Insurance Specialist

Job Details Location: Salisbury, NC 28144 Position Type: Full Time Education Level: 2 Year Degree Travel Percentage: Negligible Job Shift: Day Job Summary Insurance Specialist is responsible for managing and collecting outstanding insurance balances owed to a healthcare provider by following up on submitted insurance claims, resolving billing discrepancies, appealing denied claims, and ensuring timely reimbursement by adhering to medical billing regulations and coding guidelines; essentially, they play a key role in the revenue cycle management of a healthcare facility by maximizing the collection of outstanding accounts receivable. Serve as a backup for Payment posting duties. ESSENTIAL FUNCTIONS Denial management:Analyzing claim denials, identifying the reason for rejection, and taking appropriate actions such as correcting coding errors, submitting appeals, or contacting the payers for clarification. Reporting and analysis:Generating reports on accounts receivable trends, identifying areas for improvement, and proposing strategies to optimize collection rates. Compliance adherence:Staying current with healthcare regulations, including HIPAA and coding guidelines (ICD-10, CPT) to ensure accurate billing practices. Payer communication:Contacting insurance companies to resolve billing issues, clarify claim status, and advocate for timely payment. Payment Posting – serve as a back‑up as needed. Minimum Job Qualifications Education:2Year / Associates Degree, preferred. License/Certifications:Billing certificate preferred. Language Skills: Ability to read and comprehend insurance, outside provider, and other short correspondence, memos, and forms; Ability to respond to outside correspondence requests in a clear, concise, and accurate manner; Ability to effectively present information in one‑on‑one and small group situations to providers, clients, and other employees of the organization. Other Skills Medical billing knowledge: Thorough understanding of medical billing codes (CPT, ICD‑10, HCPCS) and insurance payer guidelines. Strong analytical skills: Ability to review complex medical records and identify potential billing errors. Excellent communication skills: Effective communication with patients, insurance companies, and internal stakeholders to resolve billing issues. Attention to detail: High level of accuracy required to ensure correct claim submission and avoid billing errors. Proficiency with billing software: Familiarity with electronic health records (EHR) and billing systems to submit claims electronically. #J-18808-Ljbffr Rowan Diagnostic Clinic, PA