Medical Insurance Collection Specialist

Job Description

Job Description

SUMMARY :

Follow up on claims submitted to insurance companies by phone, status inquiry letters or via the web. Process explanations of payments received from insurance companies and patients. Work task sent by the payment posters on incorrect or denied payments by the insurance companies. Submit appeals to insurance companies for claims either denied in error or not processed correctly. Work rejected claims on the electronic claims tracking system. Receive incoming calls to assist patients in understanding their account statements and the status of their charges. Update patient demographics and / or insurance plans via Intergy. Work guarantor balances by taking payments over the phone and issuing credit card payment plan. May perform other job-related duties as necessary for the efficient operation of SDMI.

MINIMUM SKILLS, ABILITY AND REQUIREMENTS :

• High school graduate or equivalent.
• 3-5 five years medical insurance collection experience.
• Intergy experience preferred but not necessary.
• Skill in organizing time to accommodate changes in workload and assignments in order to complete tasks in a timely manner.
• Skill to pay attention to details and accuracy in completing tasks.
• Awareness of responsibility to protect patient information.
• Responds positively to changes in assignments and priorities.
• Any employee who discovers, is directly involved in or is responding to an event / occurrence / risk is required to complete or direct the completion of an occurrence report within 24 hours of event / occurrence / risk.
• Staff members may be monitored at any time during business calls without notification. SDMI management may listen in on conversations for training, monitoring and other legitimate business purposes.
• My job performance, including current competencies will be reviewed by my supervisor on a periodic basis. If my job performance / current competencies are not (or continue to not be) at required level this could result in additional training and / or disciplinary action.
• Works as an effective team member with co-workers and other personnel.
• Able to identify hazardous material in immediate work area.
• Must know fire and evacuation plan and electrical safety.
• Understands the Nevada Right to Know Law and complies with Universal Protection standards.
• Willingly participates in cross-training activities within the department in for own professional growth in order to contribute to the overall function of SDMI.
• Assumes responsibility for updating knowledge of current SDMI department policies and procedures, protocol and practices.
• Demonstrates punctuality by reporting to work on time / satisfactory attendance record that complies with SDMI attendance policy.
• Takes full responsibility for all functions within job description and assures that all functions are completed before leaving SDMI at the end of the shift. Communicates effectively when follow up is needed.
• Other duties as assigned.