COMPANY DESCRIPTION
Borland Groover is one of Florida's leading gastroenterology providers. Founded in 1947, our mission is to provide exceptional care and improve the lives of our patients. We value ourselves on delivering quality care (quality), doing the right thing (accountability), caring for our patients (compassion), and taking care of our employees (collaboration). If you love the vision of Borland Groover, and find your values aligning with ours, apply to join our team!
POSITION SUMMARY
The Insurance Specialist at Borland Groover is responsible for managing accounts receivable related to medical insurance claims. They ensure the timely and accurate processing of claims, follow up on outstanding payments, and reconcile accounts to maintain financial stability for the organization.
ESSENTIAL JOB FUNCTIONS

• Claims Processing: Submitting medical claims to various insurance companies via paper or electronic.
• Follow up: Contact insurance companies to follow up on unpaid or denied claims.
• Resolve claim discrepancies : Working on rejected claims and denials by providing necessary documentation or information.
• Appeals and Disputes : Prepare and submit appeals for denied claims, providing additional documentation such as medical records and letters of medical necessity if needed.
• Insurance Credits: Prepare refunds for insurance overpayments.
• Payment Posting : Adjusting balances according to contractual obligation.
• Working Clearing House rejections: Correct errors on an HCFA 1500 for the claim to process electronically.
• Working on Insurance portals: Navigating the insurance portals, checking claim status, and uploading appeals.
• Calculating Payments : Adding EOBs and Checks for balancing posting batches.
• Customer Service : Assisting patients and insurance representatives with inquiries and issues related to billing and claims.
• Compliance and Regulations : PHI and HIPAA training are required, and HIPAA compliance is expected.
• Employees must follow the organization's Code of Conduct.

ADDITIONAL RESPONSIBILITIES

• Performs other related duties as assigned outside of the normal day-to-day job functions.
• Ability to be able to multi-task.
• Ability to work as a Team.
• Accurate data entry skills

COMPETENCIES

• Communication - Exhibits good listening and comprehension. Expresses ideas and thoughts in written form. Expresses ideas and thoughts verbally. Keeps others adequately informed. Selects and uses appropriate communication methods.
• Time-Management - The ability to plan your duties ahead of time and leveraging technology to help you do so efficiently.
• Collaboration - Exhibiting interpersonal skills, working with others, building trust and communication to complete goals and projects on time to achieve the organization's shared objectives.
• Problem Solving - The ability to come up with an effective solution to an issue by thinking quickly and coming up with the most reasonable solution.
• Compassion - Exhibits empathy or real concern for patients coupled with a desire to take action to address the patient's needs.

GENERAL QUALIFICATIONS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.

• Strong customer service skills to interact with team members, patients, and other departments within the practice.
• Problem-solving skills to identify and resolve billing and collections issues.
• Ability to maintain confidentiality and communicate in person, by phone, or in writing.
• Ability to work independently and in a team environment.
• Competency in Microsoft Office, EMR, and other medical software.
• Ability to communicate effectively with physicians and staff both verbally and in writing.
• Works well with patients, physicians, and staff.
• Ability to handle multiple tasks in a fast-paced environment.
• Ability to handle patient issues in a tactful and professional manner.
• Attention to detail.
• Ability to communicate in English.

EDUCATION AND EXPERIENCE

• High School diploma or equivalent required.
• Previous experience in Collections or Customer Service is preferred.

PHYSICAL REQUIREMENTS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.
Physical Demands

• Sitting: Prolonged periods of sitting at a desk and working on a computer: essential
• Moderate lifting (15-20 lbs.): marginal
• Walking: Must be able to access and navigate each department at the organization's facilities: marginal
• Pushing/Pulling: marginal
• Standing: marginal
• Repetitive motion: marginal
• Reaching: marginal
• Bending: marginal

Emotional Demands

• Fast pace: essential
• Multiple Stimuli: essential
• Intense customer interaction: essential
• Frequent change: essential

Mental/Sensory Demands

• Memory: essential
• Reasoning: essential
• Hearing: essential
• Reading: essential
• Analyzing: essential
• Logic: essential
• Verbal communication: essential
• Written communication: essential

POSITION LOCATION
4887 Belfort Road, Jacksonville, FL, 32256
BENEFITS

• Health Insurance
• Dental Insurance
• Vision Insurance
• 401K Retirement Plan
• Life Insurance
• Short- and Long-term disability
• Profit Sharing
• Supplemental Insurance
• Education and Tuition Reimbursement funding
• Initial Uniform Allowance
• Employee Assistance Program (EAP)
• Paid Time Off (PTO)
• Volunteer Time Off (VTO)
• Paid Holidays

IMPORTANT NOTE
The above statements are intended to describe the general nature and level of work being performed. They are not intended to be an exhausted list of duties, responsibilities, and skills. Borland Groover is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. We thank all applicants for their interest, however only those selected for an interview will be contacted.