Verify Medicare, Medicaid, and commercial insurance eligibility
Submit and process clean claims (manual or electronic) on CMS1500 forms
Enter accurate patient account data to ensure timely and correct billing
Correct insurance or charging errors to support claim submission
Follow up on outstanding receivables, resolve discrepancies, and file appeals or disputes
Resubmit denied or underpaid claims in a timely and compliant manner
Stay up to date with government and private payer regulations and coverage requirement
Communicate directly with payers via phone, email, and portals to resolve claim issues
Request and submit necessary documents including prior authorizations, letters of medical necessity, prescriptions, and letters of non-coverage
Maintain compliance with HIPAA and protect sensitive patient information
Monitor and manage office inventory and supplies; reconcile purchase orders and packing slips
Collaborate with management to reduce denials and accounts receivable
Answer phones and assist patients with scheduling or insurance-related questions
Support team members with special projects or other administrative tasks as needed

High school diploma or equivalent
Strong interpersonal and customer service skills
Solid organizational and multitasking abilities
Comfortable with computers, data entry, and insurance portals
Experience in medical billing, claims processing, or insurance verification is a plus
Familiarity with CMS1500 claim forms, HIPAA, and insurance denials preferred

Insurance Coordinator

About this role