Insurance Verification Representative
Huron
Insurance Claims Spec HB
WVU Medicine
full-time
Posted on:
Location: 🇺🇸 United States
Visit company websiteJob Level
Junior
Tech Stack
Ruby
About the role
- Submits accurate and timely claims to third party payers.
- Resolves claim edits and account errors prior to claim submission.
- Adheres to appropriate procedures and timelines for follow-up with third party payers to ensure collections and to exceed department goals.
- Gathers statistics, completes reports and performs other duties as scheduled or requested.
- Organizes and executes daily tasks in appropriate priority to achieve optimal productivity, accountability and efficiency.
- Complies with Notices of Privacy Practices and follows all HIPAA regulations pertaining to PHI and claim submission/follow-up.
- Contacts third party payers to resolve unpaid claims.
- Utilizes payer portals and payer websites to verify claim status and conduct account follow-up.
- Assists Patient Access and Care Management with denials investigation and resolution.
- Participates in educational programs to meet mandatory requirements and identified needs with regard to job and personal growth.
- Attends department meetings, teleconferences and webcasts as necessary.
- Researches and processes mail returns and claims rejected by the payer.
- Reconciles billing account transactions to ensure accurate account information according to established procedures.
- Processes billing and follow-up transactions in an accurate and timely manner.
- Develops and maintains working knowledge of all federal, state and local regulations pertaining to hospital billing.
- Monitors accounts to facilitate timely follow-up and payment to maximize cash receipts.
- Maintains work queue volumes and productivity within established guidelines.
- Provides excellent customer service to patients, visitors and employees.
- Participates in performance improvement initiatives as requested.
- Works with supervisor and manager to develop and exceed annual goals.
- Maintains confidentiality according to policy when interacting with patients, physicians, families, co-workers and the public regarding demographic/clinical/financial information.
- Communicates problems hindering workflow to management in a timely manner.
Requirements
- High School diploma or equivalent.
- One (1) year medical billing/medical office experience.
