Insurance Claims Support Specialist

Overview

Researches and review claims for accuracy and to ensure payer specific guidelines are met for correct billing to third party payers. Makes payer calls, and/or utilizes payer portals/resources systems to pursue payment of third party claims. Make appropriate determinations for contractual adjustments, verifies system balances, calculates and post adjustments. Ensure financial integrity of Central Florida Health by processing and expediting billing and collection processes.

Education:

• Post High School Special Training-Preferred
• High School Diploma/GED-Required

Licensure/Certification/Registration: N/A

Special Skills/Qualifications/Additional Training/Experience

Required:

• Must be able to read, write, speak and understand English.
• Requires six months billing/collection experience in hospital and/or physician’s office OR a minimum of one year experience in business setting dealing with finance, accounting, insurance portal systems.
• Experience in Blue Cross, Medicare, Medicaid and/or other Third Party payer billing or collections preferred.
• Must have above average math skills and be proficient on a calculator.
• Must be able to demonstrate the ability to communicate well with others and work independently under pressure and consistently achieve desired results
• Must be able to deal effectively with the public and be able to use good judgment in the pursuit of resolving accounts
• Medical terminology preferred.
• Prefer experience with computerized insurance billing system and Microsoft programs