Insurance Claims Account Specialist

Job DetailsJob Location: Headquarters - Mokena, IL 60448Position Type: Full TimeEducation Level: High SchoolSalary Range: $44,000.00 - $50,000.00 Salary/yearJob Shift: Full Time: 80 hours per pay periodJob Category: Billing & InsurancePosition Summary:

The Insurance Claims Specialist is responsible for posting insurance payments from EOBs, following up and correcting errors on EOBs or submitted claims, and working denials. 

Work Schedule: This position is on-site with a schedule of Monday - Friday 7:30 am - 4:00 pm

Essential Functions:


Post insurance payments timely and balance to each EOB to ensure all lines are posted accurately.
Manage electronically posted EOBs, research flagged lines and resolve issues that prevented automatic posting utilizing the company’s billing system and other internal/external systems to research claim details.
Work denied claims included on EOBs, which involves using various external tools (Availity, UHCLink, UMR) and internal resources (billing system, Westside app) to research claim status. 
Appeal denials as necessary by submitting appropriate documentation to insurance carriers and following up regularly.
Review accounts receivable balances for outstanding insurance amounts due and follow up with payers to arrange payments.
Ensure patient account records are up-to-date and accurate.
Manage insurance company correspondence, which may include medical records requests, denials of coverage, refund requests, etc.
Set the tone of quality and effort expected of the team.
Adhere to all practice policies related to HIPAA.

QualificationsRequired Education, Experience and Credentials:


High school diploma or equivalent
One year of billing experience in a medical office or healthcare setting 


 

Knowledge, Skills and Abilities:

 


Excellent interpersonal and communication skills
Able to work effectively with all levels of the organization and in a diverse work group.
Proactive and independent with the ability to take initiative.
Excellent time management skills with a proven ability to meet deadlines.
Comfortable with technology, with the ability to learn multiple systems and software.
Proficient with Google Workspace
Must maintain discretion and client confidentiality.


 

Personal Attributes:

 


Interpersonal skills with strong verbal and written communication skills
Process oriented with strong attention to detail and accuracy
Accountability  
Integrity 
Problem Solving
Initiative 


 

Work Environment & Physical Demands 

 


Prolonged periods of sitting at a desk and working on a computer. 
Must be able to lift up to 15 pounds at times.


 

Travel Requirements


Not applicable




 

This is a full-time position. Full-time employees are eligible for a comprehensive range of benefits, including Medical, Dental, Vision, and Life Insurance; a 401(k) retirement plan with company match; Paid Time Off; Sick Time; and a robust Employee Assistance Program.