Insurance

• Processes and monitors unpaid third party insurance, Medicare, Medicaid or government-assisted program accounts for proper reimbursement.
• Prepares and submits claims to payers either electronically or by paper.
• Secures necessary medical documentation required or requested by payers.
• Performs account follow-up on outstanding insurance balances and takes the necessary action for account resolution in accordance with established federal and state regulations.
• Processes daily workflow changes that depending on department may include, eligibility verification, verification of information, payment postings, initiating refunds, processing month end, resolving and troubleshooting incidents, reporting, initial billings and re-billings of claims, scanning and indexing of documents, and be the point of contact to provide assistance as needed.
• Responsible for assuring accounts are set up correctly with the information available is completed timely and accurately.
• Completes work within authorized time to assure compliance with departmental standards.
• Keeps updated on all state/federal billing requirements and changes for insurance types within area of responsibility.
• Understands edits and appropriate department procedures to effectively submit and/or correct errors on claims.
• Processes and resolves denials that are technical in nature (i.e.: records required denials).

Associate Insurance Representative

Insurance Broker

Insurance Verification Specialist

Director, Strategic Accounts, Insurance

Audit and Assurance Services – Associate