Insurance Representative

Insurance Representative

The Insurance Representative is responsible for monitoring accounts receivable, data entry, claims submission, follow-up, account adjudication, and general office/clerical duties. Works under direct supervision and follows standard procedures and/or written instructions to perform the job duties. Performs basic administrative job duties relating to Billing. Responsible for monitoring accounts receivable, data entry, claims submission, follow-up, and account adjudication. Performs clerical administrative job tasks to maintain billing information and complete required daily activity reporting, this includes but is not limited to performing and verifying data entry, reports, account database maintenance, file maintenance, etc. Ability to explain more complex billing inquires, problems, and non-routine matters related to department activity. To ensure the accuracy and timeliness of these processes productive relationships will be established and maintained with a broad range of personnel within the organization, including Physicians, managers, co-workers (including any off-site location(s)), clinic/hospital colleagues, information systems and other personnel as required. In addition, the billing specialist will also establish and maintain relationships with patients, families, insurance companies, government agencies and others as necessary. Cross-trains with other Billing personnel in order to assist with work overflow or to fill in as needed in their absence. Demonstrates teamwork to ensure achievement of team, individual and company goals. Performs other job duties as required. The incumbent is expected to determine diagnosis and levels of service based on information provided on the Electronic Health Record (EHR) and to accurately bill, using the appropriate codes.

Job Qualifications

Education: Completion of a high school diploma required. College level courses preferred.

Licensure: HFMA CPAR certification preferred.

Experience: Prefer experience in a same or similar position in a hospital or physician practice is desirable. Insurance Representatives will have 0-5 years experience in insurance claims billing and follow-up at Hamilton Medical Center.

Skills: Excellent oral and written communication skills in order to effectively interact with internal and external customers. Job duties and tasks are frequently non-routine which requires logical problem solving ability. Ability to interpret and follow oral and written instructions, policies, guidelines and standards. Ability to use good judgment in the absence of formal guidelines, policies or procedures. Ability to prioritize and manage time effectively. Working knowledge of medical A/R software programs and intermediate PC skills including Microsoft Outlook, Word and Excel. Must be detail oriented and able to demonstrate competence in basic math concepts.

Full-Time Benefits

• 403(b) Matching (Retirement)
• Dental insurance
• Employee assistance program (EAP)
• Employee wellness program
• Employer paid Life and AD&D insurance
• Employer paid Short and Long-Term Disability
• Flexible Spending Accounts
• ICHRA for health insurance
• Paid Annual Leave (Time off)
• Vision insurance