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Insurance Reimbursement Specialist

Urology Specialists

Sioux Falls, SD

Posted/Updated: 19 days ago

Job Description

Urology Specialists is a busy independent practice located in southeastern Sioux Falls.  Our group consist of nine board certified urologists and eleven mid-levels.  We offer the highest quality of comprehensive urological care in the region. 

Job Description

We have an OPEN position in our Billing Department. We are looking for a fulltime Insurance Reimbursement Specialist. Here are a few details:

This position would work in a team environment to interpret and evaluate appeals including denials management, insurance follow-up with payers and insurance providers, to assure timely turn around for claims resolution and reimbursement. 

Other tasks include, but are not limited to:

  • Identifies and resolves patient billing complaints.
  • Answers incoming phone calls or in person contacts with patient regarding account.
  • Participates with other staff to seek account resolution and help work denials.
  • Serves as liaison with insurance companies to resolve pending claims.   
  • Initiates all billing processes to include primary and secondary insurance claims, workers compensation and paper claims.                 
  • Research overpayments due to patient and insurance company.
  • Complete insurance verification process.
  • Processes referral requests and obtains referrals when necessary.
  • Communicates denials and high deductible information to appropriate Billing staff.  

Education and Training requirements:

  • High School Diploma or GED
  • Minimum 1 year medical billing experience in a physician office setting with knowledge of various medical payer practices and insurance laws/guidelines (Medicare, Medicaid, Work Comp, VA, and other third-party payers)
  • Experience with EHR and electronic claims preferred
  • Basic knowledge of CPT and ICD-10 coding principals

This position is full-time. Business office hours are Monday - Friday, 8 am - 5 pm (with a 1/2 day off per week). We offer a competitive compensation and comprehensive benefits package including health, dental, vision, 401K, life insurance, AD&D, short and long-term disability, PTO, sick leave, and paid holidays.