Insurance Specialist (FT) - LaVeta Surgical Center

Company: SCA Health
Location: Orange
Posted on: June 25, 2022

Job Description:

US-CA-Orange# of Openings: 1Category: OtherSystem ID: 21924Group Name: TGSOverviewSurgical Care Affiliates (SCA) is transforming specialty care in our communities. We relentlessly create value by aligning physicians, health plans and health systems around a common goal: delivering exceptional care and healing to our patients and communities we serve. We are driven to achieve the quadruple aim in health care: high quality outcomes and a better experience for patients and providers, all at a lower total cost of care. As a national leader in surgical care, SCA's 11,000 teammates operate more than 260 surgical facilities that serve over 1 million patients per year. For more information on SCA, visit www.scasurgery.com.Why join SCA? Consider the following fantastic benefits...Positive work cultureCareer growth opportunitiesComprehensive medical, vision and dental insurance - eligible on Day 1 of employmentPaid time off plus 8 paid holidaysMaternity/paternity/adoption benefitsEmployer-paid life and short- and long-term disability insuranceExcellent 401(k) Plan Accountabilities / ResponsibilitiesAssures prompt, accurate credit balance research of patient accounts.Processes refunds and initiates insurance check refunds requests in Accounts Payable system.Sends overpayment letters series to carriers that have overpaid per contract.Reviews and validates written requests received from insurances.Submits payer disputes as needed.Answers calls and inquiries from third-party carriers in reference overpayments or refunds requests.Follows up on all outstanding credit accounts.Calculate and verify expected pay based on contractual allowances for multiple payers.Documents all work performed in patient accounting system.Review of patient account history and notes to determine next step required for resolution per company guidelines.Process contractual adjustment requests as needed to correct account balances.Promptly processes all government refunds within timelines.Runs monthly credit reports to verify that checks issued have been posted.Performs all other duties as assigned by supervisor. QualificationsExcellent telephone skills & Customer Service SkillsHigh level of self-organization and trackingWorks independently, is a self-starter with a high level of initiativeStrong communication skills, both verbally and in writingPossesses accurate judgement, especially handling insurance claims and dealing with patient accounts. Versatile and willing to coordinate with and participate in, when necessary, all other aspects of the Business Office.Ability to handle confidential information. Possess basic knowledge of medical terminology.Possess knowledge of health insurance billing. Read and interpret EOBs and can calculate expected allowances based on payer contracts to determine reason for balance.Possess knowledge of typing, word processing, spreadsheet and computer billing systems.Must be dependable and reliable.Ability to multi-task, think critically, and solve problemsOne or more years' experience in a related position working in a medical office, hospital, outpatient surgery center or related field with core duties related to medical insurance collections, billing, accounts receivable, A/R, collecting payments, collecting re-imbursements, or related training/certificates/diplomasPI181456880

Keywords: SCA Health, Orange , Insurance Specialist (FT) - LaVeta Surgical Center, Healthcare , Orange, California