Job Title: Insurance Specialist
Job Location: Chapel Hill, NC
Job Duration: 3-4 Months (possibility of extension)

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.
• 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.

Job Responsibilities:

• 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.
• Regularly auditing patient records for accuracy and completeness of billing, coding, and clinical documentation.
• Extensive communication with various insurance companies.
• Effective use of insurance portals.
• Other duties as assigned.

Skills/Qualifications:

• Effective communication and deductive reasoning are essential skills.
• Compliance with HIPAA regulations is mandatory.