Insurance Specialist - Revenue Cycle
No salary listed
Junior
Louisville, KY, USA
In PersonOnly candidates residing in the Louisville Metro area will be considered.
Medical, Clinical & VeterinaryClinical Support & Patient Administration
About the job
Requirements
- A high school diploma or equivalent is required.
- Typing ability equivalent to 30 words per minute is required.
- Ability to communicate interpersonally and work effectively with others as a team is required.
- Ability to maintain accurate financial records and perform mathematical tasks is required.
- Knowledge of medical terminology, ICD-10 coding, and Current Procedural Terminology coding is required.
- Computer knowledge is required.
- At least two years of experience in a medical billing environment working with insurance and patient claims processing is required.
- Ability to maintain patient confidentiality and comply with corporate compliance requirements.
- Ability to use office equipment and perform typical office duties, including occasional lifting and carrying of medical records up to 10 pounds.
Responsibilities
- Complete insurance forms and CMS-1500 insurance claims according to insurer specifications.
- Maintain knowledge of billing requirements for Medicare, Medicaid, TRICARE, and commercial insurance, and monitor accounts for compliance with those requirements.
- Monitor CMS-1500 claims for demographic, Current Procedural Terminology, and charge accuracy.
- Monitor the current fee schedule and recommend updates in compliance with state and federal law.
- Assist insurance companies with account inquiries related to insurance benefits and coverage.
- Use computer systems and applicable keystrokes to electronically transmit claims and correct claims with minimal interruption.
- Maintain working knowledge of the physician billing system and PCN, retrieving information as needed for daily work.
- Follow up on unpaid insurance and patient claims by phone, fax, or mail.
- Identify patient-account overpayments and initiate refunds and adjustments in accordance with internal controls.
- Answer phones and assist patients, including geriatric patients and emancipated minors, as well as physician offices.
- Research line-item explanation of benefits statements for incorrect payment levels and work with insurance companies to ensure benefits and correct reimbursement through oral and written communication.
- Monitor and maintain controls for balancing purposes.
- Monitor appropriate diagnosis and procedure codes using ICD-9 and Current Procedural Terminology formats.
- Print, review, and mail insurance claims regularly as needed.
- Respond to or direct correspondence and maintain communication with providers and staff.
- Communicate problem areas to the accounts receivable manager.
- Perform special assignments and other duties as assigned.
Desired Qualifications
- Knowledge of evaluation and management procedural coding is preferred.
- Knowledge of Windows is preferred.
About the company
Seven Counties Services provides mental and behavioral health care, substance use treatment, and services for intellectual and developmental disabilities across seven Kentucky counties. It operates a network of clinics and programs where trained professionals assess needs, provide therapy and psychiatric care, and coordinate supports for individuals and families in the community. The organization differentiates itself through its regional focus, large staff, broad service mix, and accreditation by The Joint Commission. Its goal is to help the community flourish, one life at a time.
Company Size
1,001-5,000
Company Stage
Grant
Total Funding
$250K
Headquarters
Jeffersontown, Kentucky
Founded
1978
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Simplify's Take
What believers are saying
- Metro Council funded $1.15 million for the Louisville crisis center buildout in 2025.
- David Pankotai became CEO in January 2024, giving the organization a fresh operator.
- Crisis-center momentum aligns with Louisville's 2026 'rally' response strategy and 988 demand.
What critics are saying
- The 2024 data breach settlement covers 132,609 people and costs up to $1 million.
- Seven Counties faces ongoing insurance litigation from Scottsdale and MHRRG over coverage for J.T.'s death.
- If Medicaid reimbursement slips, the crisis-center model loses funding and service expansion stalls.
What makes Seven Counties Services unique
- Seven Counties Services is Kentucky’s CCBHC across Jefferson, Oldham, Bullitt, Shelby, Spencer, Trimble, and Henry.
- Its 24/7 crisis line and 24-hour mobile crisis team create high-acuity community coverage.
- A Louisville crisis center opening September 2026 adds walk-in stabilization and referral capacity.
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Benefits
- Flexible Work Hours