Healthcare Insurance Specialist

Boston, MA 02115

Posted: 10/09/2018 Employment Type: Contract to Perm Specialty: Accounting & Finance Job Number: 82219

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

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