Insurance Exception Processor

Insurance Exception Processor

Mortenson Dental Partners

Job ID: 9549

Job Type: Full Time

Location: 10300 Linn Station Rd, Louisville, KY 40223

Insurance Exception Processor is responsible for posting all nonautomated payments to patient ledgers. These are the claim exceptions and include, but not limited to, claims with dual carriers, downgrades, bundles, and denials. Must analyze the ERA(s) to determine the correct contract obligation for each claim. Assists with denial management by determining the cause of the denial and communicating that information to the practice staff. Ensures the accuracy of all data entry. May assist supervisors in strategic or managerial projects as necessary. Provides efficient, courteous and quality customer service to both internal and external customers. Other responsibilities as required.

• Benefits available after 60 days of employment
• Medical, dental, and vision insurance with company contribution
• Life Insurance
• Flexible spending (health and dependent care) account
• Paid Time Off & 6 paid holidays off
• Employee Stock Ownership Plan
• 401K
• Daily Pay
• Professional development assistance
• FREE continuing education opportunities
• Employee assistance program

Responsibilities:

• Analyzes ERA for claims that did not auto post for cause. Posts insurance
  payments for claims with exceptions and accurate contract obligations to specific
  procedure codes on the patient ledgers. Meets daily quality and timing standards.
• Contact insurance carriers when necessary to assist with claim payment. This may include, but not limited to, calling with seat dates, calling with COB information, or
  calling to determine specific denial reasons. Retrieves EOBs from carrier websites
  when the ERA is not sufficient to post accurately.
• Direct the practice on actions that should be taken to reprocess the claim to
  result in payment. Update SARA with all pertinent information including denial
  reasons.
• Audits the SARA report to ensure all payments are applied before the month end
  process is complete.
• Supports other insurance specialists, supervisors and managers in times of
  heavy claim influx.

Requirements:

• High School Diploma or equivalent
• Customer Service
• Computer, copier, fax, telephone
• Dental practice management software (Preferred)