Description

Department: Insurance Services
Schedule: Full Time
Shift: DAYS
Hours: M-F 8:30-5:00
Job Details:

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Position Purpose and Scope of Responsibility:

1. Analyzes medical necessity requirements and benefits, and communicates with necessary parties to ensure required data is documented in order for claims to be submitted expediently.
2. Analyzes admission and/or insurance records to ensure accuracy, completion and compliance with established procedures, regulatory requirements and insurance contracts.
3. May collect information from providers and technicians necessary to support the medical necessity of billed services on disputed claims
4. Performs daily review of specified reports and provides follow-up and documentation necessary to update insurance files.
5. Contributes to customer service by answering calls courteously and expediently, providing information and solving customer problems relating to insurance coverage.
6. Provides assigned support with other activities to meet departmental standards for customer and patient satisfaction.

Knowledge and Skill Requirements:
o High School graduation or GED equivalency
o Previous Physician office or hospital office experience with emphasis on insurance knowledge preferred but not required
o Ability to communicate with a broad range of people.
o Excellent phone skills
o Excellent keyboarding skills–possesses good knowledge of or is proficient in MS Word, Excel, McKesson HealthQuest, Insurance Internet Websites, NaviNet
https://www.healthcaresource.com/moinfirmary/?fuseaction=search.jobDetails&template=dsp_job_details.cfm&cJobId=320632&source=Indeed.com

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