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    Emory Healthcare/Emory University
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Insurance Specialist

Illinois, Decatur, 62521 Decatur USA

OverviewWork Hours: Full-time 8a-4:30pDescriptionJOB DESCRIPTION:Collects, compiles, and processes patient insurance information and patient charges for physician billing, which includes the verification of Medicaid and insurance eligibility.

Maintains records and produces reports.

Sets up files and files correspondence following policy and procedure.

Collects charge information for physician's billing; maintains records of daily count of charge sheets, total bills submitted, and in-patient admissions when appropriate.

Follows up on payments and denied claims; obtains additional information and resubmits claims as appropriate.

Works with manager to formulate plan for professional development.

Attends educational in-services as appropriate.

May work closely with Case Management, Financial Counselors and other members of the Revenue Cycle Division including precertification and registration staff.

Collects, compiles, codes, verifies and enters patient and insurance information into a database management system; maintains and updates information.

Collects signatures and verifies patient insurance and Medicaid eligibility for billing purposes.

Records and keeps ledgers for Medicaid and insurance claims; maintains files and logs by following policy and procedure.

Audits operational reports and corrects and updates information to ensure accuracy of information.

May batch charge sheets, calculate batch ticket totals and submit for processing.

May receive, sort, and direct processed batch tickets and computer print out sheets with appropriate attachment.

May prepare, code and complete physician's charge sheets for submission to processing areas by using ICD-9 and CPT coding procedures.

Codes for diagnosis, procedure, and type of patient visit.

Compiles and generates statistical reports on a regular basis; reviews records and logs pertaining to billing and patient insurance.

Performs other related duties as required.

MINIMUM QUALIFICATIONS:A high school diploma or equivalent.

At least 2 years of Medical Billing or 2 years experience working with clients in a medical environment.

Insurance verification and or pre-certification experience required.

Experience in calculating estimated patient responsibilities required.

Some knowledge of Medicaid and Medicare insurance required.

Some understanding of Revenue Cycle Operations required and a knowledge of word processing and spreadsheet personal computer applications.

PHYSICAL REQUIREMENTS (MediumMax 25lbs): up to 25 lbs, 0-33% of the work day (occasionally); 11-25 lbs, 34-66% of the workday (frequently); 01-10 lbs, 67-100% of the workday (constantly); Lifting 25 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking, Occasional sitting, Close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks.ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste Chemicals/gases/fumes/vapors Communicable diseases Electrical shock , Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation , Shift work, Travel may be required. Use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.Connect With Us!Connect with us for general consideration!Division Emory Decatur HospitalCampus Location Decatur, GA, 30033Campus Location US-GA-DecaturDepartment CORP -Financial CounselingJob Type Regular Full-TimeJob Number 80858Job Category Revenue Cycle & Managed CareSchedule 8a-4:30pStandard Hours 40 HoursEmory Healthcare is an Equal Employment Opportunity employer committed to providing equal opportunity in all of its employment practices and decisions. Emory Healthcare prohibits discrimination, harassment, and retaliation in employment based on race, color, religion, national origin, sex, sexual orientation, gender identity or expression, pregnancy, age (40 and over), disability, citizenship, genetic information, service in the uniformed services, veteran status or any other classification protected by applicable federal, state, or local law.

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