Position Overview: The Medical Office Insurance Specialist plays a critical role in ensuring the financial health of a medical practice by managing insurance claims, verifying patient coverage, and processing payments accurately. This position requires excellent attention to detail, strong organizational skills, and a comprehensive understanding of medical billing, coding, and insurance procedures.

Key Responsibilities:

Insurance Verification and Authorization:

• Verify patient insurance coverage and benefits before appointments and procedures.
• Update patient records with accurate insurance information.

Claims Management:

• Prepare and submit insurance claims for medical services rendered.
• Ensure claims comply with insurance regulations and coding requirements (e.g., ICD-10, CPT).
• Follow up on unpaid or denied claims and work to resolve discrepancies.

Billing and Payments:

• Process patient payments, insurance reimbursements, and adjustments accurately.
• Generate and distribute patient statements for outstanding balances.
• Maintain detailed records of all financial transactions.

Compliance and Reporting:

• Stay updated on changes to insurance policies, billing guidelines, and industry regulations.
• Prepare reports on claim status, payments, and outstanding balances for management review.

Patient Interaction:

• Provide clear and courteous communication regarding insurance benefits, billing questions, and payment options.
• Assist patients with understanding their financial responsibilities and resolving billing issues.

Assist and cover Front Receptionist as needed

Additional duties assigned by Supervisors

Qualifications:

• High school diploma or equivalent; Associate's degree or certification in medical billing/coding is preferred.
• Minimum of 2 years of experience in medical billing, insurance processing, or a related field.
• Strong knowledge of insurance policies, medical terminology, and coding systems (ICD-10, CPT, HCPCS).
• Proficiency in medical billing software and electronic health record (EHR) systems.
• Excellent organizational and time-management skills.
• Strong problem-solving abilities and attention to detail.
• Exceptional communication and interpersonal skills.

Work Environment: The Medical Office Insurance Specialist typically works in a clinical or office setting with standard business hours. Occasional overtime may be required to meet deadlines or resolve urgent billing issues.

This role is essential to ensuring smooth financial operations within the practice, providing both patients and staff with excellent support in navigating the complexities of medical insurance.

Job Type: Full-time

Pay: From $16.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Day shift
• Monday to Friday

Work Location: In person