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Insurance Reimbursement Representative I

October 10, 2014 - October 17, 2014
Location:Greenville, NC
Exempt/Non-Exempt:Non-Exempt
Employment Type:Full Time
Department:Operations
Description:Review of claim edits for submission to insurance carriers. Review and work A/R reports which includes review of outstanding pending claims (primary, secondary and tertiary) credit accounts and patient billing. Contact insurance companies to verify and resolve any claim issues which includes review of denials. Identify and monitor denial trends and report findings to insurance supervisor. Maintain working knowledge of all insurance carriers guidelines. Communicate effectively with insurance carriers, insurance and billing staff and management.

Typical physical demands: Requires sitting for long periods of time. Working in an office environment. Some bending and stretching required. Working under stress and use of telephone required. Manual dexterity required for use of calculator and computer keyboard.

Typical working conditions: Normal office environment

Duties:1. Review of claim edits for submission to insurance carrier.

2. Review of A/R reports which includes outstanding pending claim, insurance/patient credits and patient billing.

3. Contact insurance companies to verify and resolve claim issues and denials.

4. Verification of insurance eligibility and benefits.

5. Utilization of insurance web based resources.

6. Thorough examination of patient accounts to ensure account accuracy.

7. Identify and monitor denial trends and report findings to management.

8. Maintain working knowledge of all insurance carriers guidelines.

9. Review and complete tasks assigned from Practice Management System.

10. Communicate effectively with insurance carriers, billing staff and management.

This job description in no way states or implies that these are the only duties to be performed by this employee. He or she will be required to follow any other instructions and to perform any other duties requested by his or her supervisor.
Qualifications:Minimum of 1 - 3 years experience in insurance and billing setting and or appropriate college education required. Knowledge of NextGen helpful but not required.


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