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Insurance Services Specialist


This is a Full-time position in Houston, TX posted June 11, 2021.

Job Summary We are looking for an Insurance Specialist for our Patient Service Department. The successful candidate will accept ownership for effectively handling each form of insurance follow-up. Core responsibilities of an insurance representative include research, insurance billing, and adjustment identification to ensure proper account resolution. Responsibilities Manage a high volume of inbound and outbound calls promptly Identify Contractual and Administrative Adjustments Research insurance billing and adjustment identification Make calls addressing insurance claims and insurance follow-up Review and Interpret Contractual Terms for Managed Care, Commercial, Medicare, Medicaid, and Workers Compensation Keep records of all conversations in our call center database in a comprehensible way Frequently attend educational seminars to improve knowledge and performance level Obtain Supporting Documentation Regarding Insurance Follow-up Efforts Meet personal/team qualitative and quantitative metrics Skills Previous experience in a patient insurance specialist role (medical field required) Track record of over-achieving quota (over 60 calls) Full understanding of insurance follow-up processes (i.e. Billing, Collections, Managed Care, Medicare, Medicaid, and Commercial Practices) Medical terminology Full understanding of HIPAA and PCI protocols Complete knowledge of contracts, credit reviews, appeals, and inventory Basic knowledge of health care industry terms (e.g. primary care, provider, benefits, EOBs, CPT & ICD-10 codes, HCFAs, UB04s, HCPCS, DRGs, and authorizations/referrals) Excellent verbal and written communication skills Advanced interpersonal skills Ability to multi-task, set priorities and manage time effectively Qualifications High school diploma, or equivalent required Preferred minimum 2 years of experience with medical insurance verification and claim follow-up Acclara Solutions is an Equal Opportunity Employer

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