Insurance Reviewer II
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Job Description
Insurance Reviewer II processing medical claims, billing adjustments, and denials for Springfield Clinic. Securing third-party payments while supporting patients, audits, and insurance reviews.
Responsibilities:
- Complete assigned tasks to secure payment from third-party payors
- Report observed trends and issues to management
- Handle phone calls and messages for the designated insurance area
- Update registration screens as needed
- Review and process insurance vouchers, rebill unpaid charges, and process adjustments
- Process secondary billing
- Distribute insurance mail and respond to audits, inquiries, and information requests
- Process invoice corrections and insurance reviews
- Analyze and process front-end and back-end system edits
- Analyze and process claims denied through the clearinghouse
- Investigate and process claims in insurance work files and reports
- Report incidents to the immediate Supervisor or Manager
- Assist with special projects and assignments
- Provide excellent customer service and comply with Springfield Clinic policies
Requirements:
- High School graduate or GED required
- Previous experience in a medical billing office required
- Working knowledge of medical terminology preferred
- Working knowledge of CPT and ICD-9 coding preferred
- Computer, typing and calculator skills required
- Must be able to work individually or on a team
- Confidentiality required
- Must attend in-services and training relevant to position
- Comply with OSHA and Springfield Clinic training requirements
- HIPAA1 privacy level
Benefits:
- Comprehensive benefits offered by Springfield Clinic (details provided at https://www.springfieldclinic.com/benefits)
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