[Hiring] Insurance Follow-Up Representative @External

Role Description

The Insurance Verification Representative is responsible for researching and updating the insurance information, commercial and government, within various databases with the current benefit status for each patient. Information can be obtained electronically or by direct communication with the insurance companies.

• Responsible for verifying patient insurance coverage
• Responsible for taking data provided and submitting claims to various private and government sponsored insurance companies
• Follow up with pending claims and work denials for all payers
• Query information on remote Medicare software
• Learn new systems and process solutions as they present themselves to ensure proper assignment and workflow
• Contacts insurance companies/payers or patients to gather information necessary to complete appeal processing
• Remain compliant with our policies, process and legal guidelines
• Will need to be open to ongoing feedback and coaching aimed at improving performance
• Remain compliant with HIPPA and other State and Federal regulations
• Entering and/or updating the benefit information in an accurate manner into the various databases
• Adhere to the production standards set for the department and client
• Accuracy and confidentiality in handling medical records in compliance with HIPPA, Federal, State and Company requirements
• Other duties as assigned by manager

Qualifications

• A high school diploma or equivalent is required
• 2 or more years of experience within the medical industry is preferred
• 2 or more years of experience in medical billing required
• Experience working with both government and commercial payers required
• Knowledge of insurance terminology and processes
• Intermediate to advanced proficiency in computer skills using Microsoft Word and Excel software
• Knowledge and skill navigating insurance portals for online benefit review
• Medical system platform experience with STAR, EPIC, etc.
• Ability to multi-task in a fast-paced environment
• Excellent verbal, written and communication skills
• Strong analytical/problem solving skills
• High attention to detail
• Ability to read and understand a variety of information presented in different formats from a variety of sources
• Must be able to type a minimum of 25 wpm

Physical Requirements

• Occasionally required to stand or walk and lift and/or move up to 25 pounds
• May be required to use hands to finger, handle or feel objects, tools or controls
• Reach with hands and arms; climb stairs; balance; stoop, kneel or crouch or crawl
• See, talk and hear

Work Environment

• Works in a temperature-controlled office environment or a Work from Home office environment
• Must be able to work on a computer for the scheduled shift
• Answers and makes telephone calls using a standard or computer soft telephone
• Types on a standard keyboard; reads and comprehends information from a computer terminal and/or written resources
• Utilizes multiple screens and systems simultaneously
• All incumbents/employees are provided a Webcam and are required to be on camera 100% of the time during the scheduled shift

Benefits

Illinois, Maryland and New Jersey residents click below for compensation and benefits:

State Specific Benefits