Medical Insurance Specialist

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🔥 0 minutes ago

🌵 Arizona, Florida, +2 more states – Remote

🌵 Arizona – Remote 🐊 Florida – Remote 🏈 Ohio – Remote 🎸 Tennessee – Remote

⏰ Full Time

🟢 Junior

🔒 Insurance

🚫👨‍🎓 No degree required

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Kroger

WebsiteLinkedInAll Job Openings

10,000+ employees

🛒 Retail

🍽️ Food & Beverage

💰 $10.5G Post-IPO Debt - Kroger on 2024-08

Retail • Food & Beverage

Kroger is one of the largest supermarket chains in the United States (NYSE: KR). Kroger operates roughly 2,700 stores across 35 states, serves about 11 million customers daily, and employs approximately 400,000 associates. The company sells groceries and related consumer goods through national and private-label brands, operates manufacturing and distribution facilities, and offers omnichannel shopping (pickup, delivery, digital rewards and memberships). Kroger also runs community and sustainability programs such as Zero Hunger | Zero Waste and donates meals to communities.

📋 Description

• Analyze, audit and resolve claims outstanding, denied, or incorrectly paid • Review and respond to payer correspondence • Submit appeals as needed for denied claims • Contact insurance companies and navigate payer websites to secure and expedite insurance payments • Resolve patient billing inquiries • Document in detail all actions taken in the accounts receivable system • Meet productivity expectations as outlined by supervisor • Recognize, document and notify Team Lead of trends resulting in nonpayment or incorrectly paid claims • Answer and resolve inbound calls from insurance carriers • Participate in process improvement initiatives as needed • Keep current with Medicare and other third-party administrator regulations and procedures • Manage special projects requested by supervisor or team lead • Perform essential functions with or without reasonable accommodation

🎯 Requirements

• High school diploma • 1+ year of insurance follow-up including working knowledge of the appeals resolution process • Strong written, and oral communication skills • Analytical and problem solving capabilities with close attention to detail • Excellent organizational and follow-up skills • Thorough working knowledge of revenue cycle management including medical terminology, ICD-9, ICD-10, CPT-4 coding, Medicare reimbursement guidelines, billing and collection practices • Ability to read and interpret EOB's • Highly self-motivated, with ability to work independently and meet deadlines • Ability to remain flexible during times of change and adjusts promptly and effectively • Must be able to learn, understand, and apply new technologies • Must reside in TN, AZ, FL, GA, or OH