Specialist, Medical Insurance

 

RIVERWAY CLINIC JOB DESCRIPTION:

POSITION TITLE:Specialist, Medical Insurance 
 
 DEPARTMENT:

Central Registration

 

REPORTS DIRECTLY TO:Supervisor, Medical Insurance Specialist

POSITION PURPOSE: 

Responsible for the efficient operation of patient and insurance registration processes. This position directly impacts revenue collection through patient registration, insurance verification, and clinic schedule review.

EDUCATION AND EXPERIENCE:

High school diploma or GED required

Meets one of the following:

Two years post secondary education, which includes course work in healthcare or customer service

Graduate of a technical, business or community college which includes course work in healthcare or customer service

Two years experience as a healthcare billing representative, healthcare customer service position or similar experience within the last five years

Customer service experience with demonstrated strength in communication skills dealing with patient/public contacts

Demonstrated PC skills in a Windows environment

Knowledge of insurance terminology

SKILLS AND ABILITIES:

Demonstrated problem solving skills.

Accuracy and attention to detail.

Demonstrated skills in organizing and prioritizing work with multiple interruptions

Effective oral communication skills, including excellent telephone skills

Computer/PC skills proficiency.

Works productively as a team player.

Adapts positively to changes in the work environment.

Ability to handle confidential information with discretion

PREFERRED QUALIFICATIONS

Demonstrated knowledge of Epic

Demonstrated medical insurance/billing processing experience

Electronic insurance processing, online insurance eligibility and claims inquiry

Online insurance verification

Proficiency in other language/bilingual skills

Familiarity with medical coding systems (ICD-9 & CPT)

ACCOUNTABILITIES

Registration and insurance expert

Register new and existing patients in an accurate, efficient, and timely manner.

Complete the registration process, including reviewing the registration information for completeness and accuracy, and obtain further information as needed.

Verify insurance coverage and eligibility via computer and/or telephone as needed.

Identify and correct insurance/registration errors.

Notify appropriate staff via online messaging system of potential insurance issues and self pay patients.

Serves as a resource for patients, and clinic staff regarding insurance coverage, and coordination of benefits.

Perform patient/account/coverage clean-up as needed on the patient’s insurance record to ensure accurate billing, including demographics.

Initiate financial discussions with patients, based on insurance review and using established policies and procedures.

Investigate, document, and communicate the status of forms and correspondence from outside sources.

Provides a high level of customer service and timely account recovery as needed.

Identify and propose solutions to problems.

Participates in cross training and provides inter-departmental coverage as required.

Abides by the Code of Conduct and Corporate Integrity Program.

Performs other duties and responsibilities as assigned.

About Us

At HealthPartners we believe in the power of good – good deeds and good people working together. As part of our team, you’ll find an inclusive environment that encourages new ways of thinking, celebrates differences, and recognizes hard work.

We’re a nonprofit, integrated health care organization, providing health insurance in six states and high-quality care at more than 90 locations, including hospitals and clinics in Minnesota and Wisconsin. We bring together research and education through HealthPartners Institute, training medical professionals across the region and conducting innovative research that improve lives around the world.

At HealthPartners, everyone is welcome, included and valued. We’re working together to increase diversity and inclusion in our workplace, advance health equity in care and coverage, and partner with the community as advocates for change.

Benefits Designed to Support Your Total Health
As a HealthPartners colleague, we’re committed to nurturing your diverse talents, valuing your dedication, and supporting your work-life balance. We offer a comprehensive range of benefits to support every aspect of your life, including health, time off, retirement planning, and continuous learning opportunities. Our goal