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Insurance Credentialing and Follow/Up Specialist

Category:

Business office

Department:

Business Office

Description:

SUMMARY

This is a float position between Insurance Credentialing/Insurance Follow-up Specialist. The primary responsibilities of the Insurance/Medical credentialing specialist include processing paperwork relating to credentialing and credentialing to insure compliance for reimbursement. The responsibly of Insurance Follow-up is to increase and accelerate maximum cash reimbursement in various insurance financial classes. The responsible staff person will review daily reports to capture unbilled claims and reason un-billable. Performs the various computer clerical functions necessary to understand CPSI claims and reporting; requires positive customer service relations with other Labette Health departments within and outside the facility, physician offices, insurance companies, etc. Must be able to perform the above duties in a fast paced environment while maintaining overall objectives and goals; Understanding of basic billing procedure. Ability to correct billing errors, re-bill to payors and properly explain the billing processes of claims. Understanding of the Explanation of Benefits received from the payors.

EDUCATION and/or EXPERIENCE

High School diploma/GED required. Two to three years’ work related experience and/or training. Insurance follow up and billing experience required. Must be proficient in Word, Excel and have extensive computer knowledge. Minimum 3 years customer service experience.

Closing:

Open until filled

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