Insurance Plan Specialist

KNOWLEDGE, SKILLS, ABILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Intermediate knowledge of managed care and other healthcare contract language
Intermediate understanding of ICD-9, HCPCS/CPT coding, medical terminology and hospital billing form requirements (UB-04)
Intermediate skills in Microsoft Excel to create pivot tables and perform v-lookup function
Intermediate knowledge of query writing applications and data validations desired
Intermediate knowledge of Contract Adjudication applications (Med-Assets)
Intermediate knowledge of patient accounting principles
Demonstrated ability to detect patterns in large volumes of data
Strong communication skills (verbal and written)
Strong contract interpretation skills
Strong relationship building and collaboration skills
EDUCATION / EXPERIENCE Include minimum education, technical training, and/or experience required to perform the job.
4 year college degree preferred; High School diploma or equivalent required
2-4 years experience working with Patient Financial Services, Managed Care and other contracted payors in a healthcare operations environment
1-2 years experience in analysis of payor trends
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Ability to sit and work at a computer terminal for extended periods of time WORK
ENVIRONMENT
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions
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