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INSURANCE REPRESENTATIVE
INSURANCE REPRESENTATIVEMississippi Sports Medicine • Jackson, MS, US
INSURANCE REPRESENTATIVE

INSURANCE REPRESENTATIVE

Mississippi Sports Medicine • Jackson, MS, US
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Job Description

Job Description

INSURANCE REPRESENTATIVE

CHARACTERISTICS OF WORK :

This is professional / clerical work involving the submission, collection, and follow-up of patient insurance claims. Work includes customer service with patients, insurance companies, as well as other outside entities, and assisting with claims resolution.

MINIMUM QUALIFICATIONS :

  • Computer skills
  • Phone etiquette
  • Interpersonal skills
  • Insurance claims experience
  • Insurance claims reporting
  • Hospital and / or medical facility setting work experience

ESSENTIAL FUNCTIONS :

  • Follow-up on all outstanding insurance accounts within a timely manner.
  • Research denials / underpayments / rejections and requests / inquiries from insurance payers within standard billing cycle timeframe.
  • Submit corrected claims and process all claim appeals.
  • Ensure appropriate supporting documentation is received and complete to ensure accurate and timely processing of claims.
  • Research and perform all secondary billing.
  • Possess full understanding of EOBs to ensure payment accuracy and compliance with contract discount.
  • Review and recommend claims for adjustment / write off to management.
  • Communicate with payers about re-filing claims that were underpaid due to plan / provider errors. Use tracking system to follow up on re-filed claims with plans to ensure complete resolution.
  • Researching insurance credits and insurance refund requests
  • Other duties as assigned and directed by team management.
  • EXPERIENCE / EDUCATIONAL REQUIREMENTS :

    Education :

    Graduate of four-year high school or equivalent (GED).

    Experience :

    One year experience related to the described duties.

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