Medical Insurance Specialist

Organization Overview, Mission, Vision and Values

Washington Regional Medical System (the “System”) is our region’s only locally governed, community-owned, not-for-profit healthcare system. The System includes a 425-bed acute care hospital known as Washington Regional Medical Center (the “Hospital”) which is located in Fayetteville, Arkansas. The Hospital is supported by the System- including primary, specialty and urgent care operations - that span across Northwest Arkansas into Harrison and Eureka Springs. Being heavily supported and invested in our community makes Washington Regional a unique employer, encouraging staff to give back to the community in which we live and work … and give back to each other.

Washington Regional Mission, Vision and Values prove to be a firm foundation and inspiration from which we fulfill our purpose.

Mission: Washington Regional is committed to improving the health of people in communities we serve through compassionate, high quality care, prevention and wellness education.

Vision: To be the leading healthcare system in Northwest Arkansas --- the best place to receive care and the best place to give care.

Values: To treat others – patients and their families, visitors, physicians, and each other – as we would want to be treated.

Position Summary

The role of the Insurance Claims Analystreports to the corresponding Insurance Billing Manager. This position is responsible for providing exceptional billing and AR follow up of Washington Regional Hospital and Clinic claims. This position oversees research and resolution of insurance billing issues at the time of claims submission, receipt of denial or non-contracted payment, and refund requests. This position must have the ability to learn and understand multiple software systems.

Essential Position Responsibilities

· Review and research insurance denials receive through insurance remittances, payor correspondence, or Clearinghouse rejections in an accurate and timely manner

· Respond appropriately to payor denials through written and/or verbal appeals processes for payor specific denials

· Provide effective communication with patients, insurance companies, and staff

· Maintain AR collection of claims at less than 30 days of account age

· Collaborate with necessary departments to ensure overall account accuracy and issue resolutions

· Reconcile transactions to ensure payments are balanced

· Provide timely and efficient follow-up on all outstanding AR using assigned ATB worklist reports, using various systems including: Payor portals, Payor phone inquiries and/or written communications

· Assigned to specific insurance(s) and providers/specialties but expected to learn on the job other insurances and specialties for career growth

· Maintain current assigned insurance(s) guidelines, policies, and procedures related to payment of claims

Qualifications

• Education: High School graduate or GED
• Licensure and Certifications: N/A
• Experience:

o Previous billing and claims experience within a hospital and/or clinic business office with 2+ year experience, preferred.

o Basic working knowledge of the MS Office suite of software, and the ability to operate standard office equipment.

o Broad knowledge of medical terminology, medical collections, MS-DRG coding methodology, ICD-10 and CPT coding, preferred.

Work Environment: This position will spend 80% of time sitting while performing work in a standard office environment and 20% of time standing and/or walking while pushing, pulling, lifting, and/or carrying up to 50 lbs.

Job Type: Full-time

Pay: $36,375.68 - $43,807.27 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Weekly day range:

• Monday to Friday

Ability to Relocate:

• Fayetteville, AR 72703: Relocate before starting work (Required)

Work Location: In person