Medical Insurance follow-up, claims research.
Position Summary: Process medical insurance accounts to address claim issues and to affect payment and/or bringing them to resolution. Research claim status with carriers via various portals to reach resolution and payment of claims.
Essential Job Functions:
1.Status account and document all work performed in the company and client computer systems.
2.Assess accounts to determine the next appropriate course of action in line with company policies and procedures.
3.Place outbound calls to insurance companies, guarantors, patients, doctors’ offices and/or facilities and handle incoming calls as necessary utilizing proper customer service protocol.
4.Process related correspondence from insurance companies and perform pertinent follow-up.
5.Reconcile balances and payments between insurance companies and clients computer systems.
6.Escalate issues to Team Lead or Manager as necessary.
7.Other duties as assigned by management
8.Duties may vary by location
Visit our website www.theoutsourcegroup.com to see all open positions and apply.
Please indicate experience on resume with the following systems:
GE practice management systems IDX, NextGen, Centricity, TES/ETM webflow experience; E-Clinical; Next Gen PM system; and Medical Manager, Epic, Touch Works, Signature, and Emdeon
•Knowledge: Medical and insurance terminology (such as procedure codes, diagnoses, and patient liability), and full understanding of hospital/physician billing. Ability to read and understand EOB statements. Understanding of co-pay, co-insurance, primary and secondary payer in regards to medical insurance coverage, paper and electronic claims processing.
•Education: High school diploma or equivalent
•Experience: Minimum 1-2 years experience in Medical Billing/Follow-up for a facility, medical clinic, or doctor’s office and experience with Microsoft Office suite and standard office equipment (copier, fax machine) a must.
•Skills/Aptitudes: Demonstrated communication and problem solving skills and the ability to act/decide accordingly. Ability to collect, create and research complex or diverse information. Exceptional customer service and the ability to plan organize and exercise sound judgment.
The above statements are intended to describe the general nature and level of work being performed. They are not intended to be an exhaustive list of responsibilities, duties and skills required.
The Outsource Group
Healthcare - Health Services
1 to 2 years
Client Rep Ins CHA @ The Outsource Group
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Client Rep Ins CHA
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