Insurance Representative

Proficiency in reading, writing, and speaking English to ensure effective communication in the workplace and with patients, families, and team members.
Preferred: Associates – Business
Preferred: A minimum of 1 year Related Experience

Reviews and monitors insurance unpaid third party insurance and denials to ensure proper payment.
Keeps up to date on all state/federal billing requirements and updates proper departments to ensure all processes are updated accordingly.
Reviews, edits, prepares and submits insurance claims to the appropriate party.
Assists patients with their written, telephone or in person inquiries for the clinic and hospital billing system.
Tracks pending eligibilities and unpaid claims from the work queue. Works credit balances and under payment work queues.
Completes work within authorized time to assure compliance with departmental standards.
Communicates effectively with payers and departmental staff to remove barriers to claim payment and to answer any questions relative to benefits of our billings as well as prior authorization issues.
Submits and receives prior authorizations.
Reacts to necessary changes by staying up-to-dates on payer requirements and systems capabilities.
Performs other duties as assigned or needed to meet the needs of the department/organization.