Remote Insurance Credit Specialist

Job Description

REQUIREMENTS

Education:

• High school graduate or equivalent (GED) required.
• Associate degree or bachelor’s degree in healthcare administration or another related field preferred

Experience:

• Experience with analyzing explanation of benefits (EOBs) from various insurance companies/payers.
• One year of experience in insurance billing/insurance follow up for Medicare, Medicaid, commercial payers required.
• Medical terminology knowledge preferred.
• Knowledge of CPT / ICD-10 coding

RESPONSIBILITIES

• Resolves both patient & insurance credit balance refunds.
• Research and resolve unapplied cash activity accounts.
• Documents any request or concern received via mail, e-mail, telephone, written correspondence, or in person on the patient’s account.
• Responsible for responding to insurance companies & patient requests for refunds in a timely manner (within 30 days of receipt in credit balance work list)
• Identifies the originating cause of the need for a refund and compiles a report of recurring issues to management.
• Responsible for correcting errors in the calculation and posting of insurance contractual adjustments.
• Maintains confidentiality of all protected health information (PHI)
• Performs all job functions in a manner consistent with MGRI expectations as defined in the mission statement and values.
• Adheres to policies and procedures as required by MGRI

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