Medical Insurance Appeals Specialist
Houston, TX 77077
Temp to Hire
The Insurance Appeals Specialist is responsible for the collections of insurance claims. Essential to this position is the ability to manage all insurance follow up for maximum insurance reimbursement. To include outbound and inbound insurance carrier calls, reprocessing claims, drafting appeals, working denials and resolving unpaid claims.
Understanding and staying informed of the changes with procedures, billing guidelines, and laws for specific insurance carries or payers.
Initiating collection follow-up on all unpaid or denied claims with appropriate insurance carrier.
Research, appeal, and resolve unpaid insurance claims.
Actively follow up and collect on all electronic claims, including resolution of any billing errors assigned following established procedures.
Respond to correspondence from insurance carries.
Perform other duties as assigned by department manager.
Minimum Education: High School Diploma/G.E.D.
Minimum 3+ Years of experience with insurance follow up and insurance collections.
Knowledge of both In Network and Out of Network Facility and Physician Claims.
Strong communications skills in both oral and written.
Positive attitude, Team player, Go-getter .
Experience in reading, analyzing and interpreting EOB s is a must.
Prior experience working with commercial payers such as UHC, Cigna, Aetna, BCBS, Marketplace plans and WC/third party a plus.
Proven experience administering an appeals in a high-volume claims environment.
Ability to have a productive phone conversations with the insurances companies representative.
Demonstrates excellent problem solving skills and negotiating skills.
Medicare and Medicaid experience preferred.
Knowledge of CMR, EPower and Centricity desired.
Familiarity with computer and Windows PC applications such as Excel and Word, which includes the ability to learn new computer systems applications.
30WPM with 97% accuracy a must.
PLEASE SEND RESUME TO SHENA.BILNOSKI@LKJORDAN.COM
**WILL PERFORM BACKGROUND AND DRUG SCREEN ON SITE**
L.K. JORDAN AND ASSOCIATES IS AN EQUAL OPPORTUNITY EMPLOYE