Business Office Insurance Specialist

The Business Office Insurance Specialist is responsible for managing insurance claims and ensuring timely reimbursement for services provided in inpatient, outpatient, and clinical contexts. This role involves monitoring patient charge work queues, resolving discrepancies, processing claims, posting charges, and resolving any other issues related to insurance payments. The specialist will work closely with their colleagues in the Business Office, patients, insurance companies, and other hospital departments to facilitate smooth billing operations.

Duties include:

Coding Review - collaborate with the Revenue Cycle Manager and the Health Information Manager to review complex patient accounts to confirm accounts are appropriately coded and documented.

Emergency Room Coding - review documentation from Emergency Room encounters to appropriately drop charges for both the professional and technical components. Identify documentation improvement opportunities and collaborate with the Revenue Cycle Manager to implement improvements.