General Liability Claims Specialist
CNA Insurance
Insurance Follow Up Specialist
Margie and Bill Klesse College of Engineering and Integrated Design at UTSA
full-time
Posted on:
Location Type: Hybrid
Location: San Antonio • Texas • 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
About the role
- 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.
- Submits appeals and reconsiderations on claim denials via practice management system, payor portals, or mail.
- Analyze daily claim rejections from our clearing house, screen claims for pre-authorization, request and submit medical records.
- Work closely with the Coding, Payment Posting, Managed Care Operations, Provider Enrollment, and Clinical Operations to resolve claim issues.
- Review and respond to insurance correspondence letters related to recoupments, refunds, eligibility or additional requests from payors
- Assist customer service team in resolving patient billing concerns or disputes.
- 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 team, and clinical departments.
- Completes all other duties as assigned.
Requirements
- Three (3) years hospital business office or medical billing related experience
- HS Diploma or Equivalent
Benefits
- Some knowledge of patient billing or collection/reimbursement procedures in a healthcare setting preferred. Experience in medical claims follow-up functions specific to processing insurance claim appeals for various payors.
- Detail oriented with the ability to organize, prioritize and coordiante work within schedule constraints and handle emergent requirements in a tiemly manner.
- Ability to multi-task in a fast paced, high-volume environment.
- Proficient in Microsoft Office.
- EPIC experience.
- Experian, Trizetto/Claim Logic.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
medical billingclaims processinginsurance follow upappeals submissionclaim analysispre-authorization screeningmedical records submissionclaims status verificationpatient benefits verification
Soft skills
communicationproblem-solvingcollaborationcustomer service
