Insurance Clerk - HRPN (Clinic) - FT
About The Position
Follows up with insurance payers on claim resolution, processes account correspondence, and documents action taken on patient accounts. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all. ESSENTIAL FUNCTIONS: Understands payer contracts and member co-pay and eligibility requirements. Responds to denials from payers such as invalid diagnosis and procedure codes, contractual arrangements, and medical necessity to ensure required information is transmitted to process payments. Informs Management of any problems or changes in payer requirements and exercises independent judgment to analyze and report repetitive denials so that corrective action can be taken. Responds to patient phone and walk-in inquiries as needed. Resolves credit balances as assigned. Contacts insurance payers for resolution of patients’ accounts. Documents in the Patient Accounting system any action taken on the patient account. Meets productivity standards. Abides by the Health Insurance Portability and Accountability privacy and security regulations regarding all aspects of Protected Health Information (PHI).
Requirements
- Mathematical and compositional skills
- Basic computer skills
- Demonstrated ability to communicate effectively
- Strong customer service and problem resolution skills
- Proven skills in collections
- High school diploma or GED
- Recent third party payer experience, including insurance follow-up in a medical setting
Nice To Haves
- Recent hospital-based patient accounting experience
Responsibilities
- Follows up with insurance payers on claim resolution
- Processes account correspondence
- Documents action taken on patient accounts
- Understands payer contracts and member co-pay and eligibility requirements
- Responds to denials from payers
- Informs Management of any problems or changes in payer requirements
- Responds to patient phone and walk-in inquiries as needed
- Resolves credit balances as assigned
- Contacts insurance payers for resolution of patients’ accounts
- Documents in the Patient Accounting system any action taken on the patient account
- Meets productivity standards
- Abides by the Health Insurance Portability and Accountability privacy and security regulations regarding all aspects of Protected Health Information (PHI)
Benefits
- We offer competitive pay, a generous benefit package and a reason to be proud of what you do, every day.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
