Pacific Medical Data Solutions, a company of LifePoint Health, is a rapidly growing nationwide revenue cycle management services provider that has been offering high quality medical billing services since 2004. Headquartered in the Denver Tech Center, we offer a rewarding work environment with career advancement opportunities while maintaining a small company, employee-focused atmosphere.

We are looking for positive, energetic team members who want to grow with us!

We are currently searching for an Insurance Credit Specialist with professional billing expertise. Ideal candidates will be experienced and knowledgeable in the entire medical billing process. This position is eligible for remote work.

The Insurance Credit Specialist research, analyze, and resolve outstanding credit balance claims. Excellent position for a highly detailed, quick learner who enjoys working in a fast-paced working environment and enjoys partnering with others to provide outstanding customer/patient satisfaction and ensures work is completed timely and accurately.

The Insurance Credit Specialist must have the ability to review and analyze accounts and/or credit balance reports from insurance carriers and patients to include reviewing explanation of benefits, contacting insurance carriers for additional information, and communicating with insurance carriers to gather information.

This position requires fundamental knowledge of how insurance companies pay accordingly to contracts, how to read and interrupt an insurance explanation of benefits (EOB), and do precise follow-up with the insurance company via, phone, email, insurance web sites, etc. at an acceptable volume per day.

• Resolves both patient & insurance credit balance refunds (WEEKLY/DAILY/OTHER)
• Researches and resolves unapplied cash activity accounts.
• Documents any request or concern received via mail, e-mail, telephone, written correspondence, or in person on the patient’s account.
• Responsible for responding to insurance companies & patient requests for refunds in a timely manner (within 30 days of receipt in credit balance work list)
• Identifies the originating cause of the need for a refund and compiles a report of recurring issues to management.
• Responsible for correcting errors in the calculation and posting of insurance contractual adjustments.
• Maintains confidentiality of all protected health information (PHI)
• Performs all job functions in a manner consistent with PMDS expectations as defined in Pacific Medical Data Solutions’ Patient Accounting mission statement and values.
  Adheres to policies and procedures as required by Pacific Medical Data Solutions

Education

• High school graduate or equivalent (GED) required.
• Associate degree or bachelor’s degree in healthcare administration or another related field preferred

Experience

• Experience with analyzing explanation of benefits (EOBs) from various insurance companies/payers.
• One year of experience in insurance billing/insurance follow up for Medicare, Medicaid, commercial payers required.
• Medical terminology knowledge preferred.
• Knowledge of CPT / ICD-10 coding

Knowledge, Skills, Abilities

• Must have an enthusiastic and positive attitude.
• Excellent customer service skills
• Data entry skills and basic knowledge of Excel, Word, and Outlook preferred
• Possesses excellent organizational and time management skills.
• Must have strong problem solving, attention to detail accuracy skills.
• Demonstrates effective communication and interpersonal skills within a diverse population.
• Possesses ability to prioritize tasks, carry out assignments independently and within a team, and to practice good judgement.
• Demonstrates a commitment to organizational values by displaying a professional attitude and appropriate conduct in all situations.

Benefits

• Medical, Dental, and Vision
• 401k Retirement Plan
• PTO and EIB Pay
• Flexible Working Hours
• Remote work opportunity

Pay Range: $18 – 20/hour The final agreed upon compensation is based on individual education, qualifications, experience, and work location. This position is bonus eligible.