Insurance Follow-Up Representative

External•Duluth, GA

About The Position

The Insurance Verification Representative is responsible for researching and updating the insurance information, commercial and government, within various databases with the current benefit status for each patient. Information can be obtained electronically or by direct communication with the insurance companies ESSENTIAL DUTIES AND RESPONSIBILITIES: Responsible for verifying patient insurance coverage Responsible for taking data provided and submitting claims to various private and government sponsored insurance companies Follow up with pending claims and work denials for all payers Query information on remote Medicare software Learn new systems and process solutions as they present themselves to ensure proper assignment and workflow Contacts insurance companies/payers or patients to gather information necessary to complete appeal processing Remain compliant with our policies, process and legal guidelines Will need to be open to ongoing feedback and coaching aimed at improving performance Remain compliant with HIPPA and other State and Federal regulations Entering and/or updating the benefit information in an accurate manner into the various databases Adhere to the production standards set for the department and client Accuracy and confidentiality in handling medical records in compliance with HIPPA, Federal, State and Company requirements Other duties as assigned by manager QUALIFICATIONS To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Requirements

A high school diploma or equivalent is required
2 or more years of experience within the medical industry is preferred
2 or more years of experience in medical billing required
Experience working with both government and commercial payers required
Knowledge of insurance terminology and processes
Intermediate to advanced proficiency in computer skills using Microsoft Word and Excel software
Knowledge and skill navigating insurance portals for online benefit review
Medical system platform experience with STAR, EPIC, etc.
Ability to multi-task in a fast-paced environment
Excellent verbal, written and communication skills
Strong analytical/problem solving skills
High attention to detail
Ability to read and understand a variety of information presented in different formats from a variety of sources
Must be able to type a minimum of 25 wpm

Responsibilities

Responsible for verifying patient insurance coverage
Responsible for taking data provided and submitting claims to various private and government sponsored insurance companies
Follow up with pending claims and work denials for all payers
Query information on remote Medicare software
Learn new systems and process solutions as they present themselves to ensure proper assignment and workflow
Contacts insurance companies/payers or patients to gather information necessary to complete appeal processing
Remain compliant with our policies, process and legal guidelines
Will need to be open to ongoing feedback and coaching aimed at improving performance
Remain compliant with HIPPA and other State and Federal regulations
Entering and/or updating the benefit information in an accurate manner into the various databases
Adhere to the production standards set for the department and client
Accuracy and confidentiality in handling medical records in compliance with HIPPA, Federal, State and Company requirements
Other duties as assigned by manager