Patient Insurance Specialist

JOB SUMMARY: 

Under general supervision, performs a variety of specialized tasks involved in the preparation, processing, and follow-up of patient insurance information.

EDUCATION/EXPERIENCE:

• High school diploma or GED equivalent with two years clerical experience dealing with patient insurance.
• Excellent knowledge of medical terminology and CPT and ICD-9 coding systems.
• Prior experience in department preferred.

LICENSURE, CERTIFICATION, and/or REGISTRATION:

• Achieve Business Office performance standards within six months of hire.

ESSENTIAL FUNCTIONS: 

1. Performs specialized duties involved in the preparation and processing of particularly complex insurance issues. 2. Provides specialized information and answers to inquiries concerning insurance filing and billing procedures. 3. Audits medical records to verify, compute, and record patient charges. 4. Assists in the filing, updating, and purging of op notes, procedure descriptions, and radiology reports. 5. Replies to all claims correspondence either in writing or verbally within specified timeframes. 6. Drafts memos/letters to physicians or carriers requesting additional information. 7. Maintains a basic knowledge of all tasks performed in the insurance department to fulfill the tasks of other employees in their absence. 8. Completes assigned reports as required. Maintains logs and records in a status for assigned payors. 9. Assists with the creation and distribution of policies and procedures related to workflow and payor processes. 10. Serves as a representative of the insurance department at internal and external meetings. Performs specialized duties as assigned by department head. 11. Assists in the training of less experienced employees regarding departmental procedures. 12. Maintains Business Office performance standards. 13. Performs other related duties incidental to work described herein.

SKILLS/QUALIFICATIONS:

• Ability to provide guidance and direction to less experienced employees.
• PC experience and knowledge of the IDX system Typing test required.

WORK ENVIRONMENT:

• Typical clinic setting.

Atrium Health Wake Forest Baptist is a pre-eminent academic health system based in Winston-Salem, North Carolina. Atrium Health Wake Forest Baptist is part of Advocate Health, which is headquartered in Charlotte, North Carolina, and is the fifth-largest nonprofit health system in the United States, created from the combination of Atrium Health and Advocate Aurora Health. Atrium Health Wake Forest Baptist’s two main components are an integrated clinical system – anchored by Atrium Health Wake Forest Baptist Medical Center, an 885-bed tertiary-care hospital in Winston-Salem – that includes Brenner Children’s Hospital, five community hospitals, more than 300 primary and specialty care locations and more than 2,700 physicians; and Wake Forest School of Medicine, the academic core of Atrium Health Enterprise and a recognized leader in experiential medical education and groundbreaking research that includes Wake Forest Innovations, a commercialization enterprise focused on advancing health care through new medical technologies and biomedical discovery.

Wake Forest Baptist Health, Wake Forest University School of Medicine and Atrium Health have joined forces in a strategic combination that will enhance care, transform medical education and create economic opportunity for countless lives in North Carolina and beyond. As a part of that combination, the two health systems will be integrating technology and platforms, including our career sites.

This means that although you are applying on the Wake Forest Baptist Health Career Site, you receive communications from the Atrium Health Recruitment Team. Please know that this is an expected process, and thanks in advance for your flexibility.