The Insurance Information Coordinator supports our Denial Management department by gathering and disseminating information from hospitals, physicians, and insurance companies pertaining to referred claims.

Experience with medical insurance claims is a plus.

Duties and Responsibilities

• Verify members’ benefits, effective dates, claims, and appeal information with insurance companies
• Research claims and insurance information in hospital databases
• Document reason for denial of each claim in Firm’s database
• Ascertain time frames in which claims must be appealed
• Provide daily/weekly updates to management
• Assist Appeal Writers and management with required data collection
• Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards

Qualifications

• College Degree required
• Clear, concise verbal and written communication skills
• Must be detail-oriented and flexible in a consistently evolving role with new challenges
• Excellent analytical skill set and the ability to recognize patterns and trends
• Excellent research and problem solving skills
• Comfortable spending 50% of day on the telephone
• Proficiency in Microsoft Office applications (Outlook, Word, and Excel)

Working Conditions

• Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
• Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.
• Work Environment: The noise level in the work environment is usually minimal.

Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.