## Insurance Specialist I (NAVA)Apply: Remote: Full time: Posted 5 Days Ago: REQ******Base Pay Range:**$***** - $*******Job 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 but not yet posted.* Coordinates with credentialing liaison on provider enrollment issues.* Attends monthly meeting to stay up to date with new policies and upcoming changes and communicate to leadership.* Works closely with referring physician offices to obtain retroactive authorizations or referral numbers.* Calls client on group bills for overdue accounts, provides information upon request and serves as liaison with leadership on charge discrepancies.* Trains with peers and performs peer to peer QA.* Supports the LLC Staff to provide eligibility status for patients on site.* Other special projects and duties as assigned. **General Duties and Responsibilities:*** Ability to maintain strict confidentiality within the Inland Imaging companies and Inland's customers.* Follows all Health and Safety policies and guidelines of Inland Imaging or its partners depending on work location.* Follows all company policies including those regarding harassment, non-retaliation, discrimination, respectful workplace, and related policies.* Follows all policies regarding HIPAA, non-disclosure of confidential information and company security.* Honest, pleasant manner and good personal hygiene.* Free of alcohol and drug abuse.* Valid state driver's license and proof of insurance.* Excellent communication and interpersonal skills.* Detail oriented; ability to multi-task; organized and able to work in a fast-paced environment.* Demonstrates self-directed learning and participation in continuing education through professional journals, approved seminars, etc.* Ability to consider individual needs in communication with and assessment and treatment of patients of all ages.* Adheres to departmental standards and personnel policies by demonstrating professional demeanor in conduct and appearance.* Follows company departmental standards and personnel policies by using good teamwork and communication skills to help identify concerns and solutions, assisting where needed to ensure a smooth functioning department.* Performs other duties as required by displaying team spirit and self-growth, accepting, and performing other projects and responsibilities,



and requesting other projects and responsibilities.* Quarterly quality assurance meeting attendance is required for this position.* Attendance is a requirement for this position.* Rotates to other shifts and locations as needed.* Performs other special projects and duties as assigned.**Supervisory Responsibilities:*** There is little or no supervisory responsibility in this position**Advocacy:**Treats all clients with dignity and respect Provides excellent customer service Conforms to Joint Commission and HIPAA regulations Complies with PHI (Protected Health Information) Demonstrates the Inland Imaging Core Values:* Show We Care, Do The Right Thing, Maximize Individual Potential, Challenge Convention**Qualifications:*** *Education:* High School Diploma/GED required + Two years medical billing course is desired* *Experience:* Patient accounts billing experience is desired + Working knowledge of Medinformatix or other patient accounting systems preferred + CPT and ICD-10 coding experience preferred + Good customer services skills* *Licensure:* N/A* *Certifications*: N/A* *Computer Skills*: Experience with the following computer applications is highly desired: Microsoft Office products (Outlook, Word, Excel), Workday, Internet, Intranet, Meditech, Code Correct, Medinformatix, Waystar.* *Background Check*: + Must be able to pass a background check required by RCW ************* to work with children under the age of 16, developmentally disabled persons or vulnerable adults + In order to comply with provisions set forth in Sections **** and **** of the Social Security Act, all new employees of Navani Health Services will be checked against the LIST OF EXCLUDED INDIVIDUALS provided by the Department of Health & Human Services, Office of the Inspector General (OIG). Employees must not be included on this list.* *Drug Test*: Eligible employees must be able to pass a post-offer, pre-employment drug test.
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📌 Insurance Specialist I (Nava) (México)
🏢 Inland Imaging Associates
📍 México