At this level candidate will be expected to assist with insurance billing for our services to commercial payers and Medicaid. This position will report directly to the Insurance Supervisor. In this role, a candidate must:
- Have thorough understanding of claims filing process and terminology when working with commercial payers and Medicaid.
- Secure authorizations for services, and monitor authorizations for appropriate renewal.
- Submit medical claims in an efficient and timely manner using comprehensive billing software.
- Provide COB, submitting claims to secondary and tertiary carriers as appropriate.
- Provide follow-up on submitted claims. This may include troubleshooting issues, phone calls to carriers and providing information necessary to ensure proper claim processing.
- Participate in any claims escalation, recoupments, overpayments, etc. to ensure proper handling of accounts.
- Assist with receipt and posting of insurance and client payments to billing system.
- Provide customer service to families with questions regarding their policy benefits.
- Perform insurance eligibility checks with various carriers as needed.
- Be able to take direction from others and receive constructive feedback positively.
- Consistently utilize a high degree of accuracy and attention to detail.
- Possess excellent problem-solving skills.
- Possess excellent time-management skills and be capable of working well independently.
- Be proficient in the use of Microsoft Word and Excel.
- Possess excellent written and verbal communication skills.
Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions:
While performing the duties of this job, the employee is frequently required to sit for extended periods of time at a computer; work with highly-detailed reports and reconcile account balances; spend time on phone resolving any claims issues; able to physically life the weight of a filled archive box.