Insurance Specialist – CPAR Required

🔥 2 hours ago

🇬🇪 Georgia – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔒 Insurance

👻 Ghost score 10%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Northeast Georgia Health System

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

Northeast Georgia Health System is a healthcare organization dedicated to improving the health of the community it serves. With a presence that includes 5 hospitals, 6 urgent care locations, and more than 110 doctor's offices, imaging centers, cancer treatment centers, and laboratories, the system offers a comprehensive range of medical services. It provides career opportunities in various areas, including nursing, allied health, and support services, as well as residencies and fellowships for healthcare professionals. The organization is committed to its mission through adherence to core values, offering employee benefits, and engaging in community activities. With locations providing access to both metropolitan and natural amenities, it emphasizes quality of life for employees and residents in Northeast Georgia.

📋 Description

• Serve as a key contact for patient questions related to insurance claims, denials, coding, re-determinations, attorney settlements, and retro authorizations • Resolve credit balances and pay discrepancies by reviewing prior billing activity and correcting errors • Act as a subject matter expert on payer guidelines, underpayment recovery, aged denial resolution, and claim adjudication • Verify and update patient insurance coverage and rebill claims as appropriate • Review and update patient accounts and insurance coverage • Meet or exceed quality and productivity standards set by SPRC leadership • Follow scripting and departmental guidelines to ensure quality service • Research and resolve patient inquiries by phone and electronic messages, deescalating complaints and escalating when appropriate • Attend weekly, monthly, quarterly, annual, and department meetings • Work with patients and guarantors to find or add insurance, third-party sponsorship, and settlements • Maintain understanding of health insurance, EOBs, collection processes and techniques, and NGHS Financial Assistance Programs • Perform other assigned duties, including work queues, itemized statement requests, Detail Bills, 1500s, and UBs • Contribute positively to departmental teamwork, ideas, problem-solving, and identifying billing and customer satisfaction trends • Liaise with patients and payers to resolve billing issues, obtain documentation, and review EOBs for payment accuracy • Contact insurance companies by telephone and websites to reprocess aged facility and professional claims • Identify and correct posting errors, underpayments, and denials within the appeal window; resubmit claims for late charges and other issues

🎯 Requirements

• Certified Patient Account Representative (CPAR) required • Certified Professional Biller (CPB) or Certified Professional Coder (CPC); CPB or CPC can be obtained within one year of hire • High School Diploma or GED • Minimum 3 years of medical billing and/or medical coding experience • Knowledge of Revenue Cycle functions, including registration, coding/charge posting, payment posting, and financial assistance • Thorough knowledge of patient collections, billing regulations, denial follow-up procedures, and interpreting EOBs • Personal computer proficiency and ability to toggle between systems efficiently • Strong listening, problem-solving, and customer service skills • Excellent verbal and written communication skills and telephone proficiency • Ability to work independently within guidelines • Thorough knowledge of HIPAA regulations • Ability to read, write, reason, talk, and use a keyboard • Ability to occasionally lift and carry up to 20 lbs

🏖️ Benefits

• Equal Opportunity Employer statement and nondiscrimination commitment • Opportunities to reach personal and professional goals • Remote work arrangement

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