GetixHealth
Insurance Team Lead
GetixHealth, Tacoma, Washington, us, 98417
Position responsibilities
Review accounts placed as self-pay to determine if insurance coverage existsAnalyze unpaid claims and determine reason for them to have not been adjudicatedContact insurance carriers to obtain status on claims and ultimately paymentUtilize online tools to research insurance claims when availableObtain supporting documentation (i.e., medical records, explanation of benefits, authorizations, referrals, etc.) to submit to insurance carriersSubmit appeals in proper format when appropriateReview, interpret and apply contractual termsContact patients/ guarantors to facilitate and expedite processing of their claims when neededAssist with other duties as related to the special projectsPerform job duties in accordance with the organization's information security policiesProtect assets from unauthorized access, disclosure, modification, destruction or interferenceIndividual accountabilityReport security events or potential events or other security risks through the incident reporting proceduresMonitor inventory to ensure all claims are within compliance timelinesProvide reporting to management showing open inventory and potential recoveryOther duties as assignedEducation and experience
7+ years’ experience in a facility setting performing insurance follow-up/ denials managementKnowledge of UB04/CMS 1450 and CMS 1500 claim forms, EDI, HCPCS, ICD-9/ ICD-10, CPT, DRG’s and ability to interpret an Explanation of BenefitsComplete working knowledge of billing instructions and procedures for each payer source according to regulations and guidelinesKnowledge of Commercial, Governmental and third-party denials and appeals processesKnowledge of billing systemsMust have effective organizational skills and a high attention to detailMedical terminology requiredMust demonstrate the ability to adapt to change, maintain professionalism in challenging situations, and work in a Business professional environmentMedi-Cal knowledge a major benefitHigh school diploma or college degree from an accredited college or universityWork environment / physical requirements
Work environment is an office location. The position requires the dexterity to operate office equipment such as a personal computer, keyboard, mouse and telephoneOccasional lifting may be required up to 25 lbs.Must be able to sit for extended periods of time with frequent bending and stoopingAdditional Notes
This role profile is not intended to be an exhaustive list of qualifications, skills, efforts, duties, responsibilities or working conditions associated with the position.Must possess the ability to work independently, have excellent customer service and communication skills, patience, flexibility, and the ambition to achieve goals. Fast paced environment with multiple facilities.
GetixHealth is an equal employment opportunity employer.
Review accounts placed as self-pay to determine if insurance coverage existsAnalyze unpaid claims and determine reason for them to have not been adjudicatedContact insurance carriers to obtain status on claims and ultimately paymentUtilize online tools to research insurance claims when availableObtain supporting documentation (i.e., medical records, explanation of benefits, authorizations, referrals, etc.) to submit to insurance carriersSubmit appeals in proper format when appropriateReview, interpret and apply contractual termsContact patients/ guarantors to facilitate and expedite processing of their claims when neededAssist with other duties as related to the special projectsPerform job duties in accordance with the organization's information security policiesProtect assets from unauthorized access, disclosure, modification, destruction or interferenceIndividual accountabilityReport security events or potential events or other security risks through the incident reporting proceduresMonitor inventory to ensure all claims are within compliance timelinesProvide reporting to management showing open inventory and potential recoveryOther duties as assignedEducation and experience
7+ years’ experience in a facility setting performing insurance follow-up/ denials managementKnowledge of UB04/CMS 1450 and CMS 1500 claim forms, EDI, HCPCS, ICD-9/ ICD-10, CPT, DRG’s and ability to interpret an Explanation of BenefitsComplete working knowledge of billing instructions and procedures for each payer source according to regulations and guidelinesKnowledge of Commercial, Governmental and third-party denials and appeals processesKnowledge of billing systemsMust have effective organizational skills and a high attention to detailMedical terminology requiredMust demonstrate the ability to adapt to change, maintain professionalism in challenging situations, and work in a Business professional environmentMedi-Cal knowledge a major benefitHigh school diploma or college degree from an accredited college or universityWork environment / physical requirements
Work environment is an office location. The position requires the dexterity to operate office equipment such as a personal computer, keyboard, mouse and telephoneOccasional lifting may be required up to 25 lbs.Must be able to sit for extended periods of time with frequent bending and stoopingAdditional Notes
This role profile is not intended to be an exhaustive list of qualifications, skills, efforts, duties, responsibilities or working conditions associated with the position.Must possess the ability to work independently, have excellent customer service and communication skills, patience, flexibility, and the ambition to achieve goals. Fast paced environment with multiple facilities.
GetixHealth is an equal employment opportunity employer.