Job Title: Insurance Specialist
Location: Chapel Hill, NC 27514
Duration: 03 Months+ (High Possible for Extension)

Contract Type: Contract

Job Summary:

• This Insurance Specialist position offers both dental and medical insurance services for the client.
• The Insurance Specialist works in all areas of billing and reimbursement, including private dental insurance companies and managed care organizations.
• This role requires specialized knowledge of insurance industry standards related to billing and reimbursement, along with a strong understanding of accounts receivable.

Responsibilities:

• This position collaborates closely with private insurance carriers, particularly those contracted with the clinics. It also requires a comprehensive understanding of dental and medical terminology, dental procedural and diagnostic coding, medical-dental cross-coding, electronic claims processing, and the policies and contracts of multiple insurance vendors.
• The responsibilities of this role include filing dental insurance claims and pre-treatment estimates for privately insured patients; obtaining and providing the clinical documentation necessary for claims processing, such as x-rays, chart notes, and letters of necessity; investigating denied claims, following up on those investigations, and submitting appeals for those denied claims; verifying essential documentation including insurance cards, insurance explanations of payment, provider narratives, and insurance consent; and regularly auditing patient records for accuracy and completeness of billing, coding, and clinical documentation.
• This position will require extensive communication with various insurance companies, along with effective use of insurance portals.
• Effective communication and deductive reasoning are essential skills. Compliance with HIPAA regulations is mandatory. Other duties as assigned.