Associate Insurance Representative

Role Overview

• Processes and monitors unpaid third party insurance, Medicare, Medicaid or government-assisted program accounts for proper reimbursement
• Prepares and submits claims to payers either electronically or by paper
• Secures necessary medical documentation required or requested by payers
• Performs account follow-up on outstanding insurance balances and takes the necessary action for account resolution in accordance with established federal and state regulations
• Processes daily workflow changes that may include eligibility verification, verification of information, payment postings, initiating refunds, processing month end, resolving and troubleshooting incidents, reporting, initial billings and re-billings of claims, scanning and indexing of documents, and providing assistance as needed
• Responsible for assuring accounts are set up correctly with the information available, completed timely and accurately
• Completes work within authorized time to assure compliance with departmental standards
• Keeps updated on all state/federal billing requirements and changes for insurance types within area of responsibility
• Understands edits and appropriate department procedures to effectively submit and/or correct errors on claims
• Processes and resolves denials that are technical in nature (i.e.: records required denials)
• Performs miscellaneous job related duties as requested

Requirements

• High school diploma or equivalent preferred
• Previous billing experience preferred

Benefits

• WFH day 1