Billing and Insurance Specialist | 40 Hours per Week | Klein Center

Minimum Hiring Wage:

Job Details:

A Brief Overview

Coordinates and assists in the reimbursement for services provided in the long-term care setting. Accurately files insurance claims for the purpose of settling claims with insurance carriers. Resolves discrepancies in accounting records resolves credits verifies accuracy of all billing data and corrects identified errors. Handles electronic billing functions which includes electronically filing claims and maintaining the electronic filing system. Prepares itemized statements bills or invoices; and records amounts due for services rendered. Keeps records of supporting documents. Contacts resident or payee to obtain or relay account information. Collect information from policyholders to verify accuracy of information on claim forms company records and related documents. Follows-up on outstanding accounts making proper notations in the billing software. Work denials follow appeal processes and refile claims following through to completion. Investigate and resolve any billing discrepancies or insurance-related issues working closely with insurance providers residents/payees and internal teams. Maintain knowledge of current government and/or carrier regulations relevant to industry. Performs data entry adding calculating and operation of computers equipment and billing software. Provides assistance with resident trust accounts and front desk management. Ability to file long term care insurance claims timely each month. A general understanding of Medicaid application process filing IMPA unmet medical claims representative payees and resident trust accounts. Assists with long term care supplies ordering and distribution.

What you will do

• Prepare insurance claim forms and related documents and review them for accuracy and completeness.
• Follow-up on rejected unpaid and denied claims until claims are paid or only self-pay balance remains.
• Investigate and resolve any billing discrepancies or insurance-related issues working closely with insurance providers patients and internal teams.
• Reconcile accounts and maintain accurate balances.
• Perform AR follow up on aging accounts.
• Transmit claims for payment or further investigation.
• Contact insured or other involved persons to obtain missing information or resolve billing issues.
• Review insurance policy to determine coverage.
• Assist with front desk coverage.
• Cross train in supplies ordering and distribution.
• Provide customer service such as assisting with inquiries and billing requests.
• Monitor for missing information authorization/control numbers.

Qualifications

• H.S. Diploma or General Education Degree (GED) Preferred
• 1-3 years Experience working with computers Preferred
• 1-3 years Customer service experience Preferred
• 1-3 years General office or clerical experience. Preferred
• Knowledge of principles and processes for providing customer service. This includes customer needs assessment meeting quality standards for services and evaluation of customer satisfaction.
• Knowledge of administrative and clerical procedures and systems such as word processing managing files and records designing forms and other office procedures and terminology.
• Preferred knowledge in Microsoft Office including Word Excel and Outlook
• Knowledge to use electronic equipment and computer applications specific to the job.
• Possesses excellent time management and organizational skills.
• Possesses problem solving skills
• Ability to communicate effectively and document information accurately.
• The ability to read and understand information and ideas presented in writing.
• Ability to maintain confidentiality and discretion.
• The ability to speak clearly so others can understand you as well as the ability to read write and understand the English language.
• Knowledge of arithmetic.
• Teaching others on processes.
• Dependent Adult Abuse Mandatory Reporter - Iowa Department of Human Services within 30 Days Required

Long-term care knowledge and experience preferred.

Benefits:

We are excited to offer an aggressive compensation and benefits package for qualifying positions which includes:

• Competitive base pay

• Matching retirement programs

• Health Dental and Vision plans

• Health Savings and Flexible Spending Accounts

• Employee discounts including car rental cell-phone plans

• Employer-paid Long-Term Disability Life and AD&D

• Paid time off (PTO)

• Education Assistance Program

• Employee Assistance Program

• Employee Referral Bonus Program

• Discounted cafeteria meals

• Paid Parental Leave

• Employee Service Recognition program

• Voluntary plans including: Life AD&D Short-Term Disability Critical Illness Accident Insurance and Hospital Indemnity

Great River Health and its affiliates are Equal Opportunity employers. All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity and expression age national origin mental or physical disability genetic information veteran status or any other status protected by federal state or local law.