Muskegon, MI

We have an exciting opportunity for an Insurance Specialist to work at Shoreline Vision, a fast paced, multi-specialty ophthalmology practice. We are looking for a career oriented individual who is dependable, friendly, a multi-tasker, and flexible.

The primary responsibilities for the Insurance Specialist include; processing, reviewing, and filing insurance claims; accounts receivable; and working closely with other insurance specialists and interacting with clinical team members.

Essential Functions

  • Reviews and verifies insurance claims.
  • Works claims, denials, and rejections with insurance companies.
  • Processes and bills insurance claims to all designated payers.
  • Follows-up with insurance companies to ensure claims are paid.
  • Resubmits insurance claims that have received no response.
  • Actively works all Accounts Receivable.
  • Posts all incoming insurance and patient payments to appropriate accounts. Such payments include: checks, cash, credit cards, money orders, and Care Credit.
  • Submits refund requests when appropriate.
  • Answers and screens telephone calls, takes messages, and provides information regarding accounts to patients, insurance payers, and third party vendors.
  • Answers patient questions and concerns by phone and at the front desk.
  • Works collection accounts and follows up on status.
  • Balances out daily cash and checks received.
  • Maintains HIPPA standards and patient confidentiality. Adheres to office policies and procedures and works within Administrator’s compliance plan standards,
  • Performs other duties as requested.

Skills & Experience

  • Proficient with Microsoft Office Suite (Excel and Word).
  • Strong communication and interpersonal skills.
  • Must be well-organized, a team-player, and have a great attention to detail.
  • Minimum of two years of experience in a medical office insurance department – working claims, denials, and rejections required.
  • Certificate and/or degree in Insurance Billing or Insurance Coding is preferred.

We Offer

  • Comprehensive benefits including medical, dental, vision, life and disability insurance, 401(k), paid time off, and paid holidays.
  • Career experiences that provide team members with opportunities for personal and professional growth in a rewarding work environment.

**We are an equal opportunity employer**

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