Job Title: Insurance Specialist

Duration: 11 Months + High possibility of extension

Location: Chapel Hill, NC, 27514 (Onsite)

Job Description:

The Client is seeking a skilled and detail-oriented Medical Coding and Insurance Specialist to manage both medical and dental insurance services. This role plays a critical part in ensuring seamless billing and reimbursement processes for Managed Care and private dental insurance companies and organizations.

Key Responsibilities

Claims and Billing:

• Review treatment notes to ensure all coding, Medical and Dental, are accurate as well as the diagnosis.
• File Medical and Dental insurance claims for privately insured patients.
• Ensure accurate submission of supporting clinical documentation (e.g., X-rays, chart notes, letters of necessity).

Investigate and appeal denied claims, following up to resolution.

Accounts Receivable Management:

• Maintain an in-depth understanding of Medical and Dental insurance industry standards, billing practices, and reimbursement processes.
• Audit patient records regularly to ensure billing, coding, and clinical documentation accuracy.
• Scan and manage critical insurance documentation in electronic patient records.

Patient and Provider Support:

• Answer inquiries regarding Medical and Dental insurance benefits, claim status, and account summaries.

Qualifications and Expertise

• Specialized knowledge of Medical Coding, Dental and Medical insurance policies, contracts, and billing standards.
• Proficiency in Medical and Dental terminology, procedural and diagnostic coding, and medical-dental cross-coding.
• Experience with electronic claims processing and insurance vendor protocols.
• Strong understanding of accounts receivable management principles.
• HIPAA Compliance: Knowledge of and adherence to HIPAA regulations is required.

Skills and Attributes

• Certified Medical Coder
• Exceptional attention to detail and organizational skills.
• Excellent communication and problem-solving abilities.
• Ability to work collaboratively with insurance carriers, patients, and clinic providers.