Insurance Specialist I (NAVA)Apply: Remote: Full time: Posted 5 Days Ago: REQ4300Base Pay Range:$20.43 - $30.65Job Description:## The Insurance Specialist is a remote position working Monday-Friday. Training hours are 8am-5pm Monday-Friday PST. Hours may vary after training. Rate of pay will depend on experience and location of remote worker.Summary: Address large volumes of unpaid or incorrectly paid claims to secure reimbursement.General Description: Performs medical billing functions to third party claims. Reviews unpaid claims and denials and appropriately rebills the claim. Researches and/or resolves patient complaints. Researches and resolves credit balances, refunding appropriate party as needed. Tracks and monitors denials for trending and establishes plan of action to resolve systemic payer issues.Essential Duties/Responsibilities: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.* Reviews unpaid claims by calling for payment status, appealing denials and correcting and resubmitting claims when necessary.* Follows up with insurance companies for any unpaid or incorrect paid services provided to patients.* Helps patients understand how insurance companies process their billing claim.* Helps patients with collection questions when Collections Specialist is not available.* Writes off uncollectible balances with dollar values as high as $500 (dependent on experience).* Resolves claim edits (missing claim information) prior to the submission of the claim to insurance companies.* Reviews appropriateness and process refunds for all payers as appropriate.* Works with vendors to resolve payer issues.* Corrects posting discrepancies to reflect payor’s adjudication advice.* Researches payments received