Insurance Specialist

SSC Insurance SpecialistThe insurance specialist monitors accounts receivable, contacts insurers for information regarding non-payment, submits appeals for insurance denials, and provides needed medical records to insurers. Responsible to the Business Office Manager. QUALIFICATIONS:Must have completed high school or equivalent. Must be able to communicate the English language, both written and verbal. Experience with healthcare appeals and insurance claim adjudication. Knowledge of billing, procedural, and diagnostic codes used in billing for health care services. Knowledge of medical terminology. Must possess the physical ability and perceptive acuity (e.g. visual, hearing) to satisfactorily perform all direct and indirect clerical functions. Must have or obtain CPR certification. RESPONSIBILITIES AND DUTIES:Responsible for all aspects of insurance AR. Contact insurance companies to determine reason for non-payment. Submit insurance reconsideration requests, disputes, and appeals. Provide medical documentation to insurers as needed, and communicate with patients regarding information requests from the insurer to the member. Assists in backing up receptionist and/or other roles. Participate in pertinent educational programs and facility meetings. Perform other office functions as directed by Office Manager. Comply with the Policy & Procedures of Southern Surgery Center including, but not limited to, the identification and reporting of adverse incidents. Monday-Friday 8:00am-5:00pm