Insurance Specialist I

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    "requisitionDescription": "<div><div><p><span style=\"font-size: 14px;\">Summary</span></p><p style=\"margin-left:0in;\">Supports insurance payment processing and basic account follow-up activities to help ensure accurate posting, documentation, and timely reimbursement. Reviews Explanation of Benefits (EOBs), remittance advice, electronic deposits, and paper checks for accurate payment application.</p><p style=\"margin-left:0in;\">Performs routine account maintenance, basic insurance research, and assigned follow-up tasks under guidance. This is an entry to early-career role with narrower responsibility and less independent judgment than Insurance Specialist II.</p><h1 style=\"margin-left:0in;\"><span style=\"font-size: 14px;\">Qualification Requirements</span></h1><p style=\"margin-left:0in;\">Must have basic knowledge of medical insurance billing processes and be able to perform routine payment posting and account review functions accurately.</p><p style=\"margin-left:0in;\">Basic understanding of medical billing practices, debits and credits, and third-party payer processes is required. Ability to learn practice management and EHR systems used by ENA is required.</p><h1 style=\"margin-left:0in;\"><span style=\"font-size: 14px;\">Minimum Qualifications</span></h1><div style=\"margin-left:0in;\"><ul style=\"list-style-type: disc;margin-left: 0in;\"><li style=\"margin-left:0in;\">High school diploma or equivalent.</li><li style=\"margin-left:0in;\">1 year of directly related medical insurance, billing, payment posting, or medical office revenue cycle experience preferred.</li><li style=\"margin-left:0in;\">Equivalent combination of closely related education and experience may be considered.</li><li style=\"margin-left:0in;\">Basic proficiency in Microsoft Office, including Word, Outlook, and Excel.</li><li style=\"margin-left:0in;\">Basic knowledge of medical billing practices and insurance payment processes.</li><li style=\"margin-left:0in;\">Familiarity with EHR and practice management systems preferred.</li><li style=\"margin-left:0in;\">Basic familiarity with CMS-1500 claim form completion preferred.</li><li style=\"margin-left:0in;\">Ability to pass criminal background check, OIG exclusion screening, and drug screening.</li><li style=\"margin-left:0in;\">Reliable transportation.</li></ul></div><h1 style=\"margin-left:0in;\"><span style=\"font-size: 14px;\">Knowledge, Skills and Abilities</span></h1><div style=\"margin-left:0in;\"><ul style=\"list-style-type: disc;margin-left: 0in;\"><li style=\"margin-left:0in;\">Strong attention to detail and accuracy.</li><li style=\"margin-left:0in;\">Ability to perform repetitive tasks with consistency.</li><li style=\"margin-left:0in;\">Basic written and verbal communication skills.</li><li style=\"margin-left:0in;\">Ability to accept direction and work cooperatively with team members.</li><li style=\"margin-left:0in;\">Basic understanding of healthcare billing procedures, documentation, and payment cycles.</li><li style=\"margin-left:0in;\">Ability to organize work, manage routine tasks, and maintain records.</li><li style=\"margin-left:0in;\">Basic computer and data entry skills.</li><li style=\"margin-left:0in;\">Ability to identify routine payment or account issues and escalate more complex matters appropriately.</li><li style=\"margin-left:0in;\">Ability to maintain confidentiality and follow HIPAA requirements.</li></ul></div><h1 style=\"margin-left:0in;\"><span style=\"font-size: 14px;\">Supervisory Responsibilities</span></h1><div style=\"margin-left:0in;\"><ul style=\"list-style-type: disc;margin-left: -0.25in;\"><li style=\"margin-left:0in;\">None.</li></ul></div><h1 style=\"margin-left:0in;\">Essential Functions</h1><p style=\"margin-left:0in;\">Representative duties are listed below. Percentage estimates are approximate and may vary based on business need.<strong>a</strong> <strong>Approx. %</strong> <strong>Key Duties</strong></p><p style=\"margin-left:.25in;\"><strong>Claim and Payment Processing</strong> <strong>70%</strong></p><div style=\"margin-left:0in;\"><ul style=\"list-style-type: disc;margin-left: 0.25in;\"><li style=\"margin-left:0in;\">Review EOBs, remittance advice, electronic deposits, and paper checks for routine posting activity. 70%</li><li style=\"margin-left:0in;\">Post payments accurately to patient accounts based on established procedures.</li><li style=\"margin-left:0in;\">Annotate accounts with basic payment and insurance information,</li><li style=\"margin-left:0in;\">Perform routine account maintenance and identify obvious payment posting errors for correction or escalation.</li><li style=\"margin-left:0in;\">Maintain organized supporting documentation for posted transactions.</li><li style=\"margin-left:0in;\">Assist with straightforward insurance follow-up tasks as assigned.</li></ul></div><p style=\"margin-left:.25in;\"><strong>Communication</strong> <strong>10%</strong></p><div style=\"margin-left:0in;\"><ul style=\"list-style-type: disc;margin-left: 0in;\"><li style=\"margin-left:0in;\">Communicate with insurance companies, patients, or guarantors regarding basic claim or payment questions, as directed.</li></ul></div><div style=\"margin-left:0in;\"><ul style=\"list-style-type: disc;margin-left: 0in;\"><li style=\"margin-left:0in;\">Route more complex denials, appeals, or account issues to senior staff or supervisor.</li></ul></div><p style=\"margin-left:.25in;\"><strong>Documentation and File Maintenance 10%</strong></p><div style=\"margin-left:0in;\"><ul style=\"list-style-type: disc;margin-left: 0in;\"><li style=\"margin-left:0in;\">Maintain and organize master document files for verification and backup of entered data.</li><li style=\"margin-left:0in;\">Ensure supporting billing documentation is present and properly filed.</li></ul></div><p><strong>Stay Updated 5%</strong></p><div style=\"margin-left:0in;\"><ul style=\"list-style-type: disc;margin-left: 0in;\"><li style=\"margin-left:0in;\">Review payer bulletins, office guidance, and procedural updates relevant to assigned tasks.</li></ul></div><p style=\"margin-left:.25in;\"><strong>Compliance and Safety 5%</strong></p><div style=\"margin-left:0in;\"><ul style=\"list-style-type: disc;margin-left: 0in;\"><li style=\"margin-left:0in;\">Follow safety policies and department procedures.</li><li style=\"margin-left:0in;\">Maintain confidentiality and comply with HIPAA and billing requirements.</li><li style=\"margin-left:0in;\">Participate in required training.</li></ul></div><h1 style=\"margin-left:0in;\"><span style=\"font-size: 14px;\">Physical Demands</span></h1><div style=\"margin-left:0in;\"><ul style=\"list-style-type: disc;margin-left: 0in;\"><li style=\"margin-left:0in;\">Frequently lift or move up to 10 pounds using provided tools.</li><li style=\"margin-left:0in;\">Requires ability to read, enter, and review information accurately.</li><li style=\"margin-left:0in;\">Frequent repetitive hand motion due to data entry.</li><li style=\"margin-left:0in;\">Regularly required to talk and hear, and occasionally stand, sit, stoop, kneel, or crouch.</li><li style=\"margin-left:0in;\">Requires manual dexterity and eye-hand coordination.</li><li style=\"margin-left:0in;\">Frequent phone use may be required.</li></ul></div><h1 style=\"margin-left:0in;\"><span style=\"font-size: 14px;\">Work Environment</span></h1><div style=\"margin-left:0in;\"><ul style=\"list-style-type: disc;margin-left: 0in;\"><li style=\"margin-left:0in;\">Work schedule is generally Monday through Friday, 8:00 a.m. to 5:00 p.m., with slight modifications possible based on business need and manager approval.</li><li style=\"margin-left:0in;\">Work is normally performed in an office environment with moderate noise.</li><li style=\"margin-left:0in;\">Must be able to work additional hours as needed to support department operations.</li></ul><p><span data-teams=\"true\" data-pasted=\"true\">This position is designated as an on-site, patient-facing role. In-office presence is an essential function due to the need for real-time collaboration with providers, direct interaction with patients and caregivers, and secure handling of health data in compliance with HIPAA.</span></p><p data-pasted=\"true\">To request a reasonable accommodation for any part of the application or hiring process, please see our Accessibility Statement or contact Human Resources at</p><p><a target=\"_blank\" rel=\"noopener noreferrer\" data-fr-linked=\"true\" href=\"mailto:[email protected]\">[email protected]</a> or 252-864-2049.</p></div><p><br></p></div></div>\n",
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