Healthcare Insurance Specialist
Boston, MA 02115
A top healthcare organization located on the green line in Boston is seeking a Healthcare Insurance Specialist to join their team on a contract-to-hire basis. In this role, you will be collecting, verifying, and recording all demographic information required for financial pre-processing of patients. The Health Insurance Specialist will verify eligibility of patients, ensure correct information, and prepare insurance claims.
Don’ t miss this opportunity to work at a reputable healthcare organization and put your customer service skills to good use. Apply today!
Pay Range: $18-$21/hour
Responsibilities for the Healthcare Insurance Specialist:
- Verifying insurance eligibility utilizing available technologies, payer websites, or by phone contact with third party payers
- Ensuring that correct insurance company name, address, plan, and filing order are recorded in the patient accounting system
- Utilizing payer exception reports to update coverage / PCP information
- Contacting clinical departments and PCP offices to secure referrals and enter into patient accounting system
- Preparing and submitting accurate insurance claims to payer within proper timeframes
- Accepting, rejecting, and reconciling claim runs daily. Ensuring prompt resolution of outstanding insurance claims
- Reviewing claims for accuracy and correct errors as needed
- Collaborating with referral/authorization staff to resolve issues
- Updating demographic and coverage information as needed.
- Resolving claims processing issues with 3rd party payers and provides all requested information timely; engaging patients and family members to resolve claim or insurance issues when needed
- Providing documentation to have claims processed and paid. Researching, preparing, and providing 3rd party payer appeals. Request account adjustments in accordance with payer contractual agreements
- Preparing reports as required. Monitors and identifies trends, denials / claim errors by payer and refer as appropriate.
- Maintaining a thorough understanding of third party payer contracts
Requirements for the Healthcare Insurance Specialist:
- High school or equivalent education
- Previous experience in a medical billing setting, preferably on an automated system
- Critical thinking ability
- Strong interpersonal skills with a customer service focus
- Excellent attention to detail and organizational skills
- Ability to meet priorities within set timeframes
- Ability to work independently and as part of a team
- Must be eligible to work in the U.S. without sponsorship