Summary: An Insurance Specialist is responsible for working and managing Accounts Receivable for our Clinic and Surgery Center and providing excellent customer service to our patients.
Essential Duties and Responsibilities include the following. Other duties may be assigned.

1. Maintain comprehensive understanding of insurance company rules, regulations, and payer contract requirements.
2. Monitor insurance accounts receivable for both our Clinic and Surgery Center.
3. Follow up on unpaid claims.
4. Process credit balances within a timely manner.
5. Research account denials and file written appeals when necessary.
6. Check each insurance payment for accuracy and compliance with contract discount
7. Respond to inquiries from both insurance companies and patients.
8. Collaboratively cover phone line for insurance/billing related questions.
9. Process and keep track of incoming payments and accounts in compliance with financial procedures and policies
10. Cross-train on functions within Patient Accounts to help provide coverage as needed.
11. Participate in developing or enhancing department policies and procedures.
12. Assist with ad-hoc projects when assigned.

Education/Experience :

1. Highschooldiplomaor
2. Minimum two years in medical billing experience in a healthcare setting, required.
3. Ability to work in a fast-paced dynamic environment, managing multiple priorities and deadlines.
4. Capableof making soundjudgmentsaccordingtoproceduresoracceptable recommendations for exceptions when needed.
5. Currentknowledgeof medical insurance reimbursement

Qualifications:

1. Excellent interpersonal skills to build effective partnering relationships with internal departments.
2. Excellent communications skills both written and verbal.
3. Ability to work on variety of projects accurately and within timelines.
4. Microsoft Excel and Word experience
5. Valid WI Driver's License

Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to talk and hear. The employee frequently is required to stand; walk; sit; use hands to type; and reach with hands and arms. The employee is occasionally required to stoop, kneel, crouch and bend. The employee must occasionally lift and/or move boxes up to 20 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.
Essential Physical Requirements
Codes:
N = Never
O = Occasional, represents 1 to 33% or 1 to 2 hours of an 8 hour workday.
F = Frequently, represents 34 to 66% or 2½ to 5½ hours of an 8 hour workday.
C = Continuously, represents 67 to 100% or 6 to 8 hours of an 8 hour workday.
PHYSICAL ACTIVITY
Walking: O
Standing: O
Sitting: C
Reaching Shoulder Height: O
Reaching Above Shoulder Height: O
Reaching Below Shoulder Height: O
Climbing: N
Pulling 25 Pounds or Less: N
Pulling 25 Pounds to 50 Pounds: N
Pulling Over 50 Pounds: N
Pushing 25 Pounds or Less: N
Pushing 25 to 50 Pounds: N
Pushing Over 50 Pounds: N
Lifting 25 Pounds or Less: N
Lifting 25 Pounds to 50 Pounds: N
Lifting Over 50 Pounds: N
Carrying 25 Pounds or Less: N
Carrying 25 Pounds to 50 Pounds: N
Carrying Over 50 Pounds: N
Crawling/Kneeling: N
Bending: O
Twisting/Turning: O
Balance: N
PHYSICAL EXPOSURE
Unprotected Heights: N/A
Lighting Bright: YES
Lighting Dim: N/A
Mechanical Hazards: N/A
Hazardous Substance: N/A
Infectious Diseases: N/A
Harmful Physical Agents (Heat/Cold): N/A
Noise: N/A
Ionizing/Non-Ionizing Radiation: N/A
ACCEPTED MINIMUM PHYSICAL ABILITY
Vision: GOOD
Color Vision: IMPAIRED
Hearing: MODERATE LOSS
Manual Dexterity: GOOD
Talking/Speech: FAIR
*Note It is the Bone & Joint Clinic policy to not lift, pull/push, carry 50/50 lbs. without assistance