What are the responsibilities and job description for the Insurance Specialist position at Boone Drug at Deerfield?
Overview
We are seeking a dedicated and detail-oriented Insurance Specialist to join our Healthcare administration team. The ideal candidate will possess a strong understanding of medical billing, coding, and insurance claim processes, ensuring accurate and efficient handling of patient accounts. This role requires excellent communication skills, thorough knowledge of medical terminology, and proficiency with electronic health record (EHR) systems. The Insurance Specialist will play a vital role in optimizing revenue cycle management while providing exceptional support to patients and healthcare providers.
Duties
- Submit, track, and follow up on insurance claims for respiratory and DME services.
- Complete and manage prior authorizations, eligibility verifications, and benefit checks.
- Ensure compliance with payer guidelines, Medicare, Medicaid, and private insurance requirements.
- Review documentation for accuracy and completeness prior to claim submission.
- Resolve claim denials, rejections, and reimbursement discrepancies.
- Communicate with insurance companies, clinical staff, and patients regarding coverage and billing questions.
- Maintain accurate patient and insurance records in the billing system.
- Stay current with changes in insurance regulations and DME billing requirements.
- Support audits and compliance initiatives as needed.
Qualifications
- Proven experience in medical office administration with a focus on medical billing and coding.
- Strong knowledge of ICD-10 and medical terminology.
- Familiarity with EMR (Electronic Medical Records) systems and EHR (Electronic Health Record) platforms.
- Excellent understanding of insurance claim submission processes and denial management.
- Effective communication skills for liaising with insurance providers, patients, and healthcare staff.
- Attention to detail with strong organizational skills to handle multiple claims efficiently. Join our team as an Insurance Specialist to ensure seamless billing operations that support high-quality patient care while maximizing operational efficiency!
- High school diploma.
Work Location: In person