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Insurance Specialist

4A580A4AD8EA62204895312A9C8549BE · Hiveley Corp - Inkster, MI 48141; 30000 Hiveley, Inkster, MI, 48141, USA · Active · Paycom ATS

Job facts

FieldValue
Company4A580A4AD8EA62204895312A9C8549BE
TitleInsurance Specialist
Normalized title-
Department / team-
LocationInkster, MI, United States
Work model-
Employment typeFull Time
Salary-
Statusactive
ATS providerPaycom ATS
Posted / first seen2026-05-15 / 2026-05-31
Changed / last seen2026-05-31 / 2026-06-06

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Linked records

Company4A580A4AD8EA62204895312A9C8549BE
Source407860fb-990b-49f1-b79c-f3517704d07d
ATS providerPaycom ATS

Description

Description POSITION SUMMARY: The Insurance Specialist is responsible for managing patient insurance processes to ensure accurate coverage verification, claims processing, reimbursement, and compliance. This role serves as a key liaison between patients, providers, and payers while supporting revenue cycle operations, resolving billing issues, and maintaining accurate insurance records. EDUCATION AND EXPERIENCE: •    Associate degree required in Healthcare Administration, Medical Billing & Coding, Business Administration, or related field, bachelor’s degree preferred. •    Minimum of 2 years of experience in healthcare insurance, billing, or revenue cycle experience required. •    Direct experience with Medicaid billing and insurance verification is required. •    Experience with managed care, commercial insurance, provider credentialing, and denial management required. •    Must have knowledge of ICD-10/CPT coding, payer guidelines, and electronic billing systems PRINCIPAL DUTIES AND RESPONSIBILITIES: Policy and Patient Support: •    Explain insurance coverage, benefits, and policy terms to patients •    Assist patients with questions regarding insurance, billing, and payment options •    Set up payment arrangements for self-pay patients and provide financial guidance •    Serve as a liaison between patients, providers, and insurance companies to resolve issues Insurance Verification and Enrollment: •    Verify patient eligibility, benefits, and authorization requirements prior to services •    Maintain and update patient insurance information in the electronic health record •    Ensure all providers are linked to appropriate payer contracts for accurate billing •    Support payer enrollment activities, including credentialing, re-attestation, and updates •    Maintain accurate tracking of provider enrollment status across all contracted health plans Claims Management and Billing Support •    Review, submit, and track insurance claims to ensure timely reimbursement •    Post payments and adjustments from payers to patient accounts •    Monitor claims for errors, rejections, or delays and take corrective action •    Coordinate and process claim appeals and denial management activities •    Work credit balance accounts and ensure appropriate resolution •    Denial trend tracking and reporting Revenue and Cycle Support •    Collaborate with insurance payors to resolve denials, underpayments, and billing discrepancies •    Identify and resolve patient billing questions and account issues •    Maintain records of billing, claims, payments, and settlements Compliance and Regulatory Requirements •    Ensure all processes comply with HIPAA and applicable federal, state, and payer regulations •    Maintain confidentiality of patient and financial information •    Monitor payer requirements and ensure adherence to contract terms and billing guidelines Administrative and Data Management •    Maintain accurate and up-to-date records in billing and insurance systems •    Process renewals, updates, and documentation with strong attention to detail •    Track and report on claim status, denials, and reimbursement trends •    Assist with audits by providing documentation and ensuring data accuracy Credentialing and Payer Relations •    Assist with front-end credentialing and privileging providers and clinic locations •    Communicate with payers, underwriters, and provider offices to resolve enrollment and billing issues •    Monitor and maintain insurance contracts and payer relationships •    Ensure timely completion of credentialing and enrollment to prevent billing delays Quality and Process Improvements •    Identify trends in denials, billing errors, or delays and recommend process improvements •    Participate in workflow improvements to enhance efficiency and accuracy •    Support implementation of best practices in billing, coding, and insurance processes Core Competencies •    Knowledge of medical billing, insurance processes, and revenue cycle operations •    Understanding of payer guidelines, authorizations, and claims adjudication •    Strong attention to detail and accuracy •    Problem-solving and analytical skills •    Effective communication and customer service skills •    Ability to manage multiple priorities in a fast-paced environment LICENSING AND OTHER REQUIREMENTS: •    Valid driver’s license and / or reliable transportation. Starfish Family Services is an Equal Opportunity Employer EOE/M/F/D/V

Full job record

Job IDcc68c374cd56a773a1f61d75cd01c5500cb6340e
Org ID3aca2335-479a-4dd4-a997-a76b23a15cb3
Source ID407860fb-990b-49f1-b79c-f3517704d07d
Board ID407860fb-990b-49f1-b79c-f3517704d07d
Providerpaycom
Provider Job Key214093
TitleInsurance Specialist
Normalized Title
Statusactive
Activeyes
Location TextHiveley Corp - Inkster, MI 48141; 30000 Hiveley, Inkster, MI, 48141, USA
Department
Team
Employment Typefull_time
Workplace Type
Remote Policy
CountryUnited States
RegionMI
CityInkster
Salary RawDescription POSITION SUMMARY: The Insurance Specialist is responsible for managing patient insurance processes to ensure accurate coverage verification, claims processing, reimbursement, and compliance. This role serves as a key liaison between patients, providers, and payers while supporting revenue cycle operations, resolving billing issues, and maintaining accurate insurance records. EDUCATION AND EXPERIENCE: •    Associate degree required in Healthcare Administration, Medical Billing & Coding, Business Administration, or related field, bachelor’s degree preferred. •    Minimum of 2 years of experience in healthcare insurance, billing, or revenue cycle experience required. •    Direct experience with Medicaid billing and insurance verification is required. •    Experience with managed care, commercial insurance, provider credentialing, and denial management required. •    Must have knowledge of ICD-10/CPT coding, payer guidelines, and electronic billing systems PRINCIPAL DUTIES AND RESPONSIBILITIES: Policy and Patient Support: •    Explain insurance coverage, benefits, and policy terms to patients •    Assist patients with questions regarding insurance, billing, and payment options •    Set up payment arrangements for self-pay patients and provide financial guidance •    Serve as a liaison between patients, providers, and insurance companies to resolve issues Insurance Verification and Enrollment: •    Verify patient eligibility, benefits, and authorization requirements prior to services •    Maintain and update patient insurance information in the electronic health record •    Ensure all providers are linked to appropriate payer contracts for accurate billing •    Support payer enrollment activities, including credentialing, re-attestation, and updates •    Maintain accurate tracking of provider enrollment status across all contracted health plans Claims Management and Billing Support •    Review, submit, and track insurance claims to ensure timely reimbursement •    Post payments and adjustments from payers to patient accounts •    Monitor claims for errors, rejections, or delays and take corrective action •    Coordinate and process claim appeals and denial management activities •    Work credit balance accounts and ensure appropriate resolution •    Denial trend tracking and reporting Revenue and Cycle Support •    Collaborate with insurance payors to resolve denials, underpayments, and billing discrepancies •    Identify and resolve patient billing questions and account issues •    Maintain records of billing, claims, payments, and settlements Compliance and Regulatory Requirements •    Ensure all processes comply with HIPAA and applicable federal, state, and payer regulations •    Maintain confidentiality of patient and financial information •    Monitor payer requirements and ensure adherence to contract terms and billing guidelines Administrative and Data Management •    Maintain accurate and up-to-date records in billing and insurance systems •    Process renewals, updates, and documentation with strong attention to detail •    Track and report on claim status, denials, and reimbursement trends •    Assist with audits by providing documentation and ensuring data accuracy Credentialing and Payer Relations •    Assist with front-end credentialing and privileging providers and clinic locations •    Communicate with payers, underwriters, and provider offices to resolve enrollment and billing issues •    Monitor and maintain insurance contracts and payer relationships •    Ensure timely completion of credentialing and enrollment to prevent billing delays Quality and Process Improvements •    Identify trends in denials, billing errors, or delays and recommend process improvements •    Participate in workflow improvements to enhance efficiency and accuracy •    Support implementation of best practices in billing, coding, and insurance processes Core Competencies •    Knowledge of medical billing, insurance processes, and revenue cycle operations •    Understanding of payer guidelines, authorizations, and claims adjudication •    Strong attention to detail and accuracy •    Problem-solving and analytical skills •    Effective communication and customer service skills •    Ability to manage multiple priorities in a fast-paced environment LICENSING AND OTHER REQUIREMENTS: •    Valid driver’s license and / or reliable transportation. Starfish Family Services is an Equal Opportunity Employer EOE/M/F/D/V
Salary Min
Salary Max
Salary Currency
Salary Period
Source URLhttps://www.paycomonline.net/v4/ats/web.php/jobs/ViewJobDetails?job=214093&clientkey=4A580A4AD8EA62204895312A9C8549BE
Apply URLhttps://www.paycomonline.net/v4/ats/web.php/jobs/ViewJobDetails?job=214093&clientkey=4A580A4AD8EA62204895312A9C8549BE
First Seen At2026-05-31 19:05:43Z
Last Seen At2026-06-06 20:01:12Z
Last Checked At2026-06-06 20:01:12Z
Last Changed At2026-05-31 19:05:43Z
Inactive At
Source Posted At2026-05-15 00:00:00Z
Source Updated At
Raw Payload Uris3://job-postings-prod-raw-590183727216/raw/provider=paycom/board=4A580A4AD8EA62204895312A9C8549BE/date=2026-06-06/2026-06-06T20-01-09-527Z-ecd31cce536aba856dec17cc8f11bc3de46ebe91119043f551ecbc7db904a9bf.json
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&#160;Review, submit, and track insurance claims to ensure timely reimbursement\\n&#8226;&#160;&#160; &#160;Post payments and adjustments from payers to patient accounts\\n&#8226;&#160;&#160; &#160;Monitor claims for errors, rejections, or delays and take corrective action\\n&#8226;&#160;&#160; &#160;Coordinate and process claim appeals and denial management activities\\n&#8226;&#160;&#160; &#160;Work credit balance accounts and ensure appropriate resolution\\n&#8226;&#160;&#160; &#160;Denial trend tracking and reporting\\n\\n\\nRevenue and Cycle Support\\n&#8226;&#160;&#160; &#160;Collaborate with insurance payors to resolve denials, underpayments, and billing discrepancies\\n&#8226;&#160;&#160; &#160;Identify and resolve patient billing questions and account issues\\n&#8226;&#160;&#160; &#160;Maintain records of billing, claims, payments, and settlements\\n\\n\\nCompliance and Regulatory Requirements\\n&#8226;&#160;&#160; &#160;Ensure all processes comply with HIPAA and applicable federal, state, and payer regulations\\n&#8226;&#160;&#160; &#160;Maintain confidentiality of patient and financial information\\n&#8226;&#160;&#160; &#160;Monitor payer requirements and ensure adherence to contract terms and billing guidelines\\n\\n\\nAdministrative and Data Management\\n&#8226;&#160;&#160; &#160;Maintain accurate and up-to-date records in billing and insurance systems\\n&#8226;&#160;&#160; &#160;Process renewals, updates, and documentation with strong attention to detail\\n&#8226;&#160;&#160; &#160;Track and report on claim status, denials, and reimbursement trends\\n&#8226;&#160;&#160; &#160;Assist with audits by providing documentation and ensuring data accuracy\\n\\n\\nCredentialing and Payer Relations\\n&#8226;&#160;&#160; &#160;Assist with front-end credentialing and privileging providers and clinic locations\\n&#8226;&#160;&#160; &#160;Communicate with payers, underwriters, and provider offices to resolve enrollment and billing issues\\n&#8226;&#160;&#160; &#160;Monitor and maintain insurance contracts and payer relationships\\n&#8226;&#160;&#160; &#160;Ensure timely completion of credentialing and enrollment to prevent billing delays Quality and Process Improvements\\n&#8226;&#160;&#160; &#160;Identify trends in denials, billing errors, or delays and recommend process improvements\\n&#8226;&#160;&#160; &#160;Participate in workflow improvements to enhance efficiency and accuracy\\n&#8226;&#160;&#160; &#160;Support implementation of best practices in billing, coding, and insurance processes Core Competencies\\n&#8226;&#160;&#160; &#160;Knowledge of medical billing, insurance processes, and revenue cycle operations\\n&#8226;&#160;&#160; &#160;Understanding of payer guidelines, authorizations, and claims adjudication\\n&#8226;&#160;&#160; &#160;Strong attention to detail and accuracy\\n&#8226;&#160;&#160; &#160;Problem-solving and analytical skills\\n&#8226;&#160;&#160; &#160;Effective communication and customer service skills\\n&#8226;&#160;&#160; &#160;Ability to manage multiple priorities in a fast-paced environment\\n\\n\\nLICENSING AND OTHER REQUIREMENTS:&#160;\\n&#8226;&#160;&#160; &#160;Valid driver&#8217;s license and / or reliable transportation. &#160;\\n&#160;\\n\\nStarfish Family Services is an Equal Opportunity Employer&#8239;&#160;\\nEOE/M/F/D/V\\n&#160;\\n&#160;\",\"employmentType\":\"FULL_TIME\",\"hiringOrganization\":{\"@type\":\"Organization\",\"name\":\"STARFISH FAMILY SERVICES INC\",\"logo\":\"https://www.paycomonline.net/v4/ats/web.php/application/style/logo?clientkey=4A580A4AD8EA62204895312A9C8549BE\"},\"jobLocation\":{\"@type\":\"Place\",\"address\":{\"streetAddress\":\"30000 Hiveley\",\"addressLocality\":\"Inkster\",\"addressRegion\":\"MI\",\"postalCode\":48141,\"addressCountry\":\"USA\"}},\"validThrough\":\"-0001-11-30\",\"workHours\":\"Day\",\"educationRequirements\":\"2 Year Degree\"}",
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    "jobTitle": "Insurance Specialist",
    "postedOn": "",
    "locations": "Hiveley Corp - Inkster, MI 48141",
    "remoteType": "",
    "description": "POSITION SUMMARY: \nThe Insurance Specialist is responsible for managing patient insurance processes to ensure accurate coverage verification, claims p...",
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