Insurance Specialist

About the Role<br /><br />Are you detail-oriented, analytical, and passionate about supporting a smooth healthcare operation? We are looking for a Patient Accounts &amp; Billing Specialist to join our team in Newton, KS. In this role, you will play a crucial part in our financial health by managing the end-to-end medical billing, claiming, and collections process. You will work closely with internal teams, third-party vendors, and insurance companies to ensure accurate reimbursement while contributing to a supportive, positive work culture.<br />If you thrive in a collaborative environment, value accuracy, and love solving puzzles inside spreadsheets and billing platforms, we want to hear from you!<br />Key Responsibilities<br /><br />Claiming &amp; Billing Accuracy<br /><br />Collaborate with third-party billing vendors, internal teams, and Patient Account Specialists to gather missing or corrected information required for billing, statements, and reimbursement.<br />Support special projects aimed at optimizing billing workflows, maximizing reimbursement, and ensuring claims are paid timely and correctly.<br /><br />Insurance Correspondence &amp; Collections<br /><br />Proactively follow up on outstanding claims with vendors and internal teammates to facilitate timely payments.<br />Manage insurance correspondence: process denials, apply appropriate discounts or refunds, and coordinate with Financial Counselors and Medical Records for required documentation.<br />Act as a resource for Patient Account Specialists regarding insurance eligibility, coverage details, and payment discrepancies.<br /><br />Payment Posting<br /><br />Accurately post assigned payments from insurance companies, third-party funding sources, contracts, and self-pay accounts.<br />Identify and communicate any insurance eligibility changes or specific denial trends to Patient Account Specialists.<br /><br />Systems &amp; Platforms<br /><br />Navigate and interpret account ledgers to accurately post charges, payments, and corrections within MyAvatar.<br />Utilize various healthcare websites and clearinghouses, including Waystar, Availity, WPS/GHA, KMAP, and secure SFTP portals.<br />Efficiently organize, track, and work accounts, payments, and claims using Excel spreadsheets.<br /><br />Professional Development &amp; Team Collaboration<br /><br />Actively participate in staff meetings and collaborate with your supervisor to build a personalized professional development plan.<br />Attend workshops, continuing education activities, and required in-service training to sharpen your billing expertise.<br />Complete assigned training modules via the Relias Learning platform to maintain compliance and enhance your skill set.<br />Maintain flexibility, accuracy, and a standard of excellence as department needs evolve, always bringing a team-oriented, cooperative attitude to the workplace.<br /><br />Qualifications &amp; Skills<br /><br />Experience: Previous experience in medical billing, healthcare accounts receivable, or insurance collections is highly preferred.<br />Technical Savvy: Proficiency with electronic health records/billing systems (experience with MyAvatar, Waystar, Availity, or KMAP is a major plus) and strong familiarity with Microsoft Excel.<br />Core Competencies: High attention to detail, strong problem-solving skills, dependability, and the ability to read and interpret financial ledgers.<br />Communication: Excellent verbal and written communication skills for working with internal departments, external vendors, and insurance representatives.<br />Why Join Us?<br /><br />We believe that a positive work environment starts with our people. We offer a supportive team structure, opportunities for continuing education and professional growth, and the chance to make a meaningful impact on healthcare delivery right here in Newton.<br /><br />#J-18808-Ljbffr