Insurance Tracer
: Job Details :

Insurance TracerI. DESCRIPTION Correcting medical claims submitted to insurance companies and payers and resolving insurance payment issues. II. MAJOR AREAS OF RESPONSIBILITY 1. Reviewing patient bills for accuracy and completeness and obtaining any missing information. 2. Preparing, reviewing, and correcting claims using billing software, including electronic and paper claim processing. 3. Identifying and correcting issues related to facility and physician claims. 4. Identifying and correcting issues for secondary or tertiary insurance. 5. Answering patient or insurance telephone inquiries pertaining to assigned accounts. 6. Reporting recurring issues to primary biller and supervisors. In addition to these general duties, your supervisor may request that you perform other duties that fit with your training or provide further training for new duties. III. EDUCATION At a minimum, applicant must have at least a high school diploma or GED equivalent. IV. EXPERIENCE Experience in a medical office setting is preferred but not required. IV. KNOWLEDGE, SKILLS, AND ABILITIES After a specified time period of training and job performance, you supervisor will want to see the following knowledge, skills, and abilities demonstrated: 1. Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems. 2. Competent use of computer systems, software, and 10 key calculators. 3. Familiarity with CPT and ICD-10 Coding. 4. Effective communication abilities for phone contacts with insurance payers to resolve issues. 5. Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds. 6. Ability to work well in a team environment. 7. Problem-solving skills to research and resolve discrepancies. 8. Knowledge of medical terminology likely to be encountered in medical claims. 9. Maintaining patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA). 10. Ability to multitask.