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Become An Insurance Specialist

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Working As An Insurance Specialist

  • Identifying Objects, Actions, and Events
  • Interacting With Computers
  • Getting Information
  • Documenting/Recording Information
  • Processing Information
  • Unpleasant/Angry People

  • Mostly Sitting

  • Make Decisions

  • Stressful

  • $45,368

    Average Salary

What Does An Insurance Specialist Do At Kelly Services

* As necessary, the Patient Access Representative II may also perform quality audits and negotiate pricing.
* This position requires highly developed interpersonal and communication skills to successfully interact with patients, pharma, physicians and payers to complete the verification process.
* Will contact insurance payers to verify patient eligibility and drug benefits within required time frames to ensure services provided will be reimbursable.
* This process includes processing test claims via the company's system, or checking various databases that can provide the patients benefits.
* Will obtains Prior Authorizations from payers; including coordination with the physician and the insurance company.
* Reviews benefit plan design, contract specifics and clinical criteria

What Does An Insurance Specialist Do At Assurant

* _
* Responding to incoming customer inquiries in a high volume inbound call center environment via telephone or in writing.
* This position will receive 70 to 100 calls per day.
* Supporting processing functions such as issuing insurance policies, certificates, endorsements, and cancellations for
* clients, customers, and agents.
* Identifying, analyzing, and resolving customer and client processing problems or errors that include department premium
* discrepancies and system problems.
* Communicating with external clients as well as internal departments.
* This is a full time position.
* Hours of operation are Monday through Saturday from 8:00am to 8:00pm

What Does An Insurance Specialist Do At Rushmore Loan Management Services

* Ensures all PMI vendor bills are reconciled and paid monthly
* Complete monthly FHA billing and reconciliation
* Monitor and review loans scheduled for auto termination of PMI
* Review and respond to requests for early cancellation of PMI
* Research and respond to research requests
* Research and respond to audit inquiries
* Work with PMI vendors to ensure that PMI is maintained properly
* Ensure that PMI data is loaded correctly
* Performs other duties as assigned
* ESSENTIAL KNOWLEDGE

What Does An Insurance Specialist Do At Tarrant County Government

* Enters and analyzes coding diagnoses, procedures, and modifiers in order to bill or resolve billing and/or coding issues, rejections, denials, and appeals.
* Communicates with Medicaid, Medicare and commercial insurance carriers to resolve claim errors.
* Reviews billing charges and other data for accuracy and potential reimbursement enhancement.
* Creates, posts, generates, compiles, runs, reviews, and summarizes billing, revenue cycle management, and reimbursement reports.
* Obtains complete diagnosis information to ensure proper code assignment.
* Responds to questions from insurance companies and clients.
* Keeps up-to-date on coding guidelines.
* Performs all other duties as assigned

What Does An Insurance Specialist Do At Us Anesthesia Partners

* Track denials for problem areas.
* Process and follow up on appeals to insurance companies
* Call or check electronically to verify eligibility and or claim status
* Where appropriate obtain repricing from repricing agent and forward claim to correct payor.
* Call hospital and/or surgeon or patient to verify correct information
* Knowledge of insurance contracts to ensure proper payment according to contracted fee schedule.
* Manage clearing house denial and rejected claims daily.
* Run weekly reports of underpaid, unpaid or rejected claims.
* Employee will adhere to company Corporate Compliance policy.
* In so doing employee must report
* to immediate supervisor anything that violates the compliance policy.
* Willingness and ability to follow directions and or company policy as directed by supervisor.
* Work outstanding accounts receivable from collector que with proficiency.
* Must be able to work 50 accounts daily.
* Maintain accuracy rating of 90% or greater on audited accounts.
* OTHER DUTIES:
* Request records when necessary to file claims.
* Refile claims not on file.
* Obtain face sheets, charge sheets and make corrections in system where necessary.
* Call insurance companies for clarity or corrections on EOBs’.
* Attend seminars and in-services provided by various insurance carriers where applicable.
* Review journal to include rebilling of accounts, contacting insurance companies and surgeons, working appeals, printing scanned EOBs’.
* Follow-up on denials, make notes in system and change FC where appropriate.
* Update billing cycle, send statement reminders, and change accounts to patient responsibility.
* Follow-up with insurance corrections or changes to other departments.
* Send paper documentation to insurance carriers (face sheets, anesthesia record).
* Know contract limits.
* Qualifications

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How To Become An Insurance Specialist

A high school diploma or equivalent is typically required for a person to work as an entry-level claims adjuster, examiner, or investigator. Higher level positions may require a bachelor’s degree or some insurance-related work experience. Auto damage appraisers typically have either a postsecondary nondegree award or work experience in identifying and estimating the cost of automotive repair.

Education

A high school diploma or equivalent is typically required for a person to work as an entry-level claims adjuster, examiner, or investigator. However, employers sometimes prefer to hire applicants who have a bachelor’s degree or some insurance-related work experience or vocational training. Auto damage appraisers typically have either a postsecondary nondegree award or experience working in an auto repair shop, identifying and estimating the cost of automotive repair.

The varying types of work in these occupations can require different backgrounds or different college coursework. For example, a business or an accounting background might be best for someone who wishes to specialize in claims of financial loss due to strikes, equipment breakdowns, or merchandise damage. College training in architecture or engineering is helpful for adjusting industrial claims, such as those involving damage from fires or other accidents. A legal background is beneficial to someone handling workers’ compensation and product liability cases. A medical background is useful for examiners working on medical and life insurance claims.

Although auto damage appraisers are not required to have a college education, most companies prefer to hire people who have the formal training, experience, or knowledge and technical skills to identify and estimate the cost of automotive repair. Many vocational schools and some community colleges offer programs in auto body repair and teach students how to estimate the cost of repairing damaged vehicles.

For investigator jobs, a high school diploma or equivalent is the typical education requirement. Most insurance companies prefer to hire people trained as law enforcement officers, private investigators, claims adjusters, or examiners, because these workers have good interviewing and interrogation skills.

Training

At the beginning of their careers, claims adjusters, examiners, and investigators work on small claims, under the supervision of an experienced worker. As they learn more about claims investigation and settlement, they are assigned larger, more complex claims.

Auto damage appraisers typically get on-the-job training, which may last several months. This training usually involves working under the supervision of a more experienced appraiser while estimating damage costs, until the employer decides that the trainee is ready to do estimates on his or her own.

Licenses, Certifications, and Registrations

Licensing requirements for claims adjusters, appraisers, examiners, and investigators vary by state. Some states have few requirements; others require either completing prelicensing education or receiving a satisfactory score on a licensing exam (or both).

In some states, claims adjusters employed by insurance companies do not have to become licensed themselves because they can work under the company license.

Public adjusters may need to meet separate or additional requirements.

Some states that require licensing also require a certain number of continuing education credits per year to renew the license. Federal and state laws and court decisions affect how claims must be handled and what insurance policies can and must cover. Examiners working on life and health claims must stay up to date on new medical procedures and the latest prescription drugs. Examiners working on auto claims must be familiar with new car models and the most recent repair techniques. In order to fulfill their continuing education requirements, workers can attend classes or workshops, write articles for claims publications, or give lectures and presentations.

Important Qualities

Analytical skills. Adjusters and examiners must both evaluate whether the insurance company is obligated to pay a claim and determine the amount to pay. Adjusters must carefully consider various pieces of information to reach a decision.

Communication skills. Claims adjusters and investigators must get information from a wide range of people, including claimants, witnesses, and medical experts. They must know the right questions to ask in order to gather the information they need.

Detail oriented. Adjusters, appraisers, examiners, and investigators must carefully review documents and damaged property, because small details can have large financial consequences.

Interpersonal skills. Adjusters, examiners, and investigators often meet with claimants and others who may be upset by the situation that requires a claim or by the settlement the company is offering. These workers must be understanding, yet firm with their company’s policies.

Math skills. Appraisers must be able to calculate property damage.

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Insurance Specialist jobs

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Real Insurance Specialist Salaries

Job Title Company Location Start Date Salary
Property Insurance Specialist Worldwide Facilities, Inc. Johns Creek, GA Sep 26, 2012 $70,000 -
$95,000
Insurance Specialist The W Insurance Marketing Corporation Fremont, CA Oct 01, 2012 $60,000
Insurance Specialist W Insurance Marketing Corporation Fremont, CA Oct 01, 2012 $60,000
Equine Insurance Specialist Yearsley Bloodstock Insurance Lexington Ltd Lexington, KY Jul 10, 2011 $60,000
Insurance Specialist Marsh USA Inc. New York, NY Jul 28, 2014 $55,000 -
$65,000
Financial Analyst/Insurance Specialist Sigalit Biton CA Nov 18, 2010 $52,572
Financial Analyst/Insurance Specialist Sigalit Biton CA Nov 29, 2010 $52,572
Insurance Specialist Andritz Inc. Alpharetta, GA Sep 20, 2015 $45,368
Insurance Specialist Andritz Inc. Roswell, GA Nov 08, 2013 $43,500
Insurance Specialist Andritz Inc. Canonsburg, PA Jan 01, 2013 $43,500
Insurance Specialist Andritz, Inc. Roswell, GA Sep 20, 2012 $43,500

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Top Skills for An Insurance Specialist

InsuranceCompaniesCustomerServiceInsuranceClaimsFinancialMedicalClaimsMedicaidDataEntryInsurancePoliciesFollow-UpInsuranceCoverageAutoInsuranceInformationMedicalRecordsCPTLifeInsuranceInsuranceBenefitsPatientAccountsEOBInsuranceVerificationInsurancePayments

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Top Insurance Specialist Skills

  1. Insurance Companies
  2. Customer Service
  3. Insurance Claims
You can check out examples of real life uses of top skills on resumes here:
  • Responded to correspondence from insurance companies.
  • Clarified insurance requirements to personnel in the field and/or customers when needed providing excellent customer service.
  • Processed and provided assistance to homeowners with insurance claims via telephone.
  • Conducted strategic financial analyses with prospective clients to determine benefit needs.
  • Examined denied and underpaid medical claims to determine discrepancies.

Top Insurance Specialist Employers

Insurance Specialist Videos

Medical Coding and Billing Career: Is It Right For You?

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