Insurance Specialist

• Manage Denial procedures
• Process guidelines management

Key Performance Areas:

• Applying patient and insurance payments and corresponding contractual adjustment/write[1]offs/Offset for all bill types to accounts.
• Electronic scanning of Explanation of Benefits
• Preparing and processing credits and patient and insurance refunds and posting.
• Resolving misdirected payments and returning incorrect payments to sender.
• Copies any zero payments (denial) to the appropriate Patient Account representative for follow-up and post.
• Appealing both denied or underpayments.
• Correct and most debit/credit adjustments of misapplied payments to ensure accurate and timely reporting of accounts.
• Claim scrubbing and Claim submission
• Posting of Electronic Remittance Advice (ERA)
• Knowledge of Durable Medical Equipment is recommended

Skills required:

• Analytical skills
• Typing speed- at least 40 wpm
• MS office skills- MS excel proficiency is preferred
• Eye for details- error-free work
• Fair skills of English language knowledge and understanding
• Domain knowledge on medical billing is preferred but not mandatory

Educational Qualification & Work Experience

• Graduation in any stream
• Additional certification in typing, a medical prescription will be preferred

Individual abilities:

• Willing to work in night shift
• Self- driven/ self-starter
• Problem-solving ability- proactive approach to finding solutions
• Good interpersonal ability
• Career-oriented