Insurance Clerk - Work Compensation

Prevea Health • Green Bay, WI

40d

About The Position

Providing exceptional care for our patients as well as recognizing the value of your co-workers is the expectation of all members of the Prevea Health organization. All members are expected to focus on the patient's needs; relate to all in a friendly, accepting manner, communicate in a positive and professional way to patients and co workers; use time effectively and efficiently; demonstrate an overall high level of performance. The Insurance Clerk will work to resolve commercial insurance denials, monitor aged receivables for commercial insurance, and follow-up with insurance carriers.

Requirements

• 1-3 years Minimum 2-3 years experience in an insurance or health care setting. Required
• Previous experience in customer service. Required
• Experience with computers and Windows based applications. Required
• High School Diploma and/or GED Required
• Strong knowledge of commercial insurance billing policy and procedures.
• Ability to work independently and as a team, while performing responsibilities efficiently and accurately.
• Strong investigative skills.
• Computer experience and 10 key proficiency.
• Excellent organizational skills.
• Excellent communication skills with internal and external customers.
• Knowledge of CPT/ICD-9 codes and usual and customary charges.
• Word processing and computer experience with Excel, Word and Windows based applications.
• Ability to process and hand confidential information with discretion.

Responsibilities

• Respond and investigate denials by insurance carrier. Draft appeal letters, as necessary.
• Follow-up on improperly paid claims.
• Monitor aged receivables for commercial insurance bill types and follow-up with insurance carriers.
• Work problem accounts and resolve them in satisfactory manner.
• Answer patient account questions by phone in a professional, tactful and friendly manner, communicates on a need to know basis.
• Reviewing and following up on improperly paid claims
• Working directly with workers compensation payors
• Drafting appeals/letters to get claims paid
• Attends required meetings and participates in committees as requested.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Ambulatory Health Care Services
• Education Level: High school or GED
• Number of Employees: 1,001-5,000 employees