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Insurance Reviewer II

Springfield Clinic

Responsible for completing assigned tasks involved in securing payment from third-party payors and reporting observed trends and issues to management.

Key duties include:

  • Handle phone calls and messages related to the designated insurance area.
  • Review and process insurance vouchers, rebilling unpaid charges, and making adjustments as needed.
  • Process secondary billing as requested by patients or defined by procedure.
  • Distribute incoming insurance mail and respond to audits, inquiries, and requests for additional information.
  • Correct patient invoices by processing necessary corrections and adjustments.
  • Conduct designated insurance reviews to obtain additional payments on claims.
  • Analyze front-end and back-end system edits for correct registration, physician productivity, and billing of claims.
  • Review claims denied through the clearinghouse and investigate claims in work files and reports.
  • Assist with special projects and training as assigned.
  • Maintain confidentiality and comply with clinic incident reporting, OSHA, and customer service policies.
Requirements & Qualifications

Education and experience

  • High school diploma or GED required.
  • Previous experience in a medical billing office required.

Knowledge and skills

  • Working knowledge of medical terminology preferred.
  • Working knowledge of CPT and ICD-9 coding preferred.
  • Computer, typing, and calculator skills required.
  • Ability to work independently and as part of a team.

Location

Illinois, US

Employment Type

Full-time

Experience Level

Associate

Remote work allowed

No

Posted

2 months ago

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