Insurance Account Representative

Analyze and call on unpaid Ortho Insurance Claims that are 30 days or older. Investigate with
Insurance Carriers the reason for non-payment and take the necessary action as per the scenario.
Notify OIS Account Manager daily of any inquiries/requests that need their assistance or office assistance.

Duties and Responsibilities:

• Contact insurance carriers regarding accounts 30 days and older.
• Re-file claims. (Excluding claims that must be mailed.)
• Edit policy information and estimated insurance portion adjustments to keep accounts accurate. This information is based on feedback from carriers.
• Send daily report to OIS-Account Manager.
• Review and resolve any tickets assigned to OIS-Call Center
• Responsible for making necessary policy and estimated insurance adjustments to keep accounts accurate.

Qualification Requirements:

To perform this job successfully, an individual must be able to perform each duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience:

Requires a high school diploma or its equivalent and 2-4 years of related experience.

Language Skills:

Ability to analyze, and interpret explanation of benefits, financial screen, and collection reports. Ability to respond to common inquiries or complaints from customers. Ability to prepare clear and concise written materials for customers. Ability to effectively present information to supervisor and account managers.

Reasoning Ability:

Ability to solve practical problems with customers and deal with a variety of personalities leaving the customer always feeling that they were assisted in a professional and fair manner. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule formats.

Other Skills and Abilities:

Clear speech and pleasant telephone demeanor. Organizational skills, ability to prioritize tasks, and remain calm under pressure. Intermediate computer skills utilizing Microsoft Office Outlook, Word,
Excel.