Insurance Clerk - Medicare

Prevea Health • Howard, WI

2d

About The Position

Come work where we specialize in you! We have nearly 2,000 reasons for you to consider a career with Prevea Health—they're our employees. We're an organization that values kindness, responsibility, inclusivity, wellness and inspiration. At Prevea, we provide continuous education, training and support so every member of the team contributes to our success. Together we are the best place to get care and the best place to give care. Job Summary The Insurance Clerk is responsible for supporting Prevea Health's revenue cycle by resolving commercial insurance denials, monitoring aged receivables, and following up with insurance carriers to ensure timely and accurate reimbursement. This role requires providing exceptional care to our patients and demonstrating respect and collaboration with co-workers. The Insurance Clerk must maintain a high level of performance, communicate positively and professionally, and prioritize patient needs while performing all responsibilities efficiently.

Requirements

• High School Diploma and/or GED Required
• 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
• Strong knowledge of commercial insurance billing policies and procedures, including CPT/ICD-9 codes, usual and customary charges, and confidentiality requirements.
• Ability to work independently and collaboratively while performing responsibilities efficiently and accurately
• Strong investigative, problem-solving, and analytical skills.
• Proficiency in computer applications, including Windows, Excel, Word, and 10-key data entry.
• Excellent organizational, time management, and communication skills, both written and verbal, with internal and external customers.

Nice To Haves

• Certification in medical billing or coding (e.g., CPC, CCA) Preferred

Responsibilities

• Respond and investigate denials by insurance carrier. Draft appeal letters, as necessary.
• Follow-up on improperly paid claims.
• Monitor aged receivables for Medicare 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
• 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
• Education Level: High school or GED
• Number of Employees: 1,001-5,000 employees