ECLARO · 2 weeks ago
Insurance Specialist
Chapel Hill, NC
Contract
Onsite
Mid Level
$24/hr - $24/hrECLARO is seeking an Insurance Specialist who will provide dental and medical insurance services. This role involves managing billing and reimbursement processes, collaborating with private insurance carriers, and ensuring compliance with industry standards and regulations.
Staffing & Recruiting
Hiring Manager
Jan Lester Candilado, RPm
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
Qualification
Required
Specialized knowledge of insurance industry standards related to billing and reimbursement
Strong understanding of accounts receivable
Comprehensive understanding of dental and medical terminology
Knowledge of dental procedural and diagnostic coding
Experience with medical-dental cross-coding
Familiarity with electronic claims processing
Understanding of policies and contracts of multiple insurance vendors
Ability to file dental insurance claims and pre-treatment estimates for privately insured patients
Ability to obtain and provide clinical documentation necessary for claims processing
Experience investigating denied claims and submitting appeals
Ability to verify essential documentation including insurance cards and explanations of payment
Experience auditing patient records for accuracy and completeness of billing, coding, and clinical documentation
Effective communication skills
Deductive reasoning skills
Compliance with HIPAA regulations
Benefits
Dental and medical insurance
Company
ECLARO
ECLARO is an award-winning professional services firm headquartered in New York City and operating in the U.S., Canada and the Philippines.
Founded in 1999
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Nicholas Butcher
QA CTO Label Specialist
Dan Broderick
Chief Delivery Officer
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