Medical Office Insurance Representative

Job Description

Job Description

About Us:We are a growing, busy and patient-focused medical office dedicated to providing top-quality healthcare in a supportive and compassionate environment. We are seeking an experienced and detail-oriented Insurance Representative to join our administrative team and help ensure efficient and accurate insurance processing.Job Summary:The Medical Office Insurance Representative plays a crucial role in our billing office operations. This individual is responsible for verifying insurance coverage, obtaining prior authorizations, assisting with claim submissions, contacting insurance companies regarding unpaid claims, filing appeals, A/R follow up, patient collections and serving as a liaison between patients, providers, and insurance companies.Key Responsibilities:Verify accurate insurance information has been inputted into the practice management system on all patientsReview insurance claims for accuracy and submit to insurance carriers in a timely mannerAppeal claims that are processed incorrectly for resolution in a timely mannerContact insurance companies regarding claims that need to be adjudicated timelyFollow up on unpaid or denied claims and work toward resolutionCommunicate with patients regarding their insurance coverage, co-pays, and billing questionsCollaborate with clinical and administrative staff to ensure smooth patient flow and accurate documentationStay current on insurance policies, coding changes, and regulatory updatesQualifications:High school diploma or equivalent required; associate degree or certification in medical billing/insurance preferredMinimum of 2 years' experience in a medical office insurance or billing roleStrong understanding of medical insurance plans, coding, and billing processes (ICD-10, CPT, HCPCS)Familiarity with electronic medical records (EMR) and billing software (e.g., NextGen, Epic, etc.)Excellent attention to detail, problem-solving skills, and organizational abilitiesStrong interpersonal and communication skillsAbility to work independently and as part of a team in a fast-paced environment