INSURANCE SPECIALISTTucson Orthopaedic Institute, P.C • Tucson, AZ
INSURANCE SPECIALIST
Tucson Orthopaedic Institute, P.C • Tucson, AZ
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job_description.job_card.job_descriptionProcesses all insurance claims for assigned area Analyzes and resolves physician claim rejects and denials. Identifies trends / problems in billing process and presents viable solutions. Processes mail receipts for their respective patient types by posting payment to appropriate account, and review EOB for correct adjustment. Submits adjustment and refund requests with appropriate documentation. Reviews aged accounts receivable and outstanding reports for appropriate tracking Compiles monthly reports as requested Assists with physician billing and document training Performs related work, as required High school diploma or equivalent Three to Five years of experience in medical billing environment One year of work experience in a medical setting Knowledge of medical terminology Word processing and computer experience Must have experience creating spreadsheets, reports, and trends data Ability to work well under pressure with diverse groups of professionals and physicians Ability to communicate written and oral ideas and plan effectively Requires good communication and organizational skills Requires reasoning ability and good independent judgment Must be sensitive to cultural and bilingual issues Requires working with frequent interruptions Requires tolerance of standing or sitting posture up to (4 hours) continuously, for a total of up to (10 hours) per (12 hours) Required to operate computer keyboard, mouse, and monitor for a total of up to (8 hours) per (12 hours) Risk of occupational exposure to blood and other potentially infectious materials (OPIM) Possible risk of physical injury due to moving machinery and supplies
FLSA : Non-Exempt
Reports To : Silvia McDaniel
Main Function :
As a member of the care team, the Certified Coder is responsible for working collaboratively with other team members to assure the safe, timely and accurate delivery of patient care. The Insurance Specialist is responsible for the filing of insurance claims, including review of aged accounts receivable and outstanding claims reports utilizing appropriate CPT procedure and ICD-10 diagnosis codes.
Customer Service
- Operates within the concept of patient focused care
- Anticipates patient needs
- Delivers caring, timely service with positive body language
- Presents good telephone skills
- Greets patients at every stage of the visit
- Responds promptly to patient needs requests
- Responds promptly to Physician and team member requests and inquiries
- Participates as an active, positive member of the TOI team
Insurance Specialist Duties
Qualifications
Mental / Physical Requirements
Requires working under stressful conditions and irregular hours
Working Conditions (environmental)
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