Insurance Claims Representative -- PATIENT FINANCIAL SERVICES -- Hartman Run Road

CAMC Health System•Morgantown, WV

1d•Onsite

About The Position

The Insurance Claims Representative provides a patient-centered experience by managing patient accounts during pre- and post-claims processing. This includes submitting accurate claims according to payee guidelines, following up on accounts in a timely manner, and assisting with denial management to support Mon Health’s financial viability. The role maintains knowledge of revenue cycle operations and third-party reimbursement by local, state, and federal payers. The representative provides exceptional service to patients, families, and customers during registration; resolves conflicts in a manner that considers the organization and the individuals involved; and communicates clearly and sensitively with people from different cultures. The position also applies coding guidelines accurately, meets productivity standards, prioritizes tasks, completes assignments according to protocol or direction, and adopts approaches that improve efficiency. The employee is responsible for clarifying job duties and performance expectations, communicating regularly with the supervisor, seeking clarification when needed, and accepting change. The role is classified as light work, requiring exertion of up to 20 pounds occasionally, up to 10 pounds frequently, and negligible amounts constantly.

Requirements

High school diploma or GED.
Basic Life Support (BLS) credential.
One year of experience in healthcare billing/revenue cycle patient accounting, or graduation from a medical billing/coding or medical office program.
Ability to perform light work: exert up to 20 pounds occasionally, up to 10 pounds frequently, and negligible amounts constantly.

Nice To Haves

Knowledge of patient billing practices, medical terminology, patient registration, and federal, state, and third-party billing regulations.

Responsibilities

Manage patient accounts during pre- and post-claims processing.
Submit accurate claims according to payee guidelines and conduct timely account follow-up.
Assist with denial management issues.
Maintain knowledge of revenue cycle operations and reimbursement by local, state, and federal payers.
Provide exceptional service to patients, family members, and customers during patient registration.
Resolve patient conflicts in a manner that considers the organization and the individuals involved.
Communicate clearly, use an appropriate tone and body language, listen actively, and demonstrate sensitivity to people from different cultures.
Apply codes according to established coding guidelines and departmental accuracy standards.
Meet position or department productivity standards, prioritize multiple tasks, and complete assignments according to protocol or direction.
Embrace new approaches that improve efficiency.
Clarify job responsibilities and performance expectations, communicate regularly with the supervisor, and seek clarification when needed.
Willingly accept change.