Effective communication and coordination with insurance companies and clients to obtain the maximum benefits for our clients. You will establish relationships with insurance carriers and obtain accurate, detailed insurance benefit information by phone and via the internet. Claim follow-up will be conducted weekly, ensuring that accurate payments are received in a timely manner. Good verbal and written communication is required. Record keeping must be accurate and thorough. Flexibility with schedule so that you can meet critical deadlines as established.

Essential Job Functions

  • Review data on insurance policies to ensure accurate claim processing and payment. 
  • Create and submit HCFA claims if needed. 
  • Ensure that corrected claims are submitted in a timely manner if necessary. 
  • Prepare materials for submission to insurance companies as requested. 
  • Ensure that unprocessed claims are followed up on weekly. 
  • Develop and submit appeals, including necessary supporting documentation, as required for claims reimbursement. 
  • Attempt to have all low-paying claims reprocessed for higher reimbursement.
  • Contact clients to collect on outstanding account balances or insurance payments paid to member.
  • Maintain confidentiality of patient care and business.
  • Demonstrate strong, professional communication and interpersonal skills with clients, public, managers and co-workers.
  • Perform general office duties and keep desk clean and organized.
  • Maintain accurate and thorough records.
  • Demonstrate the ability to act as a team player in a professional and positive manner.

     

Knowledge, Skills, and Abilities

  • Basic understanding of insurance terminology (out-of-network benefits vs. in-network benefits, as well as coinsurance, co-pays and deductibles), in addition to general billing practices.
  • Communication - communicates clearly and concisely, verbally and in writing.
  • Customer orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations.
  • Interpersonal skills - able to work effectively with other employees, patients and external parties.
  • PC skills - demonstrates proficiency in PC applications as required.
  • Policies & Procedures - demonstrates knowledge and understanding of organizational policies, procedures and systems.
  • Basic skills - able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly, spell correctly and transcribe accurately.
Education and Experience

At least two years of medical collections experience required, your resume will not be looked at without this.

  • 2-year minimum healthcare experience with billing or insurance verification required.
  • Knowledge and experience with EMR and billing software programs required.
  • High school diploma or GED required.
Working Conditions

This is a Remote Employee position, employee will work from home. Requirements are a quiet work space where employee can work 40 hours per week anywhere within the United States.

Salary and Benefits

$35,000 to $40,000 per year. We offer a comprehensive benefits package. Please refer to our Careers page for benefits details.

The above job description is not intended to be an all-inclusive list of duties and standards of the position. Incumbents will follow any other instructions, and perform any other related duties, as assigned by their supervisor.