaid claims to ensure maximum and timely reimbursement for Medicare, Medicaid, Commercial, or Specialty insurance/program payors, with a focus on complex insurance denials.
• Verify patient benefits and insurance eligibility, perform claims status verification, navigate through insurance websites for specific payor guidelines, and effectively communicate findings to insurance companies, management teams, and clinical departments.
• Assist the customer service team in resolving high-complexity and/or escalated patient billing concerns or disputes.
• Review and respond to insurance correspondence letters related to recoupments, refunds, eligibility, or additional requests from payors.
• Analyze daily claim rejections, screen claims for pre-authorization, and request and submit medical records.
• Work closely with the team to manage high-complexity work queues and claims. Lead special projects to fruition and help define and streamline workflows.
• Meet or exceed current production standards set by the management team to resolve outstanding claims and maintain healthy accounts receivable.
• Handle requests from the Coding, Payment Posting, Managed Care Operations, Provider Enrollment, and Clinical Operations Team to resolve claims and patient or provider issues.
• Serve as the liaison between affiliated hospitals and organizations to maximize collection efforts.
• Completes all other duties as assigned.

Senior Insurance Follow Up Specialist

Insurance Consultant (m/f/d)

Insurance/Billing Collection Assistant III – Department of Medicine

Insurance Billing/Collection Assistant III – Surgery

AVP Insurance Pricing

Unemployment Insurance Claims Analyst