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Insurance Relations Specialist

Insurance Relations Specialist

Department 
Billing - Nc
Job Locations 
US-NC-Charlotte
Employment Type 
Regular Full-Time
Position Schedule 
..

More information about this job

Position Summary

WESTMED Practice Partners is currently recruiting for a Insurance Relations Specialist.This position is responsible for maintaining a working knowledge of WPP clients plan participation and providing support services to various departments regarding plan participation issues. This includes research, policy and procedure clarification and maintenance of the Insurance Lookup.

Essential Job Functions & Responsibilities

  • Administrator for insurance relations ticket system to resolve claim issues, determine plan participation and maintain CB and isurance lookup.
  • General support regarding plan participation, claim issues, contract and policy interpretation for all departments within revenue cycle and front desk.
  • Fee compliance maintenance including: tracking quarterly audits and fee schedule requests, interpreting underpayment reports on an manual level to determine validity, work with carriers to obtain payment and ensure correct loading of contracted rates.
  • Primary liaison to major insurance carrier representatives. Lead monthly phone calls with major carriers; track and document large carrier issues.
  • General support to physicians and executive team regarding: reimbursement inquires, policy and contract interpretation pertaining to new codes, procedures equipment and/or supplies.

Required Qualifications

Knowledge of medical billing and claims processing practices and procedures.

  • Excellent customer service skills and ability to handle fast-paced environment. Ability to multi task is essential.
  • Excellent written and verbal communication skills.      
  • Ability to analyze and troubleshoot difficult claims.
  • Willingness to assist in training and special department projects.
  • Ability to work and make accurate decisions independently.

 

Education/Certifications/Licenses:

  • Associates Degree or Equivalent related experience.

#CB

Company Overview

Here at WESTMED Practice Partners, one of the most successful management services organizations in the United States health care community, we look for individuals who are interested in and seek a challenging, growth-oriented, dynamic and friendly environment. Individuals with a strong work ethic along with a caring personality are who we find to be most successful here, fitting into our not so basic mantra of simply being “Smart" & “Nice". Our organization is constantly looking to bring on like-minded people who have a genuine interest in helping people and possess an intellectual curiosity to try and do things better and more efficiently. We strive to bring out the best in all of our team members and provide individuals with the support they need to achieve their career aspirations.