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Insurance Specialist I
Inland Imaging. Address large volumes of unpaid or incorrectly paid claims to secure reimbursement .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in medical billing processes, including CPT and ICD-10 coding, while effectively managing patient accounts and resolving claims issues. Strong communication and organizational skills are essential for collaborating with insurance companies and assisting patients with billing inquiries.
Highest-signal resume keywords
Medical Billing ExperienceCPT CodingICD-10 CodingPatient Accounting SystemsCustomer Service Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Medical BillingClaims ReviewClaims AppealsPayer Refund ProcessingCPT CodingICD-10 CodingPatient Accounts ManagementDenial TrackingClaim SubmissionBilling Corrections
Soft Skills
Excellent CommunicationInterpersonal SkillsDetail-OrientedOrganizational SkillsMultitasking Ability
Tools & Technologies
MedinformatixMicrosoft OfficeWorkdayMeditechCode CorrectWaystar
Certifications & Qualifications
High School Diploma/GEDBackground Check ComplianceDriver's License
Industry Keywords
Patient BillingInsurance ClaimsHIPAA CompliancePHI SecurityCredentialing
About the role
Key responsibilities & impact- Address large volumes of unpaid or incorrectly paid claims to secure reimbursement
- Perform medical billing functions for third-party claims
- Review unpaid claims and denials, appeal and rebill claims, and correct and resubmit claims
- Follow up with insurance companies regarding unpaid or incorrectly paid services
- Help patients understand insurance billing claims and answer collection questions
- Write off uncollectible balances up to $500, depending on experience
- Resolve claim edits before submission to insurance companies
- Review and process payer refunds
- Track and monitor denials, identify trends, and establish action plans for systemic payer issues
- Work with vendors to resolve payer issues
- Correct posting discrepancies and research unposted payments
- Coordinate with credentialing liaison on provider enrollment issues
- Obtain retroactive authorizations or referral numbers from referring physician offices
- Call clients regarding overdue group-bill accounts and charge discrepancies
- Provide patient eligibility status for onsite patients
- Attend monthly and quarterly meetings, train with peers, perform peer-to-peer QA, and communicate updates to leadership
- Perform other special projects and duties as assigned
Requirements
What you’ll need- High School Diploma/GED required
- Two years medical billing course desired
- Patient accounts billing experience desired
- Working knowledge of Medinformatix or other patient accounting systems preferred
- CPT and ICD-10 coding experience preferred
- Good customer service skills
- Experience with Microsoft Office products (Outlook, Word, Excel), Workday, Internet, Intranet, Meditech, Code Correct, Medinformatix, and Waystar highly desired
- Must pass a background check required by RCW 43.43.830-840
- Must not be included on the OIG List of Excluded Individuals
- Must pass a post-offer, pre-employment drug test
- Valid state driver's license and proof of insurance
- Excellent communication and interpersonal skills
- Detail-oriented, organized, able to multitask, and able to work in a fast-paced environment
- Ability to maintain confidentiality and follow HIPAA, PHI, security, health and safety, and company policies
- Attendance is required; ability to rotate to other shifts and locations as needed
Benefits
Comp & perks- Remote position
- Monday-Friday schedule
- Training hours 8am-5pm Monday-Friday PST
- Quarterly quality assurance meeting attendance
- Continuing education through professional journals and approved seminars