[Hiring] Associate Insurance Representative @Sanford Health

Role Description

The Associate Insurance Representative processes and monitors unpaid third party insurance, Medicare, Medicaid or government-assisted program accounts for proper reimbursement; primarily but not limited to prebilled accounts.

• 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 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
  • 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.

Qualifications

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

Company Description

Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We’re proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.