Medical Policy Specialist jobs in Fayetteville, NC

Position Summary

The Insurance Specialist position is responsible for providing a personal and unified effort to obtain payment of outstanding insurance claims. They will assist patients with questions they might have regarding their accounts.  They are responsible for providing a more comprehensive method of maintaining and monitoring patient accounts, specific accounts assignments, and regular report analysis.

Essential Functions and Responsibilities

•Responsible for telephone and walk-in inquiries regarding billing, and insurance-related matters.

•Assists with billing/coding and error resolutions, with direct participation with management and other staff members to resolve accounts.

•Works assigned accounts receivable reports claim denials and rejections taking appropriate action as needed to secure payment.

•Handles changes in patient information relating to registration information including insurance/guarantor information.

•Responsible for documenting all transactions, telephone contacts, etc. in the individual PMC patient’s account.

•Maintains appropriate records concerning inquiries, account resolutions, etc.

•Responsible for the analysis of reports and alerting management of any problems in a timely manner

•Performs other duties as assigned.

Qualifications

 Education (Including Licenses and Certifications): High school diploma or general education degree (GED); or one-year related experience and/or training; or equivalent combination of education and experience.

 Experience:  One to two years of experience in a medical office setting is preferred.  CPT and ICD-10 coding experience is highly desirable.