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Insurance Verification Specialist II

Nemadji Research Corporation is seeking an Insurance Verification Specialist II for full time employment Monday - Friday. This position participates in all the main function of the production process including match, selection, account verification, eligibility inquiries, and may assist with obtaining proof of coverage and/or various duties supporting medical billing.

Job Responsibilities:

Identity Verification

  • Reviews and selects appropriate eligibility for claims submission.

Account Verification

  • Verifies account statuses to determine appropriateness for pre-billing/billing.
  • Navigates hospital and eligibility systems remotely to investigate account status.

Eligibility Discovery

  • Requests and obtains documentation of patient’s coverage via phone calls, web inquiries, and written requests.
  • Performs data entry for selected project functions.
  • Communicates effectively with external entities such as payers, Social Security, etc.

Remittance Advice Match (RA Match)

  • Matches claim adjudication records to service records.
  • Utilizes information contained in the record as well as information from the hospital system to determine if the remittance record should be linked to the service record.

Qualifications:

  • High School Diploma and 2 + years’ experience in a related field.
  • Experience with billing claims in a medical setting.

Preferred Qualifications:

  • Knowledge of and ability to work with hospital registration, billing and/or accounting systems.
  • Good problem-solving, time management and organizational skills.
  • Proficient in the use of Excel, Word, and Outlook.
  • Ability to work independently and with a team in a fast-paced and high volume environment with an emphasis on accuracy and timeliness.
  • Ability to communicate effectively verbally and in writing.
  • Ability to interact with co-workers and clients in a professional manner.

 

Send resumes & application requests to:

Nemadji Research Corp

Attn: HR

PO Box 100

Bruno, MN 55712

(320) 838-3838

hr@nemadjiresearch.com

EEO/AAP Employer

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