Insurance Specialist

OrthoVirginia, Virginia’s largest provider of expert orthopedic and therapy care, is currently seeking a full-time, experienced Insurance Specialist to join our team! Along with a collaborative, team-oriented work environment, our outstanding employment package includes: competitive salaries, excellent medical, dental, and vision benefits, paid time off (PTO), a generous 401k incentive plan, short-term and long-term disability insurance, life insurance, and a company-wide wellness program.

Position Summary

The Insurance Specialist ensures timely and accurate payment of primary, secondary and tertiary insurance claims assigned and assist patients and others with all billing inquires.

Primary Functions & Accountabilities

• Timely follow-up of aged outstanding claims for assigned payer groups
• Ensure payer contract compliance by analysis of denials/underpayments. Generate appeals, reconsideration requests or fair hearings based on payer specific guidelines, CCI edits and documentation
• Notate billing progress using the required note format in EMR
• Respond to daily correspondence and non-payment EOB’s within 3 business days of receipt
• Accept incoming calls and assist patients with billing inquiries as scheduled.
• Assist patients on site and co-workers within the entire organization with billing inquiries.
• Inform Manager of payer issues; noted trends or need for physician coding education.
• Facilitate open communication with payer provider representatives for support, guidance and issue resolution as directed by Manager.
• Daily analysis and resolution of outstanding insurance accounts receivable

Knowledge, Skills & Abilities

• Familiarity with Electronic Medical Record (EMR) Systems; specifically, Allscripts, Centricity, NextGen, Advantix preferred
• Experience with outbound business-to-business phone calls
• Detailed orientated required for concise, accurate, and standardized note taking (for claim notes, phone call notes, inter-office emails, etc.
• Excellent communication and customer service skills
• Excellent organizational and time management skills; Ability to multitask in a fast-paced environment
• Strong supervisory skills and ability to effectively delegate responsibility
• Ability to maintain confidentiality of patient and employee information
• Knowledge of basic office equipment, Microsoft Office, and practice management systems

Position Requirements

• Bachelor’s degree in business, health management or other related field preferred, or at least five years of experience in medical practice billing and collections with evidence of progressive responsibility
  • Experience with practice management software and Microsoft Office skills preferred.
  • 2+ years of experience with medical billing
  • 2+ years current medical field experience