Healthcare Insurance Claims Specialist
hace 4 semanas
**Job Summary:**
Auxis is seeking a highly organized and detail-oriented Healthcare Insurance Claims Specialist to join our team. As a key member of our client's operations, you will play a vital role in ensuring the timely and accurate processing of insurance claims.
About Auxis:
We are a fast-growing business process outsourcing provider dedicated to delivering exceptional service to our clients. Our team is passionate about providing high-quality support and creating opportunities for growth and development.
Responsibilities:
In this role, you will be responsible for:
- Performing pre-registration and insurance verification within 3-5 days prior to the date of service for both inpatient and outpatient services
- Following scripted benefits verification and pre-certification format in Meditech custom benefits screen and recording benefits and pre-certification information in the approved standard format
- Assigning Insurance Plans (IPlans) accurately
- Performing electronic insurance eligibility confirmation when applicable and documenting results
- Calculating patient cost share and preparing to collect via phone or making payment arrangement
- Contacting patients via phone to confirm or obtain missing demographic information, quote/collection of patient cost share, and instructing patients on where to present at the time of appointment
- Receiving and recording payments from patients for services scheduled
- Ensuring appropriate documentation is entered in standard format on the patient record
- Contacting physicians to resolve issues regarding prior authorization or referral forms
- Researching Patient Visit History to ensure compliance with payer-specific payment window rules
- Performing insurance verification and pre-certification follow-up for the prior day's walk-in admissions/registrations and account status changes by an assigned facility as per SSC guidelines
- Communicating with hospital-based Case Manager as necessary to ensure prompt resolution of pre-existing, non-covered, and re-certification issues
Requirements and Skills:
To succeed in this role, you will need:
- English - Spanish Language (Oral and writing 85% or higher)
- High school diploma
- At least 6 months of experience in Data Entry
- Excellent communication skills
- Strong attention to detail
- Comfortable working in a high volume/high demand environment
Salary and Benefits:
This is a full-time position with a competitive salary range of $45,000 - $60,000 per year, depending on experience. Additionally, you will enjoy a comprehensive benefits package, including health insurance, transportation subsidy, training and development programs, employee recognition program, paid time off, and family paid leave.
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