The Insurance Follow-up Representative position is responsible for all insurance follow-up on assigned accounts from the management team. The core responsibilities of an insurance follow-up representative include research, insurance billing and adjustment identification to ensure proper account resolution.
ESSENTIAL FUNCTIONS - Following are major areas of responsibility:
This position has no supervisory responsibilities.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required.
EDUCATION AND/OR EXPERIENCE
High school diploma or equivalent. Must have full understanding of insurance follow-up processes (i.e. Billing, Collections, Managed Care, Medicare, Medicaid and Commercial Practices), and well-developed interpersonal skills. Three years experience in medical billing is required. Must have knowledge of EOBs, CPT & ICD-10 codes.
This position requires the ability to communicate effectively both verbally and in writing. Must be able to read, analyze, and interpret information and reports
The individual must be able to apply basic mathematical concepts and operations to determine accuracy of medical claims being filed.
The incumbent will be required to review, interpret insurance information and assign proper companies to the patient charges for reimbursement. They must also be able to read, and review claims to discern if errors exist.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is required to stand; walk; sit; use hands and fingers to operate office machinery, files and to handle other objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, and crouch; and talk and hear. The employee must occasionally lift and/or move up to 25 pounds.
Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.
Work requires the ability to communicate clearly and provide close attention to detail and accuracy. The employee must regularly move about inside the office to access file cabinets and office machinery. Also requires dedicated 5-day office per week.
The work environment characteristics described in this job description are representative of those an employee encounters while performing the essential functions of this job in an office environment. The noise level of the work environment is usually moderate.