Insurance Reviewer II - PA
Company: Springfield Clinic
Location: Springfield
Posted on: March 17, 2023
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Job Description:
The Insurance Reviewer II is responsible for completing assigned
tasks involved in securing payment from third-party payors and
reporting to management on observed trends and issues.
Job Relationships
Reports to the Insurance Review Supervisor
Principal Responsibilities
Handle all phone calls and messages received specific to designated
insurance area.
Update registration screens when requested by patients or as
necessary.
Review and process all designated insurance vouchers received,
rebilling charges not paid and processing adjustments as needed
utilizing websites or telephone as necessary.
Process all secondary billing as requested by patients or defined
by procedure.
Distribute incoming insurance mail received and respond to all
audits, inquiries and additional information requests.
Process corrections/adjustments as necessary to correct the
patient's invoice.
Process designated insurance reviews when requested to obtain
additional payments on claims utilizing websites or telephone as
necessary.
Analyze and process front-end system edits for correct physician
productivity and billing of claims.
Analyze and process back-end system edits for correct registration
and billing of claims.
Analyze and process claims denied through clearinghouse.
Investigate and process claims in the insurance work files and/or
on the insurance reports.
Must report all incidents to immediate Supervisor or Manager.
Assist with special projects and assignments as directed.
Must attend in-services and training relevant to position.
Perform other job duties as assigned.
Confidentiality required.
Comply with the Springfield Clinic incident reporting policy and
procedures.
Adhere to all OSHA and Springfield Clinic training &
accomplishments as required per policy.
Provide excellent customer service and adhere to SC Way customer
service philosophy.
Education/Experience
High School graduate or GED required.
Previous experience in a medical billing office required.
Knowledge, Skills and Abilities
Working knowledge of medical terminology preferred.
Working knowledge of CPT and ICD-9 coding preferred.
Computer, typing and calculator skills required.
Must be able to work individually or on a team.
Working Environment
Office environment, sitting for long periods
PHI/Privacy Level
HIPAA1
Keywords: Springfield Clinic, Springfield , Insurance Reviewer II - PA, Other , Springfield, Illinois
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