Position: Lead Insurance Review Specialist

Location: St. John Outpatient Center: 9660 Wicker Avenue, St. John, IN 46373

 

Job Summary:

Under the direction of the Insurance Review Supervisor, serves as leader for the follow-up portion of the revenue cycle.  Monitors follow-up work queues and reports and initiates action where needed. Oversees and performs outstanding claim tracking, denial management, claim appeals, retro-adjudication, and reimbursement monitoring processes. Oversees and performs statement processing, self-pay follow-up, and bad debt processes.  Motivates and educates staff to perform tasks according to baseline goals and objectives.

 

Education/Experience Requirements:

 

 

High School graduate (or GED equivalent).

1-2 years lead or supervisory experience preferred.

3-5 years of insurance or medical billing experience required; physician practice setting strongly preferred.

Possess in-depth knowledge of medical terminology and of the current CPT, ICD, and HCPCS coding systems.

Comprehension of government and third party billing regulations required.

Must be able to utilize Microsoft Office applications, perform internet navigation and research, and have prior experience using a computerized health information system.

Needs to be familiar with operating general office equipment, including but not limited to: scanner, fax machine, photocopy machine, printer and adding machine.

Ability to multi-task efficiently and effectively.

Must be able to act calmly and effectively in a busy or stressful situation.

Excellent attitude, interpersonal skills and communication abilities necessary to interact with patients, family members, physicians, and other hospital associates.

Exhibits leadership qualities: planning, organizing, delegating, leading, teaching, etc.

Excellent verbal and written communication; excellent problem solving abilities.