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Insurance Payment Specialist
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About Watson Clinic
Watson Clinic is a leading multi-specialty healthcare provider committed to delivering exceptional patient care. We are seeking a detail-oriented and highly motivated Insurance Payment Specialist to join our dedicated team.
Job SummaryThe Insurance Payment Specialist plays a vital role in ensuring accurate and timely processing of insurance payments and rejections. This position requires strong analytical skills, attention to detail, and a thorough understanding of medical billing procedures.
Responsibilities- Process insurance payments and rejections within the IDX system, maintaining a high volume of transactions per month.
- Meticulously review Explanation of Benefits (EOBs) to ensure accuracy in posting details such as dates of service, allowable amounts, non-covered items, and patient responsibility.
- Verify payment accuracy according to contractual agreements with insurance carriers and apply appropriate adjustments.
- Split invoices when necessary, ensuring accurate allocation of payments between carrier and patient responsibility.
- Coordinate charge corrections for EOBs received from contracted carriers, collaborating with designated personnel.
- Process unidentified insurance payments by contacting carriers for clarification and maintaining organized records.
- Generate and balance batch log sheets accurately.
- Follow up on unidentified accounts as assigned.
- Adhere to compliance guidelines set by the Clinic's Compliance Program, ensuring adherence to healthcare regulatory laws related to medical coding, billing, and reporting.
High school diploma or equivalent required. Two years of experience in a related field is preferred. Medical health insurance experience is essential.
Strong analytical skills, attention to detail, and the ability to work independently are crucial for success in this role. Excellent communication and interpersonal skills are necessary for effective collaboration with internal and external stakeholders.
