Role OverviewKey responsibilities include interpreting complex health insurance contracts, understanding billing processes, and effectively communicating and resolving escalated payment issues with insurance carriers working within the billing and contracting teams.
What You Will Do
Review and apply health insurance contracts to billable services, benefit policy terms, and coverage limitations to determine eligibility and payment eligibility for claims per contract expectations. Investigate and resolve escalated payment disputes, including denied, underpaid, or delayed claims.
Why It Might Be a Fit
Experience in medical or insurance billing with a track record of resolving escalated payment issues. Proficiency in billing software, EHR systems, and claims submission platforms. Experience of or strong understanding of ICD-10, CPT, modifiers, and insurance payment terms.
Requirements
- Bachelor’s degree in related field preferred
- Experience or strong understanding in contracting & contract management
- Experience in medical or insurance billing with a track record of resolving escalated payment issues
- Proficiency in billing software, EHR systems, and claims submission platforms
- Experience of or strong understanding of ICD-10, CPT, modifiers, and insurance payment terms
- Experience with MPPR/Sequestration, coinsurance and Deductibles
- Coding Certification a plus
- Excellent time management, prioritization and organizational skills
- Experience in Outlook, Word, and PowerPoint desired
- Detail-oriented with strong organizational and problem-solving abilities
- Self-motivated and results oriented
- Proficiency in Microsoft Office applications, including Excel, Word and PowerPoint
- Excellent verbal and written communication and presentation skills
Benefits
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