Commercial Insurance Billing and Follow Up

Claims Processor

Responsible for accurately and efficiently processing claims and invoices.

Job Duties

• Prepare bills and invoices for medical services and treatments received
• Manage the billing for commercial insurance and managed care payers
• Perform billing functions to review and take necessary actions to resolve billing errors ensuring clean claim submissions
• Utilize all resources available, including electronic inquiries to verify eligibility, benefits and claim status
• Exercise good judgement toward account resolution and documents all activity on an account in a clear, accurate and consistent manner utilizing appropriate online system
• Maintain claims tracking for the worker's compensation and motor vehicle billing program
• Provide support for the department and assist with special projects, as assigned
• Demonstrate excellent customer service skills when responding to incoming or outgoing calls in a most courteous manner providing clear and appropriate information as needed
• Advise team lead and/or supervisor of any billing errors, payer trends in claims processing, denials or payment fluctuations, to ensure proper handling and escalation as necessary
• Adhere to all Hospital Regulations associated with Compliance (to include HIPAA, etc.)
• Performs other duties as assigned.

Qualifications and Skills

• Excellent customer service skills and problem solving skills.
• Strong analytical and organizational skills.
• Ability to interact with varying cultures and a diverse population.
• Basic computer skills.
• Bi-lingual in Spanish preferred.

Education, Experience and Certification/Licensure Requirements

• H.S. Graduate or equivalent
• 1-2 years' experience in a customer relations driven industry preferred
• Prior billing experience a must.