Insurance Specialist
- South Bend, IN
- Permanent
- Full-time
- MISSION: We deliver outstanding care, inspire health, and connect with heart.
- VALUES: Trust. Respect. Integrity. Compassion.
- SERVICE GOALS: Personally connect. Keep everyone informed. Be on their team.
- Files Partners HMO, Michiana Healthnet, Medicare, Medicaid and other insurance types daily.
- Files all insurance forms for third party liability for Partners, Michiana Healthnet, etc. in order to obtain necessary Explanation of Benefits (EOB's) to bill the secondary insurance company.
- Reviews all Partners, Michiana Healthnet, Medicare, Medicaid, etc. reimbursement details, correct and refile.
- Enter new Insurance companies' diagnosis and procedure codes.
- Answers requests for insurance information and track claims when payment is deferred.
- Answers the many questions phoned in regarding insurance problems.
- Keeps accurate files on Partners, Medicare, Medicaid, BC/BS (and other insurance companies as appropriate) insurance claims and Explanation of Benefits (EOB's).
- Reviews Medicare/Medicaid bulletins for coding changes.
- Attends meetings regularly to stay abreast of insurance matters.
- Builds a rapport with key people at insurance companies to speak with when problems arise.
- Contribute to the overall effectiveness of the department
- Completes other job-related duties and projects as assigned.
- Attends and participates in department meetings and is accountable for all information shared.
- Completes mandatory education, annual competencies and department specific education within established timeframes.
- Completes annual employee health requirements within established timeframes.
- Maintains license/certification, registration in good standing throughout fiscal year.
- Direct patient care providers are required to maintain current BCLS (CPR) and other certifications as required by position/department.
- Consistently utilizes appropriate universal precautions, protective equipment, and ergonomic techniques to protect patient and self.
- Adheres to regulatory agency requirements, survey process and compliance.
- Complies with established organization and department policies.
- Available to work overtime in addition to working additional or other shifts and schedules when required.
- Leverage innovation everywhere.
- Cultivate human talent.
- Embrace performance improvement.
- Build greatness through accountability.
- Use information to improve and advance.
- Communicate clearly and continuously.
- The knowledge, skills, and abilities as indicated below are normally acquired through the successful completion of a High School Diploma or Equivalent. A minimum of 1 to 2 years of insurance billing experience is required. Computer experience and ability to keep accurate insurance records is required.
- The knowledge of medical terminology in regards to procedure and diagnosis codes, policies, legislation, equipment and professional disciplines.
- Demonstrated communications and interpersonal skills necessary to effectively interact with patients and guarantors.
- Ability to adapt to change and close working conditions.
- Prolonged periods of sitting and/or standing and occasional lifting.