Company Name:The Little Clinic
Insurance Specialist should possess a thorough working knowledge of the revenue cycle management process. Position is required to be a role model and demonstrate the company's core values of respect, honesty, integrity, diversity, inclusion and safety of others. The Insurance Specialist is responsible for the research and resolution of aging account receivables to that are either unpaid or incorrectly paid.
Essential Job Functions:
- Analyze, audit and resolve claims outstanding, denied, or incorrectly paid
- Review and respond to payer correspondence.
- Submit appeals as needed for denied claims.
- Contact insurance companies and navigate payer websites in order to secure and expedite insurance payments.
- Resolves patient billing inquiries.
- Document in detail all actions taken in accounts receivable system.
- Meet productivity expectations as outlined by supervisor.
- Recognize, document and notify Team Lead of trends resulting in nonpayment or incorrectly paid claims.
- Answer and resolve inbound calls from insurance carriers.
- Participate in process improvement initiatives as needed.
- Keep current with Medicare and other third party administrators regulations and procedures.
- Manage any special projects requested by supervisor or team lead.
- Must be able to perform the essential functions of this position with or without reasonable accommodation.
- High school diploma
- 1+ year of insurance follow-up including working knowledge of the appeals resolution process
- Strong written, and verbal communication skills
- Analytical and problem solving capabilities with close attention to detail.
- Excellent organizational and follow-up skills
- Thorough working knowledge of revenue cycle management including medical terminology,ICD-9, ICD-10, CPT-4 coding, Medicare reimbursement guidelines, billing and collection practices
- Ability to read and interpret EOB's
- Highly self-motivated, with ability to work independently and meet deadlines
- Ability to remain flexible during times of change and adjusts promptly and effectively
- Must be able to learn, understand, and apply new technologies
Education Level: High School Diploma/ GED Required
Required Certifications/Licenses: American Academy Nurse Practitioner (AANP); American Nurses Credentialing Center (ANCC)
Position Type: Full-Time
The Little Clinic Jobs: At The Little Clinic our locations are staffed by board-certified nurse practitioners or physician assistants and patient care technicians to provide high-quality, convenient healthcare at an affordable price. The primary focus of our healthcare team is to promote health and wellness through appropriate diagnosis, treatment and patient education. The Little Clinic nurse practitioners and physician assistants are fully qualified to diagnose and treat common illnesses and minor injuries, prescribe medications, conduct tests, interpret lab results, provide wellness and preventive care, perform physical examinations and health screenings and administer vaccinations and injections. We're growing and actively looking for qualified applicants to help us continue to provide high-quality healthcare and stellar service to our patients.
Company Overview: Kroger Family of Companies employs nearly half a million associates who serve over 11 million customers daily through a seamless shopping experience under a variety of banner names . At The Kroger Co., we are Fresh for Everyone™ and dedicated to our Purpose: To Feed the Human Spirit®. We are committed to creating #ZeroHungerZeroWaste communities by 2025. Careers with The Kroger Co. and our family of companies offer competitive wages, flexible schedules, benefits and room for advancement.
Posting Notes: TN||Nashville|| 2620 Elm Hill Pike ||37214 || The Little Clinic||None||Accounting; The Little Clinic ||Employee|| Non-Exempt || Full-Time|| American Academy Nurse Practitioner (AANP); American Nurses Credentialing Center (ANCC)