Job Title: Insurance Specialist
Duration: 11 Months + High possibility of extension
Location: Chapel Hill, NC, 27514 (Onsite)
Job Description:
The Client is seeking a skilled and detail-oriented Medical Coding and Insurance Specialist to manage both medical and dental insurance services. This role plays a critical part in ensuring seamless billing and reimbursement processes for Managed Care and private dental insurance companies and organizations.
Key Responsibilities
Claims and Billing:
- Review treatment notes to ensure all coding, Medical and Dental, are accurate as well as the diagnosis.
- File Medical and Dental insurance claims for privately insured patients.
- Ensure accurate submission of supporting clinical documentation (e.g., X-rays, chart notes, letters of necessity).
Investigate and appeal denied claims, following up to resolution.
Accounts Receivable Management:
- Maintain an in-depth understanding of Medical and Dental insurance industry standards, billing practices, and reimbursement processes.
- Audit patient records regularly to ensure billing, coding, and clinical documentation accuracy.
- Scan and manage critical insurance documentation in electronic patient records.
Patient and Provider Support:
- Answer inquiries regarding Medical and Dental insurance benefits, claim status, and account summaries.
Qualifications and Expertise
- Specialized knowledge of Medical Coding, Dental and Medical insurance policies, contracts, and billing standards.
- Proficiency in Medical and Dental terminology, procedural and diagnostic coding, and medical-dental cross-coding.
- Experience with electronic claims processing and insurance vendor protocols.
- Strong understanding of accounts receivable management principles.
- HIPAA Compliance: Knowledge of and adherence to HIPAA regulations is required.
Skills and Attributes
- Certified Medical Coder
- Exceptional attention to detail and organizational skills.
- Excellent communication and problem-solving abilities.
- Ability to work collaboratively with insurance carriers, patients, and clinic providers.