Job Title: Client Representative - Insurance
Reports to: Unit Manager - Insurance
Position Summary: Process insurance accounts to address claim issues and thereby affect payment and/or bringing them to resolution.
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
- Knowledge: Medical and insurance terminology (such as procedure codes, diagnoses, and patient liability), and full understanding of hospital/physician billing.
- 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. Type 60 wpm and 12,000 kpm on 10-key adding machine.
- 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.