Regional Outstanding Insurance Specialist

Riccobene Associates Family Dentistry is looking for a full-time Outstanding Insurance Specialist! (This position is remote.)

The Outstanding Insurance Specialist is a critical role responsible for effectively and efficiently managing the accounts receivable process for an assigned group of payors or supported region/company. This is an in office position!

Responsibilities

• Ensures claims are processed accurately to secure timely payment.

• Responds to inquiries, questions, and concerns from patients regarding the status of claims in a clear, concise, and courteous manner.

• Conducts follow-up and submits reimbursement appeals for unpaid and/or inappropriately paid claims; ensures appropriate documentation of billing, follow-up, collection, and appeal efforts are recorded on accounts.

• Identifies, researches, and ensures timely processing of billing errors and corrections as they relate to claims; actively participates in problem identification and resolution and coordinates resolutions between appropriate parties.

Requirements

• Ensuring all claims are submitted within 24 hours of being batched. (exceptions credentialing)

• Managing rejections, ensuring claims are sent out cleanly and quickly
• To be tracked once DXC can provide. Clean Claim Rate (Goal 90%)
• Quality touch per claim every 30 days.
• Average of 30 claim touches per day.
• Managing all region’s denials and claim adjudications (corrective claims, appeals, insurance refunds).
• Working with team to achieve and maintain KPI’s and benchmarks

Benefits

• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance